Monday, March 4, 2013

My Stand Against the Stigma of Mental Illness

A few weeks ago, I had officially added the Stand Up for Mental Health Campaign's header to my Twitter account and a link on my blog. I had already had the header up on Twitter for a couple of weeks prior to notifying HealthyPlace, the originator of the campaign, that I had done so. In that notification to HealthyPlace I included a brief outline of why I had added the header and of my background. I was asked if I would share my story either in a blog post that they could link to or in a story that theycould host on their page. I chose the former after reading this article about self-stigmatization which is something I haven't really done too much least I think. I put myself out there for varying reasons...I've posted about my struggles in old blogs that I used to have or just venting on Facebook or Twitter, but it's just my nature and part of the career path that I chose...

I was diagnosed in 1997, about 2 months before I was supposed to graduate from my Masters degree program in nursing with a specialization as a Family Nurse Practitioner. Like many of us with bipolar disorder I had been an outstanding student throughout my whole life. Then all of a sudden, in late September I became increasingly depressed. Near suicidal at that point. I was doing preceptored clinicals, working on a thesis, working full time at an outpatient clinic and being a military wife/mom to two elementary aged kids. Luckily I had already been in treatment for unipolar depression for a year or two and was
seeing a therapist who also noted my mood swings and recommended an evaluation for bipolar.

Within a couple of weeks the official diagnosis of Bipolar 2 came in. My first action was to
read An Unquiet Mind by Kay Redfield Jamison. In this book, I found so much of me with a
lesser degree of symptoms as compared to Dr. Jamison. A lightbulb went off in my head and
that great "A-ha!" moment happened. Over the following years I would be able to retrace
my symptoms to my mid-teen years and so many questions about my previous behavior were
clarified. It was a year of finding out who I really was and the positive and negative
implications that my disorder had provided me with in my life.

I did manage to graduate with my master's degree that December with a lot of work and tears
and the dropping of my thesis course...thankfully it was optional. I went on to work as an
RN, never getting my license for my FNP because of the newness of the diagnosis and my own
fear of making wrong decisions if I was in a bad way. However, I did excel as an RN in different positions
but there always seemed to be a time that the stress just got to be too much and I ended up
resigning and taking several months off and even considering leaving nursing all together.

In 2004, after a 4 month or so hiatus from nursing, I began subbing at a clinical site for
the local nursing program. Teaching was something that I had wanted to do since I was in
licensed vocational nursing school so many years ago. I had found my niche. I came onto
the faculty full time the following Fall and the following year I volunteered to take over
the Psych/Mental Health component of the program for the upperclass students when the
previous instructor left.

This specific content was truly my niche. Teaching psych. I loved it. My interest in psych/mental health
had exploded with my focus was primarily on bipolar and other mood disorders,
but I loved it all...the whole confusing lot of the DSM-IV-TR. While my goal was to teach
the students about the different diagnosis involved in mental health and their treatments
my personal goal was to help them learn to get over the stigma that the media and past
generations had built up about mental illness. I didn't want my students to be me when I was on my
psych/mental health clinical rotation in RN school...fearful and trying to avoid interacting whenever
possible.  I first question to the third semester classes was always, "Look around you...can you tell who might have a mental  illness?" Inevitably, they would all look around and appear a little blank as if to ask, "Why is she asking us this?" My next response would be to raise my hand and say, "I do!"

You see, I've never been shy about sharing my diagnosis. I've told employers almost from
the start even though I'm not required to by law. I've told co-workers not only for my own
good and patient safety but also so that they can be attuned to what's happening with me and call me out when things get a little stange (and they often did). Maybe it's only because I was in nursing but I'd
like to think that I'd be that open if I were working in a different field as well.

For me, personally, I felt that having the students know that I was battling what could be
a serious mental illness (I've attempted suicide at least 12 times in the past), that they
could see that it doesn't mean a mentally ill person could not be successful. I wanted them to
learn that they didn't need to fear mental illness. Granted, we're not all fully functional
but just the realization that a mentally ill person could look like me and be teaching a
class of 30-35 students about such a weighty subject could be an eye opener for some.

The students learned observations skills, communication skills and hopefully empathy from
not only classroom exercises and study, but also from observing me through  my good days
and my bad days. They learned to recognize when I had gone off my meds or when I was
becoming depressed or a little hypomanic. They were learning about mental illness in a
non-threatening way...OK, if you can just imagine nursing school being non-threatening.
But they were also learning to accept that I was a human being with a mental illness, no
different than any other human with a physical disorder. I just happen to have  an illness
that originates in my brain versus having diabetes which begins in the pancreas. They,
hopefully learned to understand that a mentally ill person is a human being...period...not
a monster or crazed individual to fear. Having this experience with me, I hope, prepared
them for our one week clinical at the state mental hospital where they had to
encounter more acute states of illness with a more open mind rather than fear; as well as for future encounters that they may have with the mentally ill.

Teaching gave me that opportunity to share not only my illness but to help, hopefully, break
the stigma of mental illness among the majority of my students. Granted, not everyone will
have made the connection, but I feel safe in saying that the vast majority did have their
eyes opened to the reality of mental illness while working with me. By the time I chose to finally
leave teaching in 2011 I was working on a second master's degree in Psych/Mental Health Nursing
and was within two semesters of graduating as a PMH NP as well as concurrently working
on a PhD in Nursing. Even though I have had to voluntarily remove myself from nursing due to a severe exacerbation of my symptoms between  2009 and 2011 I continue to do a guest lecture at the same nursing school each semester to try to help demystify mental illness and the stigma attached. That is the least I can do for now. At some point I'd love to start a support group through DBSA or NAMI but until I feel that I can be stable for a long period, or find a backup co-ordinator, that dream will have to stay
on the back burner for now. But no matter what, I'll continue to do what I can to help
break the stigma of mental illness and will hopefully one day be satisfied that I have done
everything I could to do so.

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