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 of...at 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 diagnosis...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 remember...my 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.

Recap: Prairie Fire Half Marathon

Race Day: Sunday, October 14, 2012 @ 8:00am

Race Day - 1

In the weeks prior to this race I had been combating a massive depression that I did my best to hide from friends and family...not always with success. It wasn't until yesterday, October 12th, that I finally decided that I would participate in Prairie Fire. This involved last minute packing and planning which I really hate as I typically pack several days in advance even up to a week in advance. To top it off, I planned to car camp for the night prior to the race in order to save a few bucks ($7 on base vs $100+ at the starting line...I reservation I now regret having cancelled). Anyway, I managed to get everything that I thought I needed while still packing minimally after waking up at 3am and doing my packing then.

By around 6am I was on the road to Wichita, Kansas which would be about a 9 hour drive including the loss of 1 hour due to the change to Central Time. The drive itself was fairly uneventful and I made pretty good time arriving at the expo at just before 3pm CT. After stopping to pick up my race packet, I got in the car and set my GPS for Offutt AFB where I had planned to camp out for the night. Lo and behold! Offutt AFB is located in Nebraska and was the base I had planned to stay at when I had planned to originally do a Saturday half marathon at Valisporo just outside Omaha. Okay. So I began to freak out. I was on a very limited budget...just over $100 for the trip (gas on the gas card). I knew there was no way I could pay for a room near the start so I decided to go ahead and drive to McConnell AFB to see if they had rooms available. Unfortunately, the Air Force lodging prices had just gone up from $39/night to $53/night at the beginning of the month. Figuring that at least I'd know it would be a decent room I was lucky enough to find the base after incorrect directions from the GPS and getting lost for about 10 minutes.

After finding the back gate to the base I finally made my way to the Air Capital Inn and was able to get a temporary lodging facility (basically a 1 bedroom apartment) for $54 for the night. As I got back into the car after registering it began to rain and by the time I made my way to the building that I was assigned (just behind the building with the office) it was throwing down. I don't mean just a little hard rain, but torrents of rain. Monsoonal rain. Wet to the bones rain. As I drove slowly through the parking lot I searched for where my room was...I saw the room number preceding my room and decided that would be the place to park. Wrong. When I got out to start carrying my stuff to the room I was unpleasantly surprised to find that my room was not where I thought it should be, but rather on the other end (not side) of the building. In order to find it, I had to walk in an open corridor getting pelted by the rain. I walked up the north corridor and didn't find the room. I walked down the south corridor and found the room at the very end of the building...the total opposite of where I had parked. I threw whatever I had in my arms and took a deep breath before tackling the rain that was coming in almost horizontally and rather painfully. I ran back to the car and moved it to a space just outside my room and began grabbing what stuff I needed for the night. As I finished up, I turned on the TVs only to find a severe thunderstorm watch in effect with the potential for 2" hail. Joy. Not only was I soaking to the bone, but my car may get smashed up here in tornado country. I took a few minutes to try to wring out my shirt during which time I realized that the pasta dinner would be starting in just literally over an hour. Here I was with a dinner ticket and soaking clothes and hair. Luckily the rain had let up and I decided that I'd take a chance and go to the base exchange to see if I could get a cheap outfit for the night.

About 40 minutes later I got back to the room having found a shirt, skinny jeans on clearance and an umbrella for less than $25. I quickly dried my hair (the rain had stopped by now) and stuck the blow dryer in my shoes, alternating every few minutes, to dry them out a bit. Thank goodness I don't wear makeup! I got dressed and headed out to the dinner with just enough time for the ~15 minute drive to the venue. I arrived just in time to sit down towards the rear before dinner was served and introduced myself to the table. There was another Beth who was also a relatively new runner with this being only her 2nd half marathon, another nurse who had just finished a contract at a hospital in Santa Fe and was heading home to Florida (if I remember correctly) after running the full marathon and finally a young man with his family who was running his first full marathon and would be heading east to visit his family right after the race. The food was pretty good although there was absolutely no protein offered...kind of odd, usually there's at least a little protein at these things. Dane Rauchenberg, ultra runner and author, was the guest speaker and was really rather interesting and entertaining. We all left at around the same time, before the event actually closed down...actually I think I was the last one at the table.

