Friday, March 28, 2014

Psychosis and Living with "The Voices"

   The report came in: "We have a suicidal patient with two large slices running laterally along her wrists. Bleeding controlled and patient cooperative. We will arrive to your facility in five." 
   
  It always catches my attention when I see a truly suicidal patient. Our healthcare system allows for a lot of "suicidal patients" or people in stressful situations who make passing comments, shoot texts about life being difficult, or maybe they upset the wrong person. When deemed "suicidal" at triage, there is a lengthy series of events that must occur to ensure proper screening and treatment of true suicide. With these patients, we go through the protocols and are prepared in case they were to become a danger to themselves or others. Truly suicidal patients do not exist as often-possibly because they are successful. When they do show up, their attempts often leave us with the double challenge of the physical and the mental to treat.

   This patient was different than the normal, truly suicidal patient. The voices had been telling her all day how worthless and what a burden she was. They had pointed out that she was over fifty, unable to hold down a job, and completely dependent on her eighty-year old parents due to her mental instability. They had pointed to the razor blades in the bathroom and suggested she help society. The voices had only been silenced after she carved the second linear slice through the layers of her skin leaving exposed tendon. She "awoke" to find her wrist bleeding and after an hour of trying to control the bleeding, woke up her father to request a trip to the ER.

  Now pause and rewind thirty years. She was in her early 20's, driving to Reagan National Airport to pick up her father. He was a Marine and flying in to visit. She was a successful TA in a well known college in the area with an incredibly bright future. That day her world changed.

   A driver of another vehicle side-swiped her vehicle at highway speeds. She was unable to regain control of the vehicle. Firefighters using the Jaws of Life pried her limp body out of the pile of metal. She was rushed to the Hospital. She survived the experience, but in many ways several parts of her remained in the wreckage. 

  She spent hours over the next ten years in exploratory surgeries as specialists attempted to repair the damage causing residual symptoms. One of the surgeries she needed was a total jaw reconstruction and a repair of part of her skull. When she awoke from the surgery, it was evident something had gone terribly wrong when she began to seize. She was diagnosed with epilepsy and more medications were added to her already growing list.


   Shortly after the accident, she began to struggle with depression. Raised in a very strong and successful family, she had a wonderful support group including several siblings, but her new-found limitations and dependencies wore her down and made her feel like a burden. She was prescribed medications for depression and assigned counselors. Things seemed to stabilize until the reconstructive surgery. Suddenly she was hearing voices. The voices were loud and unfortunately very much in the foreground of her world. They continuously reminded her of how worthless she was and how much everyone had to accommodate her. These episodes would throw her into acute psychotic medications. Doctors prescribed more intense therapy and stronger medications.

   Back to the present day and the woman that sat before me. Merely the shell of a woman. She drifted into the room and began to change and bag her belongings. The system is well known to her. Her eyes bulge wide as she listens to me. Her obvious analysis of my words and body language are reminiscent of a child on high alert for stranger danger. It is 0300 in the morning and her eighty year-old father sits in the waiting room reading his kindle and prepared for another long hospital visit. 

   As I update him, he explains. She was recently put on a large dose of Lithium-an extremely strong anti-psychotic medication-so that she could be discharged after months from the psych ward. The side effects of the medication caused such intense tremors that she was unable to walk. Doctors cut her dose in half and the voices returned-hence this episode. Not actual suicide, he believed, just a cry for help. His eyes looked to me for answers, "Her mom and I just don't know what to do anymore. She has a PHD from (a well known college) yet she rarely leaves her room. She can sit on her bed doing nothing for hours. She comes to me for permission to have a snack. Her siblings don't believe any of this is real and her mother and I won't be around much longer."

 

 Her story is duplicated in patients all around the world. I bring it to light because it makes me think about a few things. Most obviously, how many of us have so much to be thankful for-things that we don't even realize? Things like not being hit when that car cut us off last week or not having to take a pile of medications every day?
 The bigger idea her story makes me consider is about the thoughts I entertain daily. How many negative thoughts to I allow to float through my mind? How many of those thoughts do I entertain or explore in more depth instead of chasing them out? How many times do I look in the mirror and dislike what I see? How many times do I see another or  younger person's success and begin to consider how much of a "failure" I have been in that area? I am taking her story to an extreme in many ways but I wonder how much more you and I could accomplish if we removed those negative "voices" in our mind. I am a huge proponent of surrounding myself with positive people who share a mutual desire to challenge and improve both self and one another. While it is great to put yourself in a controlled environment, the larger question is what is inside of you and who or what controls that environment? Do we allow the media and society and the great thinkers of the world to control our thoughts or do we consider their opinions and make our own decisions based on a greater purpose? What makes their human thoughts more valuable than ours? Education? Experience? 

