The Mental Illness Stigma That Won’t Die

The author came clean about his own battles with mental illness and addiction exactly because of stupidity like this…

Mood music for this post: “Push Comes to Shove” by Van Halen, from the “Fair Warning” album:

[youtube=http://www.youtube.com/watch?v=g3aW7oofNgs&hl=en_US&fs=1&]

Kay Lazar from The Boston Globe wrote a story this week that sent my blood boiling. My problem wasn’t with the reporting or writing. She does a fine job. It’s the topic that burns.

The story, available here, is about firms putting limits on coverage for mental health care. It’s the same sorry song that ratchets up the fear level for those suffering from depression, OCD, bipolar disorder and the like.

It proves to the sufferer that mental illness is still viewed as a less-than-legitimate illness, something that’s more a figment of the sufferer’s imagination.

In the eyes of many health insurers, it appears this sort of thing doesn’t justify the same kind of coverage it offers for those with heart problems or asthma.

The industry can be just as daft when it comes to fair coverage of those things, too, but I look at mental health issues differently than most, given my own experiences. [Summed up in OCD Christmas, The Bad Pill Kept Me From The Good Pill and The Most Uncool Addiction]

Here’s the intro to Kay’s report:

Spiraling medical costs have driven many employers to place new limits on coverage for mental health care, raising concerns that the rules may violate federal regulations intended to make it as easy for patients to see therapists as other doctors.

At issue is the growing practice of requiring therapists to undergo lengthy and repeated phone interviews about their patients’ progress before the insurance company will approve further treatment. According to patients and therapists interviewed by the Globe, the reviews have established tougher criteria for additional visits and have been burdensome and intimidating. That has sometimes led to curtailed treatment and protracted appeals.

Among those feeling the squeeze are state and municipal employees who get their insurance through the Group Insurance Commission, a quasi-state agency that provides mental health coverage for more than 100,000 workers and their families.

The commission, facing double-digit increases in its mental health insurance costs, changed its rules last year and now requires therapists who are not in the commission’s roster of approved specialists to justify, usually through lengthy telephone reviews, a patient’s need for continued treatment after every 10 sessions. Previously, the commission simply required the therapists to regularly fax the insurer a progress report.

I would be simple to point the finger at one party and say they’re evil. Truth is, this is a mess that’s splattered all over the place. I think most employers want to do the right thing and offer the best coverage possible, but when costs spiral out of control they sometimes make decisions that prevent the mentally ill from getting the right treatment.

It’s especially easy to say the health insurance industry is the devil in this tale. After all, it’s the one making this outrageous demand for lengthy phone interviews before approving further treatment.

But I’m biased. My view of the health insurance industry is that decisions are based exclusively on the bottom line than on what’s right. I see it all the time. I also take the simple and probably naive view that if a sizable chunk of one’s salary is being used to pay for healthcare and all the extra expenses that come with medication, the insurer has no business putting the squeeze on patients.

I’m not an expert. I can only base my opinion on personal experience. But I’ve heard enough horror stories from other people to know this crap is for real.

That’s exactly why I started this blog.

I chose to out myself and share my experiences so other sufferers might realize they are not freaks and that they have a legitimate, very easily explained medical problem that’s very treatable. It takes that kind of understanding for someone to get up and get help.

I try not to engage in political debate because this is such a personal issue, though sometimes I have to make a point on current events like I did when Health care Reform passed in March.

I do know this, though: Many good people have died because of mental illness. They were ashamed and afraid to get help because of the stupid notion that they are somehow crazy and either need their ass kicked or be institutionalized. So they try to go it alone and either end up committing suicide because their brains are knocked so far off their axis or they die from other diseases that develop when the depression forces the sufferer into excessive eating, drinking, starvation, drug taking or a combination of these things.

There’s also the ridiculous idea that a person’s workmanship becomes valueless when they’re in a depression. If someone misses work because they have cancer, they are off fighting a brave battle. They are fighting a brave battle, of course. No doubt about it.

