Her Homeless Brother

Ashley Womble is writing a memoir on Salon and this piece about her homeless brother will resonate with anyone who has experience working with homeless people with mental illness.

“Do you consider yourself homeless?” I asked.

“Oh, yes!” he answered proudly. I wondered if the constant motion of wandering from town to town, never knowing where he would sleep or eat next, helped quiet the voices he heard. If it was his own kind of medication, and if so, could I really tell him that was the wrong way to live?

When the food arrived, Jay dug into the chips with his grubby hands. As he lectured me about the New World Order, I thought about little specks of dirt flying off of his fingers and onto the salted chips. “You can have some of this,” he motioned to the chile con queso. I had a choice at that moment: I could ignore the gross factor and eat with my brother — insanity, filth and all— or I could keep my hands clean and preserve the distance that had grown between us. I went for the chips.

We’re taught as Catholics to go beyond all those usual boundaries to care for the poor and homeless. However, sometimes people just don’t can’t receive the help that they need because they refuse the medication that will remove their psychosis. It’s a tough thing to let go. But there aren’t many other choices. It’s a waiting game, waiting for the day that they sink into a depression so low that they would rather reach out than be in that painful state. Coming down from mania takes a long time when one goes unmedicated and it’s tough to sit and do nothing.

A homeless man who I’ll call “Tom” that I met doing work at a shelter in New York spoke of a brother. I looked at him strangely and said, “Um, hold on, you have a FAMILY? Why don’t you just go live with them?”

He replied tersely, “Well, I tried. But I can’t deal with being indoors anymore. I’d rather be on the streets.” Another would refuse meds staying in a jumble of confused thoughts and paranoia.

I was no help to either.

I pray for these all the time and hope that they find safe shelter, food and can one day “deal with” simply being indoors.

Dorothy Day once said “The greatest challenge of the day is: how to bring about a revolution of the heart, a revolution which has to start with each one of us?”

Each one of us, whether homeless, or those who wish to serve them, need that inner revolution–a heart that is committed to change and often one might be able to cause a revolution in another by helping them see that their choices are not healthy–but when it comes to mental illness, one committed to helping another may need to wait for a different kind of conversion, indeed, a conversion that may never come. This conversion deals with unbalanced chemicals in the brain the we cannot make aright by the sheer force of the will.

So today, lads, let us pray for all those who are homeless not by choice, but by the inability to control their own brain chemistry. We pray for those whose mental instabilities cause them to choose homelessness and distorted thoughts. Let us pray for our own helplessness and for our own stresses when we are not received as helpers. We pray that someone, somewhere may help them and that their help may be accepted when ours is not. We pray that evil does not take advantage of their vulnerability and that justice can be done when it is called for.

And most of all, let us pray that all may be united with those who are alienated from their friends, families and all those who love them.

Are People with Mental Illness Overmedicated?

Therese Borchard at her great blog on mental illness, Beyond Blue, takes on the question.

Are some people overmedicated in this country? Yes. Absolutely. I devote a few chapters of my book, Beyond Blue, to describing the dangerous phase in my recovery led by a doctor whom I call “Pharma King.” I was taking something like 16 pills a day, enough to drop my head into my cereal bowl every morning for about three months. And I wasn’t at all uncomfortable with how the nurses at the outpatient psych program I attended jumped to an increase in medication every time a patient voiced a complaint or raised an issue.

I wanted to scream out, “For crying out loud, let the woman try to sort through this a tad before we up her prescription.”

I think there are many people with mild depression who would be better served by a change in diet, a strict exercise regiment, some psychotherapy, and the other tools we have to help us, than simply by swallowing a pill.

I would tend to agree in some cases, but not in many. I know a few people in my life and in my ministry who would be lost without the use of drugs to stabilize their brain chemistry.

And therein lies the problem. Many people with mild depression rely on meds to bring them back to the borderline when simple talk therapy will do.

Then there are people with serious issues who NEED meds simply to stabilize their brain chemistry and correct the imbalance that causes mania or depression–or both.