   These are just some things to consider as you wake up and begin another day, perhaps not happy at where you are. Consider what is inside of you and what your internal voices are saying, then consider replacing unnecessary ones with a more positive perspective.

Wednesday, March 26, 2014

So you think you want to date my mom?


So, you think you like my mom. You and a whole slough of the male population. What makes you special? Just to give you a foot up, here are a few things you need to know before even considering dating her:

1. My mom. She is MY MOM. She could potentially be your girlfriend, maybe even your wife, but she brought me into this world and has made me a priority my entire life. She has known me from diapers to diplomas and I'm not going anywhere. Us kids have made our fair share of mistakes and she's loved us through them all so don't even think you are going to be able to change that. If anyone would have changed it, it would have been my little brother and he's still in the will.

2. She is incredible. She is a rock. She is independent and strong and knows what she wants and puts her everything into getting it. If she opens up to you and makes herself vulnerable, I hope and pray you are wise enough to realize what a wealthy man you have become. There is another thing you should know. I grew up with a shotgun, rifle, and 9mil and am well versed in their use. I currently work as an ER nurse in the President's hospital. I have connections. If you hurt her...well, consider this a fair warning.

3. My mom does not tolerate facades and empty words. Be real with her and she will be real with you. Be fake with her and she will be real with you. She doesn't lie well and is not good at hiding her emotion. Learn that early on and be straight up with her. Oh, and that goes for me too. Don't even try to play any games with me. I've had the ultimate game been put down and have learned a thing or two.

4. I'm her daughter. I'm also her best friend. She opens up to me, even when she tries not to. I have the same problem. She used to terrify me by saying I would tell her my deepest darkest secrets in my sleep. It only scared me because I didn't know what else they were because I had already told them to her. I hope you are able to have that kind of connection with her, but know that I was there before you and I'm not going anywhere. Expect to have to deal with phone calls and visits and someday grandkids because she's always going to be a huge part of my life.

5.My mom is gorgeous. You already know that. She will occasionally complain about cellulite, extra pounds, grey hairs, wrinkles, etc. It is your job to find creative ways to complement her-not the, "Oh honey, you look great!" but something much more original. She and I don't listen to empty complements, so don't waste oxygen. There are old people who have to carry around tanks and could use it!

6.Perhaps you don't know this, but my mom has problems. She is human and she does have struggles. Finding someone you want to spend your life with is about finding someone who's problems you are willing to accept and perhaps help with. In return, they agree to do the same for you. It is give and take. She will give her soul but you better be giving yours in return. A selfless love is what she needs because it is what she offers. Be prepared to make sacrifices because she will do the same.

7.I'm an adult. Don't try to be my dad. I will treat you like family if you earn my respect by being real and treating my mother well. She deserves the best this world can offer. None of us expect you to be perfect-in fact we expect you to fail because we will fail. It is up to you to be willing to admit when you fail and make it right. We all struggle but we all help one another. It is what family is about. Don't bother with expensive things-they are nice but you can't buy my family.

For now, I think I have given you enough to think about. Just know, once you are in, you are in. We believe in trust and loyalty and I hope that you have a better understanding of what you are about to take on. It will be a lot of work, but I can guarantee you that if you are up to it you will never be disappointed.

Good luck!
Her protective daughter, Grace

Monday, March 10, 2014

"You Complete Me!"

     I am going to start with something that might not grab the attention of many, in fact it may dissuade many from reading further. I say that because I have been guilty of it. I am going to start with an excerpt from the Bible:
   Colossians 2, "See to it that no one takes you captive through philosophy and empty deception, according to the tradition of men, according to the elementary principles of the world, rather than according to Christ. It goes on to say, "For the entire fullness of God's nature dwells bodily in Christ and in Him you have been made complete, and He is the head over all rule and authority."

Background.
   Lately, several things have surfaced in my life that have made me question some of my views on relationships. My whole life I have lived in the US. I grew up in a small town. Life was simple and my concept of love was strongly forged by my surroundings. Lyrics to mainstream songs included, "What am I supposed to do when the best part of me was always you" (The Script), "Please remember how I feel about you, I could never really live without you" (the Beatles), and "Wise men say only fools rush in, but I can't help falling in love with you" (a UB40 remix). Movies frequently portrayed a female lead in some sort of distress or seemingly lacking in some area when suddenly she meets this man and life is forever better. Even at church, I was encouraged to be a lady and wait for the man to come along whom God would send and who would take care of me and be the supporter of myself and my children. As I matured into...well independence from my parents, I left with more of those core beliefs than I realized.

   Moving to D.C. was a bit of a shock when it came to my views on relationships. Women's rights advocates and progressive movements discourage the more "old-fashioned" approach and made my head spin as guys would make comments like "well aren't you going to get my number?" or "I thought you weren't interested because you didn't ask me out!" It was so backwards to what I was used to.