I made my way back to the base...with correct GPS instructions this time and got my gear ready for the race the next day. I was just glad that with the rough afternoon that the race had a start time of 8am rather than 7am that had been the norm through out my earlier races. I was glad that I opted for a room instead of trying to find the Famcamp since the t-storm warning was still in place with the continued chance of hail...at least I would be warm and dry, not having to run to the bathhouse to use the restroom or shower in the rain, etc. And mostly I'd be able to sleep in comfort and spread out as much as I wanted. I had forgotten my meds (realized that at about 5 hours into the drive) so I had to settle for Benadryl for sleep, Tylenol and some Endurance Caps (electrolyte capsules) instead. After I taped up my knees for support, I headed to bed and was finally asleep by around 11pm.

Race Day

Woke up at 5:30am. Went straight into the shower, ate my typical breakfast, taped up my feet and got dressed. I left the base at about 7:10am which was plenty of time to park and get to the starting area...or so I thought. The drive into downtown was fine until I started hitting all the closed streets. Ugh! I finally got to a lot that I thought was relatively close to the starting area only to find out that it was no where near. So, I headed back to the car and drove around again and again parked in an area that I thought was close to the start. It was now about 7:40am. As I followed some obvious spectators I became a bit worried when I saw a mile 1 marker. I asked the volunteers there if the start was straight ahead but they weren't sure. I broke into a jog (mind you I typically do a 12 to 13 minute mile) and passed one of the course bands. I asked another set of volunteers if I was headed in the right direction and they said I was...I guess I should have gotten a little more specific. I was now in a slow run...rather than a jog. I was beginning to panic. I began thinking how I drove 9 hours, suffered through the storm and now was going to miss the start of the race because I had parked a mile and a quarter away from the starting area. I finally began to recognize the area and headed in the direction that I thought that the starting line was at. I was near tears by this point. After hitting several dead ends, I finally saw the venue. I broke into a full run as I heard the announcer declare that the race would be starting in a couple of minutes. I literally had just enough time to tear off the tab on my bib and toss it and my gear bag to one of the girls at gear check before heading to the start where I heard the words..."We'll be starting in 1 minute!" Whew! I fired up my MotoACTV's GPS, tried to catch my breath and tried to calm the surge of anxiety that had suddenly welled up with the relief of finding the start. It wasn't good though that I was already panting before the race had even started. "GO!!"

And the run was on...I began walking with the occasional jog still trying to recover from my unofficial pre-race mile. I eventually felt like I was in a groove and began  an alternating run-walk. Bad idea. The first part of the race wasn't too bad. mostly flat going through part of the Riverside area, Old Town, along the Douglas Design District into College Hills and back (for the most part...the last part of the run was on the other side of the river). I had stopped a regular run-walk system at about mile 9 opting to just run as far as I could...typically only 100 feet or so then walking as long as I needed to. Since I was passing my car on the way back I decided to go off course and dump my race belt in the car. I just grabbed one of my 10oz bottles of G2, my camera and my phone (I thought) and got back on course. By the last 2 miles or so I was exhausted and had started to cramp up in my right foot. By that point it became a mostly, if not all, walking event. I'd look out for the course photogs and try to pretend that I was running as I went by them with not a lot of success. I tried to run across the 2nd bridge but it was a no go and I finished the race walking...slowly. I was way over my goal of 3 hours and my foot was cramping badly. After stopping for a massage (where I realized that I must have forgotten my phone in the car), some oranges, a whole bunch of chocolate milk and a Gatorade I made my very first trip to a medical tent to get an ice bag. I sat around listening to the band while waiting to get an ART (active release therapy) chiro to do a demo on me in hopes of loosening up my legs and back before the drive home. I waited for over an hour...everyone else was packing up to go and this chiro was just there chit chatting with the person before me. I had to get on the road so I just said forget it and headed out on the 1.25 mile walk back to the car.