But depression? That person is slacking off and no longer performing.

I’ve been able to debunk that idea in my own work circle. It helps that I’ve been blessed to work with exceptional, amazing and enlightened people.

Luckily for me, I got rid of my fear and anxiety long ago, so I’m going to keep sharing my experiences. It probably won’t force change  or tear down the stigma single-handedly.

But if a few more people get just a little more fight in them after reading these diaries, it will have been well worth the risks.

The Brenners Invade The White House

The author on returning from a journey that would have been impossible a few years ago.

It’s 5:30 a.m. and I’m running on less than four hours of sleep, so excuse any typos that follow…

I’m back in my “sunrise chair” the morning after returning from one hell of a road trip that included a private tour of the White House West Wing, a stay at buddy Alex Howard’s place and a stay with our wonderful Maryland relatives, Charron, Steve, Stevie and Maggie.

There’s a lot about the trip I’m still stunned about. I’m still in awe of the fact that I got to poke my head in the Oval Office and Cabinet Room and that I got a quick peek inside the Situation Room when a staffer was leaving the main room (the Situation Room is actually made up of several rooms).

I’m very thankful for Howard Schmidt for giving us the tour and for Alex for letting the whole family stay in his cramped but very cool townhouse on Capitol Hill.

I’m also thankful for the level of recovery I’ve achieved, because without it I never could have done the trip, especially with the whole family on an 8-hour drive down and a longer, 12-hour drive home Sunday (lots of traffic).
I’ll be honest and tell you I wasn’t perfect this trip. Friday morning we got a late start to the day and I found myself in an OCD-enhanced mood dive. It was a classic control freak out: I wanted to show Erin and the boys EVERYTHING. But with two small kids with shorter legs than their Dad, you can’t do that. And for a few hours Friday afternoon, as we walked from the Lincoln monument to the Museum of Natural History, I was in that brain-clouding mood I used to live with 24 hours a day.
But it was still a good day, and an even better night. Being in the West Wing of The White House, where every president of the last century has toiled away (some for the good, others for the not-so-good), was just magical for a history nerd like me. And I’m grateful my wife and children got to see it all.
It was a joy the next day to spend time with our Corthell cousins on the Maryland coast: Charron, Maggie, Steve and Stevie. Such a wonderful family. Charron took us to a maritime habitat that included time out on the water and inside a really cool lighthouse.
I especially enjoyed watching Maggie and Duncan bond during the boat ride.
So why wouldn’t this trip have been possible a few years ago? For starters, driving ANYWHERE outside the comfortable confines of the north-of-Boston area used to send me into panic. My fear and anxiety extended to a terror over getting lost. Even getting lost in Boston was cause for fear.
This trip, I did the whole drive down and back with none of that. I even enjoyed the journey.
I also wouldn’t have had the guts a few years ago to inquire about a White House tour. Too much work and I’d have to actually talk to someone with a big title. That would have been too intimidating.
I also would have been afraid to take the time off from work, since being a people pleaser was more important than living back then.
My 12-Step recovery program helped a lot. It kept me from wasting time and energy on binge eating and so I got to experience more from the journey. My Faith also helped, because I know now that the key to everything is to Let Go and Let God. I worked my tools, and everything was fine.
Not perfect. I feel like an idiot for taking that mood swing Friday afternoon. I also realize now more than ever that I’m addicted to computer screens. Erin decreed that we leave the laptops behind and I’m glad we did. But man was it hard to not run to a computer and upload those White House pics right after taking them. That’s something I still have to work on.
But then I knew I was still a work in progress. I always will be.
But I’m a grateful, lucky work in progress.

How a Binge Eater in Recovery Packs for a Trip

The author’s program of recovery from addiction makes travel more interesting. Here’s how.

Mood music for this post: “White Trash Circus” by Motley Crue:

[youtube=http://www.youtube.com/watch?v=1w5eegIa97s&hl=en_US&fs=1&]

Traveling was easier when I had my face in the junk food. I would just buy whatever poison I wanted to binge on and that was that. Of course, in doing so I had practically no drive to get out there and live.

