We have a lot of work to do in this country, to manage mental illness constructively. When my son Caleb was 16, he was admitted to a psych hospital for treatment, which only lasted 10 days. Then he was transferred to a drug rehab farm that was intended to be dual diagnosis. Though it was a fine facility with intensive counseling and psychiatric medication management, it was a nightmare. Caleb had tried to self medicate as a teenager with marijuana, which was devastating to me, as a parent who didn’t understand the desperation of mental illness, or really even what bipolar disorder was. However, to conform to his environment, he pretended to have done every conceivable form of drug abuse when he was admitted, and was bunked with “other heavy users.” It was in that confinement that he learned all the ways to abuse substances, where to get it and how to get it. His substance abuse skyrocketed when he returned home. The experience was also terribly traumatic because the facility felt insecure with the medications that had been prescribed for him, and ended up experimenting with 22 medications over a 30 day period. That was 16 years ago, but he still remembers it as one of the cruelest times of his life. His mind was put through more chaos by the medications than the disease had ever caused…and he was on suicide watch. After his release, his escalation of substance abuse led to the first of many arrests. For years he spent more and more time in jail, for Minor in possession, DUI, etc and finally at 17 was arrested for passing marijuana to an undercover officer and faced his first felony. He spent 9 months in jail one time, 14 months another time, 5 months another time…sometimes in county jails and sometimes in state jails. His mind and emotions were in such chaos that I had difficulty knowing what was going on with him…all I saw was illicit and extreme behaviors. I tried to reach out…he tried to respond…but before long he was bolting away and using again.
He learned to shave in jail. He grew up there from a scared kid with high anxiety to a toughened man who knew the culture of inmates and how to survive. As an adult, he has his own form of post-traumatic stress syndrome from all the time he has spent with hardened criminals, many of whom are also ill. As a young adult man living in the free world, he has had many struggles discerning the difference between the culture of normal upper middle class society and state jail inmates. His first response to an offense or perceived tension in another is to respond as he would in jail… not realizing that another person would not understand that violent ‘respect-driven’ reaction, in a peaceful society.
All of this, because we aren’t equipped to treat mental illness, and because bipolar is so misunderstood. We send an ill kids to a hospital to start their meds, then send them out to dangerous places. He’ll spend his life coping with his symptoms, but he’ll also spend it working his way through those knee-jerk reactions learned in a terrifying place for a sheltered kid.
We must find alternatives to spare teens in the future of what Caleb has endured. And the first step, is learning to understand the illness. Learning what is causing it…where in the brain is it taking place? Is it a generalized brain chemistry issue? Or is there a place in the brain to pinpoint it?
There was a time when I believed from what I read that somehow there was a chemistry in the fluid that washed over the brain somehow and that we were improving the balance of that chemistry with medication. I guess it was my lack of understanding about serotonin re-uptake that started that idea. But lately, I’ve been learning more and more about the amygdala and the work it does in conjunction with the hippocampus, the hypothalamus and some other brain things… and have learned that the anxiety, fear, rage and even sexual inappropriateness is actually originated there. Who knew? And if I just learned about that, imagine what we’ll learn in five more years? They’re talking in the neuroscience journals about laser surgery to the deep brain without an incision…deep brain stimulation (there is an article about that in our scientific section), and all kinds of possibilities. Let’s watch for them together.