The Stranger Within: Living With Mental Illness

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    A perspective on the special problems faced by healthcare professionals with psychiatric disorders. It's time to end the stigmatization and shame, and to recognize all mentally ill persons as human beings with a right to proper treatment.

    The Stranger Within: Living With Mental Illness

    The alarm jolts you awake as it does every morning after yet another restless, short night's sleep, throwing your systems into fight-or-flight mode as you groan inwardly: "Oh, lord....not again". Your mind fills with dread in anticipation of yet another workday; thoughts swirl and tumble, like squirrels in a cage, as you shower and dress for the day in dark and nondescript clothing. On a relatively good day, you might put on some makeup and a hint of perfume, while on others all you want is to blend into the background and it's an effort just to run a brush through your hair.

    At work, a compliment from the boss during stand-up sends you to Cloud Nine for the rest of the morning---suddenly you are INVINCIBLE and everything is wonderful! You breeze through your work while offering words of encouragement to struggling co-workers....and then somebody's family member berates you for refusing to give her mom 650 mg. of Tylenol every two hours around the clock. "What kind of nurse are you?!" she demands. "My mother needs to be PAIN-FREE, don't you understand that? I don't care if it affects her liver, you give her that Tylenol right now or I'm calling Senior Services!"

    You somehow end the diatribe with a polite "I'll see what I can do" while on the inside you seethe with rage, which quickly turns to fear and more than a little paranoia ("OMG, they'll report me to the BON and I'll lose my license and my family will be on the street, etc., etc."). The rest of the day goes by in a blur and you can't stay on any one task longer than a bird can stay on one telephone pole; and on the drive home you find yourself reacting with unreasonable and even inappropriate levels of hostility to other drivers who forget to signal before changing lanes.

    Of course, you've thought about all this and wondered why it seems as though there's a stranger living within you. You're so blessed to have a job, blessed to have a family and a home and enough money to live on; why isn't it enough? You've talked to people; you've tried sleeping pills or benzos; you've even prayed and asked God to quiet your mind and make you grateful for what you have. And yet....nothing works for long.

    Once home, you grunt a brief greeting to your family and try to act normal at dinner....whatever that is. Afterwards, you promptly bury yourself in whatever activity will isolate you until bedtime, when you once again find yourself anxious, agitated, and unable to sleep.


    That's what life with mental illness is like for all too many people, myself included. The difference between nurses and the general public is that we have a large knowledge base of diseases and treatments. Unfortunately, this is a double-edged sword because we tend to self-diagnose, often to our own detriment. About 11 years ago I asked my doctor for meds because I was going through a spell of depression---a condition that's recurred every few years or so since the age of 13---and he complied. Thus began an odyssey that finally led me to a psychiatrist's office recently......and ultimately to a diagnosis of bipolar disorder.

    To say that this journey has been rocky would be the understatement of the year. When my PCP referred me for the psych eval, I was immediately offended and became defensive: "I'm not crazy, Doc, I've just had very bad mood swings for forty years!" But with meds beginning to kick in---and as the recent excellent threads here at Allnurses on this subject demonstrate---I realize that we're really only scratching the surface of a vast and costly issue.

    There is something fundamentally wrong with the way mental illness is viewed not only by society at large, but even within our own ranks. Even here, we cannot agree on what constitutes a mental illness, let alone correct treatment, and there is often harsh condemnation levied against those who are too "weak"---or too lazy---to pull themselves up by their bootstraps, while the fact that many of us are barefoot when we hit bottom is forgotten in the rush to judgment.

    Even when there is an indisputable diagnosis, however, the stigmatization continues. Nurses taking anxiolytics and antidepressants are routinely accused of being unable to practice safely, while frankly, I wonder if the naysayers would rather have a nurse working on them (or their loved ones) who is as unstable as the example at the beginning of this article.

    As I said in one of the other threads, medications are usually the LAST resort because we're afraid of the possible repercussions of admitting to our psychiatric issues. We know that if this information were to end up in the wrong hands, it could affect not only our chances to get or keep a job, but our licenses as well, as many states require applicants to disclose conditions that could theoretically prevent one from practicing nursing safely. Who wants to go before the BON to explain their depression or BP II and be treated as if they had committed a crime?