A couple years into my 12-Step Recovery program, there’s a lot more preparation to be done on the food front. Breakfast and lunch for each day of the trip gets packed in advance. I’ll do the restaurant thing at dinnertime each evening, but my choices will be limited to my plan.

Otherwise, my meals look like this:

BREAKFAST FOR EACH DAY OF TRAVEL:

8 ounces of Greek yogurt

2 Ounces of granola

1 bannana

LUNCH FOR EACH DAY OF TRAVEL:

–10 ounces of vegetable (6 ounces cooked, 4 ounces raw)

–2 ounces of potato

–4 ounces of protein (meat)

Clean livin’ aint easy, my friends. But it beats the hell out of the alternative.

Road Kill (a Family Adventure)

The author on why he’s taking the family on a 10-hour car ride.

Mood music for this post: “Heading Out to the Highway” by Judas Priest:

[youtube=http://www.youtube.com/watch?v=MoDbAd4fYBA&hl=en_US&fs=1&]

A few years ago, this would have been impossible.

I never would have put the whole family in the car and driven 10 hours south to Washington D.C. Too scary. Too much planning. Someone might break into the house while we’re gone.

Well, the house part is a valid concern. So before anyone gets any bright ideas, I should note that I have someone staying here to look over the place while we’re gone. My neighbors are keeping an eye on things as well, and you don’t want to piss them off. Trust me. I write about security for a living, so I always plan these things out.

So we’re going to the nation’s capital because a friend works in the White House and we’re getting the tour. It’s also high time we took the kids to the Smithsonian museums. Meanwhile, Duncan thinks the Lincoln Monument is part of the White House and doesn’t believe me when I tell him that’s not the case. So I have to show him the evidence.

Living on a tight budget, we’re driving down and staying at a friend’s house and then a cousin’s house. We’re packing lunches to take along instead of buying restaurant food.

I’m grateful to the folks who are making this trip possible, because this will be something that the kids remember forever. Pictures will follow.

I should also point out that I won’t be posting anything new here until after the trip. My laptop is staying behind.

So here’s another reason this trip will be so special:

Back when I was tight in the grip of fear, anxiety and depression, the mere thought of embarking on something like this would have been too frightening. The work involved. The planning. Leaving the house. All notions that were too terrible to contemplate.

Now I realize how Blessed I am that I can do something like this for my family.

And I’m looking forward to the ride down almost as much as being at our destination. I used to hate long drives. Today I love a good road trip. The planning is a lot of work, but it doesn’t take the wind out of my sails like it used to.

I’ve done this run a couple times now on the RV to the ShmooCon security conference, though I wasn’t driving.

This is what you can do in Recovery.

Seize it.

The Fear of Current Events

Digging through storage boxes the other day, I found old, 20-plus-year-old copies of Time Magazine, Newsweek, Mother Jones and a host of others. There had to be four years of them, well over 200 volumes.

And so I was reminded — again — of all the fear I used to carry around.

As I’ve written before, fear and anxiety were byproducts of my particular brand of OCD, just like my addictions were a byproduct.

The fear meant a lot of things. Working myself into a stupor over the safety of my wife and children. An obsession with cleanliness, which was interesting since depression always meant my personal hygiene took a dive.

It also meant a fear of world events. When that Nostradamus movie “The Man Who Saw Tomorrow” came out on HBO in the early 1980s, I was terrified by the “future” scenes, especially the one where New York and Paris are destroyed in nuclear attacks.

Later, when Iraq invaded Kuwait, I thought the scene from above was playing out and it left me in a huge depression, one where I stayed in my basement with the lights off.

Similar emotions took hold on Sept. 11, 2001. Of course, those emotions took hold on everyone that day.

Most recently, in 2005, I had a long panic streak over the bird flu in Asia, which was predicted to be the next great pandemic, as deadly as the one in 1918-19.

