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: Women's Trail Running Clinic

Well, a few weeks ago I got a email from Active.com (the site where I register for the majority of my races) and it was an announcement for an all women's trail running clinic up in Red River, NM at The Enchanted Forest Cross Country Ski Area there. Since I had been thinking about signing up for a trail half marathon (which was really stupid now that I've done this clinic) and I have a quite substantial amount of fear/reservation about doing trail runs I decided that I'd check on attending. I wrote to Ellen, the coordinator for the clinic, and warned her that I was slow, had ankle and hip issues and a fear of trails and she told me that not to worry the class was for all levels and speed. So once that was cleared up I went ahead and checked with my local running friend, Teresa, to see if she might be interested in joining. After a week or so she decided that she was going to go and so we got registered and worked on logistics.

Day Before the Trail Clinic
Last Friday finally arrived and it was time to head out to Red River. Now, I'd never been up there and I didn't do any research other than finding a place to stay. It is about a 5 hour drive from home and the drive is pretty boring until you get up to the mountains. I'd say an hour or so out of town I started coughing for no reason, like I had something in my throat...this is something that would hang out for the whole weekend. It was just a cough...I didn't feel ill or anything so I think it had something to do with the altitude. When we arrived in town and got settled, we walked up and down the main road and stopped at some of the gift shops, candy shops and knick knack shops before hitting up Texas Red's Steakhouse for a bison rib eye. Now, if you really know me you know that I usually take pics of my food especially if I'm traveling but I'm not sure why I didn't this time around. The bison  rib eye was good, but too lean for my taste. At least now I can say that I've tried it, but I'll stick with beef rib eye thank-you-very-much. After dinner we headed back towards the hotel stopping at several other shops on the way. Teresa found a map that showed the elevation in town to be 8,672 feet. I thought that was great because I wasn't feeling tired or anything so I was taking it as a good sign for my Madison Half Marathon in July where the race starts at 9,200 feet elevation. About the only thing, aside from the cough, that I could attribute to the elevation at this point was my skin becoming very dry and itchy. We got back to the hotel and turned in for the night to rest up before the big day on Saturday.

Trail Clinic - Day 1
I ended up waking up at 3:22am on Saturday. Not a happy camper especially since I couldn't fall back asleep and my phone signal was sporadic. We headed out to a light breakfast (just some donuts and coffee/hot chocolate) at T Buck's Hole Thing since we knew there would be some breakfast at the class. Then we headed down to the town grocery store so that I could get some lotion because my skin was just itching terribly. While I was picking up my items, Teresa met Laurie who was going to be our primary instructor for the class. Laurie looks like she has zero body fat and has so much energy it's crazy! Here's a little bit of her bio:

"Laurie Lambert has been a lifelong runner and racer. She's an avid trail runner and cherishes long mountain runs with her favorite four-legged running partner. Laurie has raced road and trail extensively all over the U.S. and the world in 10K's, half-marathons, and marathons and is a three-time member of the U.S. National Snowshoe Team."

Since we had a little time before the class started, Laurie said that there had been big horn sheep near where we were going to go check out a mining area. So we decided to search for some big horn to take pictures of as well. After we got the last of our stuff ready for the class, we packed up and headed west to go check out the mine and look for those sheep. As luck would have it...there were no sheep to be found! The closest we got were a few rocks we thought may be sheep. So, with our photo hunting mission failed we headed back to town and checked out the car show before over to the ski area for the clinic.

My favorite car at the car show...lover the pearl paint job!

This would've been the hub's favorite car...he drools over '69 Camaros!

The night before we had wondered how many of us there would be attending the class but when we met Laurie she told us about 8 total. Not bad...not so many that you get lost in the crowd and not so few that it feels like a private class. As everyone started arriving we found out that we had ladies from Denver, Albuquerque, Los Alamos, Taos and ourselves. Most had done some kind of trail running in the past and only myself, Teresa and Stephanie (from Denver) were the trail newbies. We hung out in the shop at base camp for a while eating some more breakfast before heading outside to talk about some more technical aspects. The class wasn't structured and we could discuss whatever came to mind but some of the things that came up were gear (specifically hydration), downhill running, how trails were marked and most important...how to pee without being noticed if there was nothing to hide behind!

Pre-run discussion & introductions

I want to say that around 10:30 we packed up and started onto the trail. It was then that I found out that we were already up above 9,300 feet in elevation in base camp and would be heading up to over 10,000 feet if you did the full 10K course. I had thought that the 10K would be fine, but we didn't get much more than a quarter mile up the trail before I was huffing and puffing and trying to catch my breath. Somewhere around 3/4 of a mile my head started pounding...no head ache...just pounding to my pulse (which was pretty quick...my stupid MotoACTV failed to charge overnight for some reason). All I could feel in my head was: boom-boom, boom-boom, boom-boom...Between that and my breathing, which in turn made my chest feel like it was going to explode I changed my goal from the 10K to hopefully the 5K. Much thanks to Ellen who hung with me and got me down to the base camp...she told me in our initial email that she was slow...she didn't know the meaning of slow until she met me!! lol! Anyway, as I slowed down and headed back down the mountain things seemed to start settling down but I began second guessing my choice to participate in the Madison Marathon in July in Montana because that race would be starting at about 9,200 feet and going up to nearly 9,700 feet in elevation. The rest of the day was spent having lunch (salads from Trader Joe's), and a yoga class by one of the other coaches, Kimberley. Here's a little of her bio:

"Kimberly Ritterhouse is an avid fitness and nutrition enthusiast. After being diagnosed with a gluten allergy Kimberly had to rethink fueling and adjust to new ways to conquer "bonking" on long hikes and runs. She has a passion for teaching and sharing her joy in the beautiful Sangre de Cristo mountains. Kimberly has a level 3 Yoga-Fit certification and has run several half-marathons and the San Diego Marathon. She has also been a two time snowshoe racing national qualifier." 