When I got back to the car, I noticed that my phone wasn't anywhere in the car. I spent a half hour searching everywhere in and around the car even following part of the course (after traffic had already started back up) to see if it was smashed on the street somewhere. Crap! That was my lifelink home. Luckily I had my tablet with me and texted the old man that I had lost the phone (again). I decided that it was permanently lost so I decided to go to the nearest Y and take a shower before hitting the road. I checked my texts (no voice capability on the tablet) and the old man had gotten a call from a man whose wife had found it. I used the Y's phone to call him and we began a several hour long telephone tag to get my phone back. Since it was already past 4pm I decided that I'd have to stay another night and drove back to the base to try to get a room. Luckily they had plenty of rooms available and I ended up in a first floor room in the main building. After getting some near San Francisco quality Chinese food in town, I was finally able to get back in touch with the guy and get directions to meet his wife for the return of my phone. That happened at a little after 8pm so I was really happy to have found a room already.

By the time I got the phone back, my right foot was hurting terribly and I could barely put weight on it. In fact, I was basically just walking on the instep because I was fairly sure that I had managed to get a stress fracture of my 5th metatarsal (the outside foot bone). I was going to go to a civilian urgent care/ER when I remembered that there was a VA medical center (read ER) in town so that's where I headed (I didn't need any extra medical bills). After nearly 4 hours I was out on crutches with a post op walking shoe. Joy. I was to be non-weight bearing for 7-10 days...lovely. I got back to the base, figured out a way to carry 2 cans of soda while walking with 2 crutches. At 48 years old, this was the first time I had been on crutches let me tell you...I was no good at using crutches. I finally fell asleep sometime after 2am...

Race Day + 1

I woke up just after 6am. I decided to just take my time and head out by 9am or so. I lounged around a bit, played on the laptop and finally started getting ready. Let me tell you, I was just glad that there was a shower stall instead of a tub in the bathroom. Being non-weight bearing on one foot really made for an interesting shower.

I finally headed out a little before 9am. The only eventful things happening on the way home was getting lost within the first 5 miles and having to backtrack and my first stop at a McDonald's on I-35 service area for lunch (my first lunch at McD's in a couple of years).

I arrived home around 7:30pm MT to a choir of 7 canines barking and howling for mama/gramma. After a weekend like that I was really surprised that I never really fell apart emotionally. I had come close on race day, but I managed to get through it without melting down. Maybe I was actually on the mend...

Official Time:  3:11:27 (Personal Worst by about 5 minutes)

What did I like about this race?
Nice, mostly flat course, nice weather this year (for the race itself), goes through some nice areas.

What did I not like about this race?
Finish area was a bit disorganized...ran out of food for the late half marathon finishers (only had half a tray of oranges when I arrived and I was essentially chased off of the marathon finishers table). The food was almost out at the runner's food tent in the runner's village as well.

Would I do this race again?
Yes, but I'd train correctly (had only run a max of 5.5 miles and only about 15 runs total most of which were only 3 miles or less) and be much better prepared. It was my fault as far as getting an injury all due to poor preparation.

Dane Rauchenberg, ultra runner and author.

I represented Team Red, White & Blue for this race.

Celebrating Breast Cancer Awareness Month on the course.

I believe this was in the College Hills area.

Going down Douglas Ave, the return trip.

Keeper of the Plains Plaza & Sculpture in the Riverside area.

Coming over the pedestrian bridge at Keeper of the Plains Plaza.

Finally...finished!

2012 Half Marathon Finishers medal.

Close up the HM Finishers medal.

Back in the classroom, again!

Today was one of the high spots for me each semester at the local community college where I used to teach. Since one of my dearest friends took over the psych content I used to teach to the fourth semester nursing students, I go over at the beginning of each semester when they begin talking about mood disorders. The goal is not to necessarily "teach" the book learning to them, but rather to give them the viewpoint of a patient with a mental illness. I do a little book learning such as the basic differences in the ranges of bipolar disorder and general symptomology but I spend most of my time sharing my perspective as a mental health patient...who just happened to be a nurse (I let my license lapse, after nearly 22 years as a nurse, at the end of January as I have now been deemed unemployable due to my 100% service connected disability by the VA).

