Choose, Gladly, Using Resources

Being a friend to yourself includes choosing, being glad that you can, and using resources to make your choice a good one.

Mrs. Smith told me with a barely noticeable arch in her back that she was still planning on God healing her daughter.  I don’t know if Mrs. Smith thought about how her daughter felt about that.  Was Kristy personalizing her illness?  Did she think God rejected her?  The problem of her continued illness must show something more than a physical flaw in her perhaps.

Will we know it when we are healed?  Until then, what to do?

Years ago, I met Fran.  She was pulling her hair out.  Her annoyed husband disrespected her for it.  Fran kept willing herself to stop.  She said,

I’m doing it less now I think.

The good news for Fran is that she responded well to fluoxetine.  Her anxiety decreased and she almost stopped pulling out her hair.  She’d wear her growing bristles pressed down with bobby-pins and hide it with her long hair.  As her hair grew longer, she had fewer bobby-pins and I knew she was taking her medication.  There were other problems between Fran and her medications.  Taking medication shamed her.  And, she blamed her fluoxetine for her weight gain and rash on her face.  She felt uglier than ever in her husband’s eyes.

I don’t pull hair any more.

Fran stopped her fluoxetine and half her head went bald.  She did not lose weight and she still had a rash on her face.  Fran went back on her fluoxetine and she has cycled on and off of it this way over the years we’ve worked together.  Somehow despite all our time together, Fran does not believe me when I tell her that when she is better symptomatically, she is not healed.  Fran does not grasp that her behaviors come from something at a genetic level.  We can treat her, influencing the way her genes express themselves, but in her case, not cure her.

We are a team.  She and I, and sometimes her husband, and sometimes her sister.  I give her medications when she thinks she needs it.  I don’t leave her when she doesn’t.  Either way, we keep trying.  It is very hard for Fran to know that she has not been healed.

I don’t have many clear examples of treatment-to-cure in psychiatry.  The statistics vary between diseases as to their rates of recurrence.  The brain being human, we can yell at the serpent for our insanity.  However, in the end, here we are.  As Billy Joel says in his great ’70’s hit song “My Life

Either way it’s okay to wake up with yourself.

The opportunity to choose our own answers, to decide what to do about it, and believing if we are sick or not sick  – is all our own.  These can be hard decisions but until we lose capacity to choose, we own them.  Decision making capacity of course is a medical decision.  But competency is a legal decision made in a court of law.  Having the right to choose is a beautiful privilege.  This does not mean to ignore counsel, evidence, data.  On the contrary.  That would not be a friendly thing to do to yourself.

Self Care Tip # 75 – Choose well and be glad you can.  Be a friend to yourself.

Question:  What do you think?  Agree or disagree.

Good News

Many people see needing to take medication as bad news. But I think about what it would be like without it. Suicide, progressive deteriorating processes in the brain biology, contagious behaviors and moods spreading to those you love, inflammation…. That is bad news. I think about the not so many years ago before most of our medications existed. Before much of our understanding about the brain biology was around. Those times were hard. Misinformed people had ugly ways of looking at others with emotional illnesses. Hearing someone thump out their opinions on the pulpit about human behavior has always been a pleasure for me as well – not! Now we know that our essence isn’t dependent on our brain biology.

But here we are, in the land of milk and honey, depressed economy and all. We have a more informed public opinion (check out NAMI – awesome!), evidenced based medications, etc…. More than ever before in our history, the responsibility to take care of ourselves comes down to us as individuals. The external barriers to treatment are not what they used to be. However, what are the internal barriers? We own our choices. Our beliefs are our own. Letting yourself close off to the good news of medication – that is a tragedy.

Now is the time to fight for yourself. You are worth it. When you see the difference in your life, your perspective on good news and bad news might change a little too. Even public opinion starts with the individual.

Self Care Tip #22 – Be your own advocate. Be a friend to yourself.