Wheeler Peak

The others went on another 5K run in the afternoon before the clinic let out for the day, but I was so worn out by my short jaunt I decided to sit it out and try to take a nap in the truck. After everyone got back we made plans to go to dinner with a could of the girls and ended up at Sundance Mexican Restaurant where I ended up with a nice 12 oz beef rib eye (yay!) with a side of cheese enchilada. What a combo right? It was great, but again no picture and I did enjoy this steak much better than the bison since it had more flavor (read "fat"). After dinner we headed back to the hotel for a shower and turned in for the night.

Trail Clinic - Day 2
We were awake and packing everything up by 6:30am. We decided against breakfast since there was going to be breakfast at the clinic so instead we packed up and went to look for the big horn sheep again. Strike 2. Apparently the sheep either 1) did not want to be found or 2) got chased off by the rally that was in town the weekend before. For both my friend and I our luck with finding some of the unusual wildlife is pretty much nil. (However we did see a female bedded down on the side of the road on the way to the clinic and on the side of one of the hills the night before). Since we struck out again, we headed back into town and made one last check of the room before checking out. As we drove through town, we noticed that The Pied Piper's Pastry Shop was already open so we stopped and picked up some goodies. I had an apple turnover which was seriously yummy...yet again no picture. Wow, I'm really lacking on my foodie pictures!

At the base camp we were the first to arrive so we helped set up while we waited for the others to get there. After allowing some time for everyone to eat we broke up into groups...one the ones that wanted to go faster (yet slower than the day before) and one that preferred a slower pace on easier trail/forest roads (this was where I was). This run/hike, while even slower than yesterday, was still hard for me with the elevation. I was still lagging behind but at least the head pounding was less than the day before, the breathing situation was just a little bit improved but my heart rate monitor was maxing out at 168-178bpm with almost minimal wogging (walk/jogging). I usually don't get into the 160 range until the middle to late portion of my half marathons and even then my heart rate recovers pretty quickly when I start walking...no so at elevation. It seemed like it took forever to get my heart rate back down into even the 150bpm range! I do have to admit that the trip was worth it with some of the views that we got to see. We did a couple of  staged action shots of everyone and managed to finish about a 4 mile loop. I almost thought I'd come out of this clinic unscathed, but I ended up spraining my ankle about an hour into the jaunt...then it slipped another 3-4 times as we were returning to base camp. Luckily (or unluckily) my ankle has been sprained many times before although this time I did hear it pop; I was still able to mostly walk on it with just a slight limp and as soon as we got to camp I put some ice on it. It only ended up swelling to about twice it's normal size without any bruising.

Wheeler Peak in the background.
Full group except for Ellen who is taking the pic.

Wheeler Peak/Gold Hill/East Red River View
9,960 feet in elevation at this point.

Aspen Grove

Latir Wilderness with view of Red River

Since it was the end of the clinic, the awards were given out. One of the leaders wrote up the calligraphy slips and found off the wall prizes to go with the awards. The day's run was supposed to be an unofficial "race" but that idea was set aside for a more relaxing activity. Each of the awards was tailor made for each participant. For me it was the "Least likely to become a vegetarian" award with a bar of chocolate. This award transpired because during the first day when we were talking about how to eat we got off on a tangent when I started discussing my recent experience with deep fried/chicken fried bacon and my love for all things meat! lol! You've got to realize I was with a bunch of women who probably ate way more healthy than I do. :)  After a little while just chatting and laughing it was time to say goodbye and leave for the 5 hour trip home.

Concentrating too much on my feet!

"Most likely to never become a vegetarian Award
(and bravest newcomer to trail running!)

All in all it was a great weekend even though it confirmed what I already pretty much knew...that I am not a trail runner. If I do decide to do any trail runs they'll be short 5Ks and at much lower elevations! I'm just wondering now how I'm going to deal with the elevations at the Madison Marathon in Montana next month which has the start at 9,200', maxing out at 9,675' and finishing at 8,850'. I'm thinking that since I have a race in Wyoming on July 14, then Idaho July 21 and finally Montana on July 22 that I'll just have to take the travel trailer and head up to Montana on Tuesday or Wednesday prior to the race to start acclimating and drive back down 3 hours for the race on Saturday before heading back up to Montana. I had even entertained the idea of taking the trailer up to Red River and staying up there for a week before leaving for Wyoming but I'll be in Oregon and Washington for three races during the July 4 week. At least it's a road race rather than trails...granted, not paved roads but as long as I can have pretty sure footing I'm good with that! :)

If you have an opportunity to do a trail running clinic at The Enchanted Forest Cross Country Ski Area in Red River, NM I'd recommend that you do!