One of the first things I always start with is to find out how many of them are "wary" or outright "scared" of going into a locked down, inpatient facility. There are always at least a few hands that go up and I try to do my best to reassure them that they will survive. In four years and 16, week long clinical rotations with my students I only had one freak out a little and that was resolved by the 2nd hour after I pulled her off of that particular floor for the morning. No, I didn't whip her into submission...I simply let her get acclimated to the setting a little longer!

We, or rather I, talk about my history, suicide attempts, medications, triggers, symtomology, etc. to give them a viewpoint to look at that they may never had thought of before. I try to encourage them to see each individual as just that, an individual...who happens to have a diagnosis of a mental illness. I try to remind them that the patient is not the disease...that the patient has a disease. I tell them how hard it is sometimes to not say "I am bipolar" instead of what really is true..."I have bipolar disorder." We talk about any and all things that they want to bring up...not just what I or my friend, the instructor, have in mind. My overall goal is to help alleviate fears of their clinical rotations and to help them understand that mental illness is just another disease process except that it's brain and chemical based versus just being able to look at lab, xray and other procedural reports to help make a determination. 

I had some good questions posed to me today..."Can a patient see different providers and be told he/she does not have bipolar or a diagnoses that they had been given earlier?" The answer is unresoundingly YES! With mental health there's really no cut and dry line saying this is what you have. A lot of it has to do with the clinical experience of the provider...have they seen this disorder, how much experience have they had treating the disorder, do they have the full story? Yes, diagnosis can differ from provider to provide, but it is also the responsibility of the person with the illness (or their caretaker) to learn about the diagnosis and bring up questions and concerns, if possible, to clarify the diagnosis. Another was "Was it a relief to finally be diagnosed with bipolar disorder?" For me YES!! I knew something more than major depressive disorder what wrong with me, but I didn't know what. When I was finally diagnosed and started studying the disease I could automatically see just how closely I fit the criteria for bipolar disorder type 2. To finally know what was wrong with me was a definite relief. Another question was about how the diagnosis affected the family. Well, when your kids find you, when they are the at the ripe old age of 8 or 9, after ingested multiple pills in an overdose attempt (several times), there's going to be some affect. My son harbors resentment, my daughter tends to avoid the subject, the husband tries to watch for my symptomology while at times denying his own (recovering alcoholic). So yes, it takes a huge toll and like I said in a previous post if I knew back then what I know now I probably wouldn't have had kids.

I did a little bit of a social experiment with my purple hair too, which is going back to a dark auburn or what ever color it turns out to be if I can't strip the purple out of it this evening. I just showed up and started talking never really bringing up the subject of my hair. Finally after the Q&A session and no more questions were posed, I asked them..."So who has been sitting there wondering if I was manic when I dyed my hair purple?" I had told them over and over again during my visit that I was completely open to ANY questions during my visit. I saw a few people kind of get that look of "OMG...how did she know?"  and finally I'd say about half a dozen hands went up. I told them that it wasn't a mania but fundraising that led to my purple hair and hopefully a bald head on May 11th. I wonder if I'm a little imposing or unfriendly that they were afraid to ask? Naw...probably more like they just didn't know how to ask. Well, hopefully they learned something out of this guest speaking gig. The last class I did it with seemed to have a good time. Some of them even remembered me as I was shopping in the local WalMart months after the presentation. I guess time will tell...

100 Days Challenge: 

• Day 37
• 2.43 mile walk with the grand pup in 45:46 around the neighborhood

What I Ate Today: (Still being updated)

• 12 oz low fat chocolate milk
• 5 pcs Albertson's fried chicken - 2 thighs, 2 wings, 1 drumstick
• 10 oz non-fat, lactose free milk
• 4 chocolate chip cookies