    No one, and I mean NO ONE, chooses to have mental illness, any more than they choose to have diabetes or glaucoma or osteoporosis. Society doesn't seem to have a problem with medicating people who have physical disorders; why, then, should people be denigrated for taking meds to help straighten out their brain chemistry so they can work on the problems their illness has created? Antidepressants and antipsychotics are NOT "happy pills"; they are serious medications with a lot of side effects that we wouldn't ordinarily put up with if we had any choice in the matter. But then....depression, bipolar d/o, and other mental illnesses are serious diseases too. Deadly serious, in fact.

    That's why all of the long-held prejudices against healthcare professionals (and others) with psychiatric disorders need to end. Here. Now. With us. Let's spread the message far and wide that while there are many ways to treat these conditions---with AND without drugs---it is first necessary to recognize their existence. Thank you.
    Last edit by Joe V on Jun 16, '18
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  3. by   dream_nurse
    Very informative post. I know nurses that have been in the field so long that they have no compassion or empathy. They see patients as a diagnosis not as a person. I think this post is a beautiful eye opener. Thank you!
  4. by   nurseprnRN
    many years ago as i was leaving a very bad marriage, i underwent some intensive therapy. two years later, when she was discharging me, she told me that when she first saw me she wanted to hospitalize me. "really," i said. "that bad, huh?" "yep," she said. the only thing that stopped her was that i was caring for two children under the age of four, apparently doing it safely (and looking back, i can see she was constantly checking to see that all was well in that sphere of my life), and she knew their father, my narcissistic, abusive husband, was completely unable to do that, and there was no one else. my kids were the best part of my life; part of my motivation was to see that they grew up safe and happy.

    long story left out, i separated and divorced, got better, and discovered there was someone else inside my head: me. i'd been missing so long i barely recognized this healthy, creative, loving person. it was like putting on a beautiful party dress and realizing damn, i looked just fabulous. a few years later i became engaged to and married a lovely man who has just this minute walked into my office to put his hand on my shoulder and tell me he loved me so then and loves me so now, decades later. there are times when i wish i could go back to the city where i lived then to seek out and apologize to all the people i worked with, for being such a black hole of emotional energy. i must have been just horrible to be around. i do regret that deeply. fortunately my kids were so young that they don't remember it; they are both married to wonderful people and are providing me with a steady stream of completely perfect grandchildren.:d

    one of the things she taught me is that mental health is like physical health; using an analogy she knew i'd understand, she said i was like someone with major trauma: starting out in icu (seeing her three times a week, and barely holding on), then moving gradually to stepdown, a regular floor, and then outpatient care. i learned how to do a good home exercise program to keep myself in stable and then improving condition for my injury; i learned what kind of flare-ups to expect, and that i could handle on my own and how to do that, and what kind i had to go see a pro for.

    i tell my sweet husband that he wouldn't have liked me very much before i did all that. he doesn't quite believe me, but the little person inside my head remembers what it was like to be dead inside. i have never been dead since.
  5. by   VivaLasViejas
    Now THAT is a beautiful story, GrnTea!!! Thank you so much for sharing it with us. I'm absolutely thrilled for you that things have worked out so well.
  6. by   mazy
    That was beautifully written and poignant and I can't even say much more than that, because it really left me breathless.

    One thing I have always thought is that having bipolar disorder is like seeing everything in the world as if it were poetry, the highs, the lows, the wonder, the pain, and the intensity of it all, sometimes overwhelming, but always worthwhile.

    You have an amazing gift. Don't stop writing!
  7. by   Simply Complicated
    Very well said!! I absolutely loved your description in the beginning. I work in psych, it can be very sad to see what those living with mental illness go through. Especially when you see the torture it can be for the people who manage to function in their day to day life. Thank you for sharing.
  8. by   SHGR
    If I ever have to go before the BON and stand up and say that I have been mostly successful in my years-long battle with depression, I will have to say, every thing that I suffer helps me understand others that much better. Every chronic (crap) that I have, helps me in my work with others who have ANY chronic condition, because the daily struggle is in many ways the same-- whether it is a physical condition or a mental one.