I would read every magazine and every website tracking all these world events as if my personal safety depended on it. If a hurricane was spinning in the Atlantic, I would watch with deepening worry as it edged closer to the U.S.

When did all this stop? It’s hard to pin an exact date or year on it.

I only know it stopped.

One day the anxiety attacks stopped. Then I started to crave all the experiences I once feared. Not the terror attacks, plane crashes and pandemics, mind you, but the traveling, the public speaking and more intensified writing. One day I started craving those things with the same vigor with which I craved all the junk I polluted myself with.

Therapy — years of it — and Prozac definitely played a role. So did my deepening Faith.

Whatever it was, I’m glad it happened.

Just Like a Car Crash

The author is in a pretty good mood for a guy who cracked up his car last night.

Mood music for this post: “Stigmata” by Ministry:

[youtube=http://www.youtube.com/watch?v=rbMbTx6HyvE&hl=en_US&fs=1&]

Last night, on the way home from an OA meeting, I cracked up the car. Badly.

The good news is that nobody was hurt, though my car is another story. The front end is smashed in. Oddly enough, the headlights, while popped out of place, are intact and working. Even the front bumper looks unscathed. The grill and hood are a mess, on the other hand.

The other person involved in the accident was very nice, as was the cop who pulled up, surveyed the scene and took the report.

Now I’m sitting here remembering 1997, the year my 1996 Ford Escort was smashed no less than three times.

Now I have to work from home, call the insurance folks and file the accident report with the Haverhill Police, Registry of Motor Vehicles and my insurance agency. This, on top of an already jam-packed day where I’m trying to get a lot of work done ahead of the trip to Washington later this week.

But strangely enough, I’m not depressed. Much. I don’t even think it would be accurate to say I’m stressed. Much. I’m certainly annoyed. A lot. But I’m not undone. Not one bit.

I’m not binge eating or drinking.

I’m not melting down from an onrush of fear and anxiety.

I’m just intent on doing what needs to be done today, and I feel calm.

Compared to how I reacted after those 1997 accidents, that’s some heavy-duty progress.

Peace With the Past

As bad as the past was, the author is no longer afraid to face it.

Mood music for this post: “Yesterdays” by Guns N Roses:

[youtube=http://www.youtube.com/watch?v=57Fic0XjrSs&hl=en_US&fs=1&]

The Guns N Roses song above is about letting the past go. “Yesterdays got nothing for me,” Axl Rose sings. I used to feel that way. But lately I’m finding it’s OK to go back into the past.

I thought it would be better to leave past relationships in the dust because it would be too painful trying to resurrect them. I also thought it would be too damaging to those from the past who I’ve hurt.

Sure, I’ve been through the meat grinder. A lot of memories are bad. But nestled between those memories are some good stuff I now realize I should treasure and be grateful for.

When I dug through some boxes in storage Saturday, one of my discoveries was a VHS copy of a 1991 performance if “Cabaret” put on by the theater group at North Shore Community College, where I went before Salem State.

A good friend of mine played a lead role in that play. I reconnected with this person on Facebook a couple years ago. She’s happily married with a great job and two beautiful children. But back in the day, she went through a lot of difficult stuff, including the death of a parent.

When we talk about the past she often can’t remember a lot of her time at NSCC because the memories are too painful. And on the surface, given how Blessed her life has been in more recent years, I can see why she’d prefer to leave the past where it is.

But that video tape is a snapshot of some of the fun we all had back then, too. It should be OK to remember the good stuff, as long as we don’t let the memories consume us and keep us out of the precious present.

She may disagree with me on that one, so I’ll keep her identity secret here.

There was a time when I wanted to leave the past sealed away. Then I went into therapy for OCD and had no choice but to open that vault. I had to because that was where I had to start on the path to sanity. I had to re-examine what happened to figure out how I got the way I did and, when I went into a 12-Step recovery program for the compulsive binge-eating addiction, I had to keep digging up the past because that’s an important part of the program. When we share in an OA meeting, we discuss how we used to be, followed by the moment we entered program, followed by what our lives are like today.