A Partial Person?
   As I began to consider all of these things, I realized that growing up, I was submerged in a culture that preached an "incomplete-ness" that would only be filled by a significant other. There was the occasional outlier that encouraged finding yourself in God, but the popular belief was much to the contrary. A similar mindset exists in D.C. although it uses a different and more politically correct approach.

   I will stop here and say I am not accusing my teachers, mentors, or parents of doing a poor job raising me. I am merely pointing out a popular idea in our culture that I believe permeates our mindset and can sabotage our expectations of relationships.  

   An idea is that you roam around aimlessly doing your thing and one day something happens and you meet this person who changes your life and makes you whole. You realize you cannot live without them and you realize how dull your life was prior to them. Essentially, the prior life you lived devoid of this person was simple preparation for this one moment and these new chapters of your life with this person. 

   In returning to the opening verses the Bible says, "See to it that no one takes you captive through philosophy and empty deception." I believe these ideas have held generations captive-especially the female side of it. I believe the Bible is very clear on the fact that only Christ can "complete" us. We have significant and unique needs that no one individual can fully satisfy. We are all human and that one individual who we commit to will fail and be unable to fulfill us every time. In addition, the added stressors of a relationship (i.e. kids, bills, work) will again distract them from satisfying or completing us. When this happens repeatedly, discontentment will set in and the temptation to look elsewhere for completion begins. 

   At the stage of discontentment, society allows us to believe we as individuals have "grown apart" or lost commonality. The escalated divorce rate demonstrates society's acceptance of realizing the relationship was good while it lasted, but now it's time to move on. Therapists push ideas like, "You deserve to be happy!" Perhaps we do, but is it happiness we are pursuing or joy?


"LightBulb" (Despicable Me)
   I offer an alternative. I have not had extensive experience, but what I see based on reading and observation is that the happier people are those who are complete without another human. They don't scour the earth looking for their soulmate and carrying a load of expectations to dump at their feet. Instead they take the initiative to be complete in something that does not change (Jesus). They then find someone with whom they share that commonality. In so doing, when hard times happen, they are shaken but their foundation is not shattered because it is something that humans cannot touch. Your relationship with Christ is like nothing else in life. People can hurt your family, your reputation, your feelings, even your physical body, but they cannot touch you and your God. 

   The encounter with this person that I found myself subconsciously waiting for...it isn't realistic. I expected this encounter, the following emotions and moments of passion to fulfill me, however feelings are up and down. As a wise person said, "Feelings are like the tides of the ocean:they come up and go back down. However commitment is like the ocean and is always there." 

   When I stop waiting around and work on completing myself in Christ, I am able to bring my "whole" self to a relationship instead of a person with gaps. From there I can choose to love freely. Society pushes the idea that love is something we have no control over and that we fall in and out of. With this new-found freedom, I am able to leave the details of the person to God. The best part about this mindset it that I will not walk into a relationship looking for what someone can do for me and what I can get out of it. Instead I will be loving the other freely with no expectations. Of course I would hope to be loved in return, but if they were to stop loving me, it would not leave me a broken and defeated person. Instead of "needing" the other person and being "unable to live without them" I am free to fully enjoy my moments with them, and still enjoy life when they are not around. Instead of fearing their death and wondering what I would do without them, I could enjoy our time together and realize that if they were to die, I will continue to live because I am "whole".

   I will offer another alternative as I realize many readers may not believe in God or a higher power. For those, I offer that you still work to better yourself and make yourself complete without waiting for another. Learn who you are, your weaknesses and your strengths. Identify what you want out of a relationship and acknowledge what it is you are willing to sacrifice. In the event you are unable to find yourself complete, perhaps you might consider the possibility of a God or Creator who has a higher purpose for you. The best way to identify what our purpose is here on earth and who is meant to complete us is to find out where we came from. 


Another Thought...
   Something that really bothers me about relationships is this idea that we always have to be focused on/thinking of that person. I am very independent and the thought of being so attached to another turns me off of the whole idea. With a "whole individual" approach, imagine all of the potential we would have to help others or better ourselves instead of spending every idle minute away from our lover thinking of them or wondering what they are doing. Those idle moments are when the "crazy" comes out and when temptation to cheat or thoughts of "what is he really doing?" begin.

   Finally, imagine what two whole and complete people could do if they joined forces. Think of superheroes. Those guys and girls who are singlehandedly saving the world. Then suddenly they get together with another who has superpowers and has been on their own doing just fine. Each understands that they have this "saving-the-world" gig going on, but each longs for the love and affection of another. Does it mean they lose their power? No, but together they are even stronger because they compliment each other.


   When we get our fulfillment in Christ, His love pours out of us. His love is perfect and does not make demands or look for it's own pleasure but rather seeks the best of the other. If you truly want to love to the best of your ability, tap into the love of Christ and let it flow through you.