    It has made me stronger, and a better nurse.

    Thank you for this beautiful post. We need to stand together.
  9. by   rn/writer
    Thank you for sharing a reality that affects many. Rather than being stigmatized, nurses who have battled mental illness ought to be commended for doing what other nurses do while they wear a ninety-pound backpack.
    Last edit by rn/writer on Mar 4, '12
  10. by   DixieRedHead
    What a wonderful article. And GrnTea, a beautiful story.

    Please for give my choice of words, but if you read my posts, you know that I lack a little bit in the PC department.

    My considered opinion of being mentally ill is, "If you ain't been crazy, you just ain't been crazy yet."

    Hang on, you'll get there. Been there, done that.
  11. by   allforthekidds
    Thank you for posting this. I have struggled with anxiety related issues since I was little(I'm now 34, currently a prenursing student), and in 2008 my stress and anxiety got so bad that I developed depersonalization(If you do not know what it is, do a google search there is lots of info on it). Depersonalization is in my opinion the worst and scariest symptom of stress and anxiety one can have. Long story short I found, by the grace of God, a wonderful website that specializes in this symptom and many other anxiety/depression related symptoms. It took me a couple of months to find this site, two long months of suffering. Before this No one knew what I was going through, because they never experienced it, they could not relate, so it translated to them as overexageration and they could not understand why I just could not "get over it." Well with the help of the people from the mentioned website, I did overcome depersonalization, it took a couple of years, but it has gone away. Long story short again, I have been accepted to a great nursing school and for my essay that I had to write to apply, I wrote about my struggle and triumph with depersonalization. I debated for a while if I should actually write about that topic because I didn't want them to think I was weak, but I decided that If I was going to write about a personal experience, I had to put myself out there and pray for the best. I got my acceptance letter five days from the day my application went under review, Praise God!! If anyone on here has or is struggling with depersonalization and need to talk, I would be more than willing to listen.
  12. by   VivaLasViejas
    Quote from mazy

    One thing I have always thought is that having bipolar disorder is like seeing everything in the world as if it were poetry, the highs, the lows, the wonder, the pain, and the intensity of it all, sometimes overwhelming, but always worthwhile.
    That's the best description of it I've ever read, mazy. It's also dead-on accurate, for life with this disorder is a wild ride---always a little too bright, a little too loud, a little too intense. Yet I already miss the highs, even as I swallow pills and remind myself that I never again want to feel the way I've felt these past few months, and I do fear losing the ability to create. I'm no Hemingway, but it's true that bipolars are often very creative and sometimes the tormented brain goes into vapor-lock when it's no longer quite so, well, tormented.

    But that's a worry for another day. In the meantime, I hope to help other nurses in similar circumstances, as well as patients and families who are dealing with the devastation of mental illness. I've been blessed enough to have a few really good friends reach out to me during this stressful time, and they have literally been my lifeline; now it's time to begin paying it forward. This article was the first step in that process. Onward and upward!
  13. by   GitanoRN
    thank you for sharing this post with all of us...aloha~
  14. by   dirtyhippiegirl
    My particular niche in nursing tends to attract patients who are overtly mentally ill, addicts, self-destructive, and/or usually a mix of all three. (I feel like a psych nurse at times, although I'm not.)

    I, personally, think that my very, very long history of self-destructive behaviors that led to dozens of psych hospitalizations, scores of psychiatrists, therapies, medications, etc. helps me...stay calmer when I'm dealing with someone who has an obvious personality disorder, is detoxing off alcohol, etc. I don't know if empathy is the right word. I think that implies certain emotional thought processes that I don't feel should be part of my nursing process - at least in regards to those issues.

    But I definitely am less apt to get angry or frustrated as quickly as some of my coworkers. Or as weirded out, for that matter. :lol:

    But that was a very touching article.