At the end of each meeting, we read something called the promises, which has this passage:

If we are painstaking about this phase of our development, we will be amazed before we are half way through. We are going to know a new freedom and a new happiness. We will not regret the past nor wish to shut the door on it. We will comprehend the word serenity and we will know peace.

I didn’t understand that idea at first. Now it’s something I cherish.

By not shutting that door, I’ve been reconnected with people who were important to me back then. And while those relationships can never again be what they were, getting back in touch with them has shown me that I was wrong about some of my past. Specifically, I thought those people hated me now. They don’t.

The biggest example is Sean Marley’s widow, Joy.

She’s remarried with kids and has done a remarkable job of pushing on with her life. She dropped out of my world for nearly 14 years — right after Sean’s death — until recently. I assumed  she hated my guts and wanted nothing more to do with me. I wouldn’t have faulted her for that. I hurt a lot of people back then. But I’ve at least learned that she doesn’t hate me.

I have to be careful with this particular reconnection. I still have a lot of questions about Sean’s final years and the OCD in me wants to know everything now. If I’m lucky, some answers will come in time. But I’m not going to push. I have no right to.

Besides, simply being reconnected is, as Joe Biden might say, “A big fucking deal.”

Finding my brother’s 1984 high school yearbook was a big deal, too. I had worked so hard to keep those memories in the drawer that I had almost forgotten what he looked like. That’s a shame. Now I remember, and it’s all good.

Finding old pictures of me and my great-grandmother reopened a chamber in my brain of memories to be treasured. I’m grateful for that.

The key is to keep the past in perspective and not let the life of today be shackled by whatever came before. You can never really go back.

But you can enjoy the good memories sandwiched between the bad.

That’s what I’m learning, anyway.

Granny

The author introduces his Granny, a funny gal with an edge.

Mood music:

http://youtu.be/9mcloY9BlOU

During my storage dive yesterday, I found a bunch of photos of me and my late great-grandmother, Jesse Wiener. She was Granny to me.

My first memories of Granny are from the basement in the old house in Revere. I’ve written about that basement as my hiding place, but a decade before I took the space over Granny lived there.

We would sneak down there in search of doughnuts and cereal in the little boxes. I’d bring my friends downstairs and ask her to do the teeth trick, where she’d push her dentures out and back in again.

She had a couple different dogs during that period. One was a vicious  little scamp named Gigi, who met an untimely death after swallowing a pill Granny had dropped on the floor. I forget the second dog’s name, but I do remember he was docile and ugly. In fact, the day he arrived Granny laughed so hard over his appearance that she went into a crying fit.

One night my mother had Laurie Cabot, the witch of Salem, over to read palms. She refused to read Granny’s palm because Granny wouldn’t stop laughing at her. That’s how the story has been told over the years, anyway. I believe it.

I do know Cabot was in my house, because I snooped a bit that night. I was supposed to be in bed but there was too much commotion and noise that evening.

That was the 1970s for ya.

Granny eventually moved to an elderly apartment building at the other end of Revere Beach. She was always sick with one ailment or another but her wit was still like a double-edged knife.

One Christmas, as she struggled up the stairs to my mother’s place, my mother yelled down “Merry Christmas!” Granny yelled back, “Oh, fuck you.”

Granny used to delight me with stories of her younger years. She ran a nightclub in Boston that a lot of drag queens and mobsters hung out in. There was the story of a large snake found in a bathroom toilet, and when the movie “Johnny Dangerously” came out she laughed herself to tears. The mobsters in the film were just like the characters she used to deal with. This part especially hit home for her:

<object width=”853″ height=”480″><param name=”movie” value=”http://www.youtube.com/v/gA02GZLHd8M?version=3&amp;hl=en_US&amp;rel=0″></param><param name=”allowFullScreen” value=”true”></param><param name=”allowscriptaccess” value=”always”></param>[youtube http://www.youtube.com/watch?v=gA02GZLHd8M&version=3&hl=en_US&rel=0]</object>

Yes, she told me, the mobsters did do a lot of nodding.