And that being said, those people also need to participate in talk therapy on a minimum monthly basis. These two therapeutic solutions work well in consort for the seriously ill. The issue is that one usually favors one over the other when both are actually necessary.

As is the case with most things, fear is at the heart of this, I think. Mildly depressed people hear horror stories of people who are seriously mentally ill and they don’t want to find themselves in that situation so they medicate unnecessarily. Seriously depressed people take their meds and it stabilizes them, but they don’t thrive on meds alone–they need the talk therapy as well. Those who are seriously ill can participate in talk therapy from now until the end of time without meds and they will never recover –but they fear taking meds for one reason or another. And there are many who lobby against the pharmaceutical industry who tell people to chuck their meds and it leads to a rapid downfall. Others can bring themselves naturally up to the borderline with simple talk therapy–but choose to do nothing.

For many of us in ministry, we see a good deal of people who come to us for pastoral care or for spiritual direction. We’ve learned the signs of mental illness and know when people need more help than we are able to provide. And yet, many people really trust us and want to use us for talk therapy when they really need to see a psychologist–perhaps one who is open to spirituality in their practice would be best. I’ve even toyed with the idea of working on a psychology degree for these reasons. I love doing direction with young people, but at times I can see the blocks that doesn’t let someone even see the possibility of God working in their lives. It becomes my job to send them elsewhere–which really is hard for them to hear sometimes.

I think this is an area where a great conversation can happen between the psychological community and the religious community. We really can help one another here and I know a good deal of psychologists who consult religious professionals for assistance including one who said “Until my client went to confession regularly, I couldn’t get them past their negative feelings. Confession was the piece that helped me to help them make a breakthrough and forgive themselves and the others in their lives and be more able to see the world as a safe place again.”

Indeed. Any other experiences with this?

Blinded by a Suicide Bomber, Soldier Forgives

A huge h/t to Tony Rossi of The Christophers for this Veteran’s Day special.

Given short notice that he could go on leave from his tour in Iraq on April 2, 2005, Captain Scott Smiley decided to delay that leave by one month. On April 6, while on patrol with his platoon, a suicide bomber exploded a car bomb that sent shrapnel and debris into Captain Smiley’s eyes and brain permanently destroying his vision.

Captain Smiley was “crushed” by the news he would never see again. Despite coming from a Christian family, he admits, “I definitely questioned God, whether He really existed.” Also, hatred for the bomber led Captain Smiley into months of depression.
He was moved toward forgiveness by contemplating the Biblical mandate to “love your brother as yourself…Until I made that conscious effort to forgive him and realize he may have been lost, he may have been tricked or duped into doing what he did – that’s when I was able to move out of depression and begin to…really start taking a positive step forward.”

Scott Smiley had now climbed Mt. Rainer with the help of other soldiers and lives a full life claiming the scriptural platitude: “I can do all things through Christ who strengthens me.” More importantly, Smiley did not let hatred or anger define his future, he moved well beyond those emotions with the help of others in his recovery from depression.

See what happens when soldiers get the help they need?

Hear the entire interview here

Today’s Headlines will suggest Jihad but should they scream War Trauma?

After reading about the tragic shooting at Ft. Hood yesterday, I couldn’t help but react with sadness and frustration at another random act of violence in our country. CBS News reports on the shooter:

A law enforcement official identified the shooting suspect as Army Maj. Nidal Malik Hasan. It was unclear what the motive was, though it appeared he was upset about a scheduled deployment. U.S. Sen. Kay Bailey Hutchison said the Army major was about to deploy overseas, though it was unclear if he was headed to Iraq or Afghanistan and when he was scheduled to leave. Hutchison said she was told about the upcoming deployment by generals based at Fort Hood.

Faizul Khan, a former imam at a mosque Hasan attended in Silver Spring, Maryland, said he spoke often with Hasan about how Hasan wanted to find a wife. Hasan was a lifelong Muslim and attended prayers regularly, often in his Army uniform, Khan said.

CBS News reports that Hasan, 39, is a licensed psychiatrist who has lived in Bethesda and Silver Spring, Md. and Roanoke, Va. A spokesman for Texas Sen. Kay Bailey Hutchison says Hasan was upset about an upcoming deployment to Iraq.

