I have two children, four step-children, ten grandchildren and l am pack leader to three fur-babies.
I have worked as everything from a Buxom Wench at Kryal Castle, Office Manager, Girl Friday, Bookkeeper, run a Piggery and featured in a series of TV ads for the local YMCA.
I have travelled extensively. Crossed the Sahara Desert on a camel (well five kilometres of it), been to the top of Mt Everest (admittedly it was in a plane), walked the wonder that is the Great Wall of China, witnessed the beauty that is the Taj Mahal, been charged by a juvenile bull elephant on the Savannah Plains, charged by a Black Rhino in Masi Mara, been climbed all over by 6-week-old Tiger Cubs in Thailand and the list is much longer.
Why am I telling you all this? Because even though I have a severe mental illness, when I am well I can achieve great things. And sometimes when I am unwell I can achieve even greater things (when hypomanic). For most of us who experience mental illness, this is the case. In fact, we are more inclined to pack as much as possible in our lives when we are well, than the average lay person does. We strive to make positive and inspirational memories, get involved in community through volunteering and complete challenging activities to fuel us when we are at our worst; to remind us why it is we are alive.
I have Bipolar, PTSD, with OCD & Borderline Personality tendencies (yep, I don’t like to do things in halves). Whilst all these illnesses have common traits, as for others experiencing these illnesses, no two of us experience the illness, in its entirety, in the same way.
This is just the same for the lay person. No two people are the same. Each person has their own idiosyncrasies, quirks and way of doing things.
Each of us face and travel through life, living it the way we do, because of our past experiences. Because of our childhood learnings and experiences. Because of our past interactions with others, the good, the bad and the ugly. Because of the level of intimacy we have shared with others. Because of the social groups we have been part of. Because of those who have been role models and inspirational in our lives. Because of those who have hurt and traumatised us. All of these experiences, and more, have come together to make us the individual we are today. Future experiences will continue to shape the individual we become.
It is for the above reasons you cannot put a person with a mental illness in box labelled ‘Bipolar Symptoms’ or ‘PTSD Symptoms’ or ‘OCD Symptoms’.
Lets look at Hallucinations for example. Hallucinations can affect any of your five senses; touch, taste, hearing, vision, smell. Some people with a mental illness will never experience a hallucination. Some people will experience a variety of hallucinations aligned with one sensory area. Others will experience hallucinations in various sensory areas, even sometimes at the same time. But you would be hard pushed to find any two people who experience exactly the same thing.
Two people may experience the same sensory hallucination, let’s use hearing voices as an example. However, the voices they hear are not the same. The content of what the voices are saying are not exactly the same. The frequency of the voices is not the same. The number of different voices heard are not the same.
The strategies used to cope with the voices are different for different people. The treatments used to help manage the voices is different for different people. Different therapies are available but only work for some, not all of the people; because of their different presentation and experiences.
Wow, how do Doctors diagnose someone with a mental illness when they are so obviously an individual and unique experience for each person?
Well, there are some basic commonalities in each mental illness, but, each commonality is experienced differently. Let’s look at Bipolar for example. Most people know that Bipolar is descriptive of extreme highs and extreme lows. But, people often are not aware of mixed states, which incorporates symptoms from both poles at the same time. So, we have: -
A few of the commonalities for each are:
Mania: Risk taking behaviour, excessive libido, racing thoughts, rapid speech, extreme energy, loss of touch with reality. The list is quite extensive so we will stop here.
Hypomania: Euphoria, elevated energy, increased libido, elevated sense of wellbeing, elevated productivity, and much more.
Moderate Depression: Lethargy, slowed thought processes, increased sleep, heavy body, slowed movements, decreased libido. Sometimes inability to sleep because of negative thoughts churning in your mind. Loss of desire, drive and motivation. Loss of will to live, thoughts of dying.
Major Depression: Total withdrawal from human contact, excessive sleep, loss of libido, desire to die through to intent to take life. Negative thoughts, self-recrimination, sense of being a burden, guilt, shame, brain shutting down, devoid of emotion and inability to find any pleasure in life’s gifts and beauty, etc, etc.
Mixed States: Agitation, restless energy, negative thoughts, aggressive, critical, tiredness, frustration, thoughts of suicide and various other combinations of symptoms from throughout the whole range of other states.
The diagnosis is based on the core symptoms for each mental illness. Finding out what our own variations or deviations from these takes time, effort and self-reflection. I found the best way to identify what symptoms were unique to me, was to keep at mood/symptom daily chart, in which you track the variations of your personal presentation each day. You also record any issues/challenges encountered that day and reflect on how they impacted your presentation. Doing this provides self-insight, helps to identify triggers, which then enables you to consider what you might do in these situations in future, establishing coping strategies to minimise the impact of the trigger.
For those who are an integral part of life for a person with a mental illness, you will observe things, behaviours, presentations, that the person themselves are often not aware of. It is worth noting these presentations and at a later date, when the person is stable, initiate a conversation about your observations. Be wary of the tone and approach you use, as if it comes across as judgemental or confrontational in any way, the person will become defensive, argumentative, sometimes leading to agitation and aggression.
It is not easy, neither for the person with the illness or the people integral in their life. The person with the illness, especially early after diagnosis, does not know what is and what is not as a consequence of their illness. I remember when I first identified that my reaction to certain things was outside the realms of reasonable. I had thought I was responding and reacting to situations, no different than anyone else was. This was very unsettling and I no longer trusted my feelings, thoughts and reactions. I lost my sense of self, asking myself constantly, ‘what is me and what is my illness?’
The basic approach needed, is to not put a person in a box based on the common symptoms, keep in mind that each person experiences the illness in their own unique way and allow and aid them to discover each aspect of their uniqueness.
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