I especially appreciated Granny’s humor because she had a hard life.

Her husband had a fatal heart attack in the 1930s and she never remarried. She brought up my Nana and two great-uncles on her own. In the 1950s, she was hit by a car on Revere Beach Boulevard and lost most of her money in the ensuing hospital stays.

She lost a lot of people in her life, including my brother. I’ll never forget, as long as I live, the night my brother died. Granny was driven to my mother’s house late at night and when she came in the house and demanded to know what was the matter, my mother told her. I’ll never forget how she collapsed into a pile of rubble right there.

But she was made of leather, and she bounced back. She always bounced back.

Though there was a lot of love from her to my grandmother and my mother, the relationships were also pretty volatile. A lot of abuse was passed down the family line. Saying so will piss off some of the people in my family. But it’s the truth, and those who might take offense are already pissed at me, anyway.

I’m pretty sure I inherited some of my addictive and obsessive-compulsive impulses from Granny.

But that’s not her fault. I’ve learned that in many ways, a person can’t avoid the addictions their genetic code comes embedded with. Nobody becomes an addict because they woke up one day and decided it would be a shitload of fun. We evolve into addicts because we’re trying to smother deep emotional pain.

I inherited something much more important from Granny: That biting sense of humor. It has gotten me through the roughest moments of my life. I can never thank her enough for that.

Granny spent most of the last year of her life in a rehab center after going through surgery. I can’t remember which limb was being rehabbed. While there, she discovered her long-lost brother was also a patient there. That reconnection was a gift of the wildest sort. It’s a drag that they would only have weeks to enjoy it.

I was very wrapped up in my own sordid world that year — 1994 — and I never got around to visiting her. I was a self-absorbed idiot knee deep in other, less important things that seemed pretty important at the time.

You might say it was revenge that she died a couple hours before my 24th birthday, on Aug. 25, 1994.

I don’t consider it revenge, though. Some would lament having their birthday ruined, but to me it wasn’t ruined at all.

In a strange sort of way, I’m honored that she picked the hours before my birthday to leave this world. She had suffered enough. It was time for her eternal reward.

Spending that day remembering her and all the wonderful stories was a pretty good way to spend a birthday. I wouldn’t change it for the world.

Thanks, Granny.

Digging Through Trash, Finding Treasure

I’ve slowly been digging through a bunch of old boxes I put in storage in my father’s Saugus warehouse, and while I have yet to find my old journals, I did strike some gold in today’s rummage fest.

The biggest find of all: my late brother’s high school yearbook, which he never lived to see. Near the end of the book they put a page in tribute to him.

Also in the pile: A very faded photo of my brother fishing on the Marley Family boat. At the wheel is Sean Marley. This is around 1980, half a decade before the friendship between me and Sean truly began taking root.

I also found pictures of my great-grandmother, Jessie Wiener. To me, she was always “Granny.”

Expect upcoming entries that focus on these finds.

OCD Humor

It’s Saturday morning and my brain is fried (but sober and abstinent, so it’s all good). I’m waking up to some videos that do a delicious job of poking fun at my condition. Since I love videos that poke fun at my condition, I must share:

Ringu the OCD cat:

[youtube=http://www.youtube.com/watch?v=hyHaSYvwrY4&hl=en_US&fs=1&]

OCD granny:

[youtube=http://www.youtube.com/watch?v=TEleD6klvhc&hl=en_US&fs=1&]

As Good As It Gets:

[youtube=http://www.youtube.com/watch?v=44DCWslbsNM&hl=en_US&fs=1&]

Howard Hughes OCD (not meant to be funny, but with my sense of humor, well…)

[youtube=http://www.youtube.com/watch?v=d7ucqimdau8&hl=en_US&fs=1&]

OCD patient on Grey’s Anatomy:

[youtube=http://www.youtube.com/watch?v=ETFQ9fyRP0s&hl=en_US&fs=1&]