It doesn’t help the anti-Muslim sentiment amongst some segments of our society that the shooter was a Muslim. I have more suspicions that perhaps he was self-medicating for depression and perhaps not effectively dealing with his own fears. Often psychiatrists only believe in the power of medication on the mind as a proper aid to help in the treatment of psychoses. Talk therapy is often also prescribed and the client would be sent to a psychologist for that additional treatment–much needed in many cases to help.

The Guardian agrees with me:

He was not a soldier returning from deployment in either Iraq or Afghanistan, suffering from stress or combat fatigue. Hasan, although 39 years old, he had never served in a war zone. Instead, his horror of war came second-hand. He was a psychiatrist who listened to the harrowing stories of his comrades at the Walter Reed Hospital in Washington DC, and latterly at Fort Hood, Texas.

Unusually for a soldier, Hasan appeared to have little taste for violence, at least up until yesterday. His cousin, Nader Hasan, said: “He was someone who did not enjoy going to the firing range.” That may have been a consequence of the stories he had heard in the hospital wards from the returning soldiers.

Mental health is a severe issue in our country and the headlines should scream this today. But I fear that they won’t–or if they do, it will merely denigrate those with mental illness instead of talking about the real tragedy–the lack of proper treatment for those who have severe mental disorders and who often go unmedicated. Secondly, all soldiers should be required to talk with a counselor, if they are not already, on a regular basis. Many won’t seek help out of fear of looking weak, the worst stigma a solider can face in military circles.

The sad thing is that many of those who suffer from mental illness in our country are still stigmatized. This includes those who take their medication and receive the therapy that they need. When moments like this happen all of the mentally ill struggle because of this stigma and those that have been doing well get lumped into a package that defines them as a freak. With the expanded exposure to war in military circles I fear that the number of those soldiers who do not seek help for trauma is increasing and many are being lost in the shuffle. Our Armed services needs to address this immediately and we should be making this a top priority. Until we do, more will suffer. And that suffering will only lead to more violence, death and further stigma on all of the mentally ill in society.

Today let us pray for Ft Hood and for those who suffer from mental illness.

Beyond Blue

Therese Borchard is an excellent writer and knows how to carve out a niche well with her writing. Her touching and very real blog at Beliefnet, “Beyond Blue” often moves me “Beyond Words” as she writes unhesitatingly about her struggle with mental illness, something that has effected many of my own friends and family. It is a serious and treatable illness, one that often goes undetected. Therese takes us into the midst of her struggle and how she deals with it in this touching post.

On a discussion thread at Group Beyond Blue, Larry wrote: “Underneath my mental illness are simply enormous, even incalculable, mental reserves. And if my illness strikes again, I need to remember those reserves are there, even if I can’t get to them right now.”

I had an opportunity to do that yesterday.

I journeyed back to the exact spot where I felt a calming hope when I was so desperately seeking a solution to my severe depression three and a half years ago: to the 10-foot statue of Jesus in the lobby of Johns Hopkins’s Billing Administrative Building, where Eric and I stopped on our way to my psychiatric evaluation in March, 2006.

I remember that moment so clearly.

I looked around at all the students with their backpacks and wondered if I’d ever be able to use my brain again. I peered skeptically at the doctors–wondering if they were thieves wanting to steal any creativity or passion or zest I had left in me with the toxic drugs they would pump into me.

I was so afraid.

Of everything.

Until I saw that statue. And read the inscription, written in capital letters on the pedestal: “Come unto me all ye that are weary and heavy laden, and I will give you rest” (Matthew 11:28).

Suddenly I felt lighter. As if Jesus really did relieve me of the backpack of rocks I had been carrying for a good year. I began to cry, to release all the fear inside of me. I couldn’t stop crying until we arrived at the consultation.

Now, of course, I can see it in perspective.

That moment at the statue was, indeed, the beginning of my miracle. It was thirty minutes before I would meet the psychiatrist who would be able to successfully treat my bipolar disorder.

Read the rest here and then offer a prayer for all those who have mental illnesses and those who care for them.