Be Better

I found myself saying something to a family member I love very much.  I said "You need to take steps necessary to be better, to get well."  Right after that,  I saw the  picture above, which is a piece by photographer John William Keedy.  This started me thinking about how we perceive normal and abnormal behavior.

One of the interesting features of mental illness is the tendency of some sufferers to resist  treatment.  The resistance is caused by many things. One issue is the desire to avoid the stigma associated with the "mentally ill" label. The mind-altering/personality-altering effects of psychotropic drugs is another hurdle.  When a mentally ill person has full-blown anosognosia, they really believe that they are fine.  It is confusing and alarming to these folks when others tell them they are mentally ill.

Here is the other thing I am learning about mental illness - it is similar to physical diseases in some ways.  If you have diabetes or a heart condition or any other difficult malady and you don't get the appropriate treatment, your disease will progress and you will become  less healthy until you die.  This rule applies to serious mental illness, too.  Serious mental illnesses are progressive.  Untreated sufferers get worse, and often kill themselves when their misery and confusion becomes too much to bear.

Dr. Xavier Amador wrote a book in 2002 entitled "I Am Not Sick, I Don't Need Help."  As I struggled with my own confusion over relatives with mental illness, I ran into a wise person who recommended the book.  I read it, and learned how well-meaning actions can drive a wedge between a mentally healthy person and a mentally ill person. The book is well-written and understandable with a clear blueprint - L.E.A.P., which stands for Listen, Empathize, Agree, Partner.  While the blueprint is clear, executing the plan is hard.  "Sane" responses to the behavior of a mentally ill person get in the way of Dr. Amador's steps.  All the natural feelings that occur when dealing with mentally ill folks - frustration, anger, worry, fear - also impede progress.

After a discouraging series of events, I find myself clinging to hope.  These diseases can be controlled, people do recover.  Good things can happen to the people that I love who are suffering.  While the events "on the ground" may be challenging, this hope remains. 

This will sound trite and corny, but I will never give up that hope.

Worry

Worry is a very interesting problem.  There is specific, limited  worry, and free-form, bottomless pit worry.  There is functional, motivating worry and useless, immobilizing, soul-draining worry.  With worry, less is more.

A pessimistic view of the world can be perfectly functional if it isn't too extreme - a "good" worrier sees the downside and acts prudently to prepare for that downside.  A good pessimist sees the flaws in a situation and strives to improve it.

I have a family member who carefully reviews every possible outcome to each  situation and assumes that the most disastrous outcome is the most likely.  This is often referred to as "catastrophic thinking."  If you are expecting the worst possible outcome in every scenario, it becomes difficult to carry on.  Worry morphs into anxiety and inactivity, isolation and depression.

Too much optimism can be also very bad. Optimists tend to have an unrealistically positive view of the world and their own capabilities.  Optimism morphs into grandiosity and manic behavior.  The most optimistic people I have ever known have made some horrifically bad decisions, especially concerning  money and relationships.  Confidence can lead you badly astray.

"Good worry" stiffens the resolve.  It is the type of emotion that leads to the following statement of purpose - "Things are going to get much worse unless I act now!"  A good pessimist doesn't try to fix everything that is possible to fix - only the things that MUST be fixed.  A good pessimist sees all the problems, but is not afraid or demoralized. He/she grinds forward with grim determination, and sometimes things turn out better than expected.

Conversely, a good optimist understands that no matter how hard he/she works, much of life is random.  A good optimist is aware of the downsides and plans for them, but doesn't assume that the downside case is likely to occur.  And if a bad thing happens, a good optimist doesn't personalize it ("Why does this always happen to me?").  They direct their thoughts forward - "Well, I learned something and will apply it to my future."

Training the mind to moderate both worry and confidence is a lifelong pursuit.  Hope I get better at it someday.