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.
Lather......rinse......repeat.
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.
