Thursday, March 15, 2012

"Do You Think..." ?

How's my mental health today?

I've been thinking about why mental health is an issue for me.

After my mother read some of my writing two weeks ago she asked me, "Do you think my being depressed while pregnant with you is the reason that you have a mental illness?"

What a question!

I never knew my mother had ever been depressed. Learning that she had been depressed while she was pregnant with me added a whole new layer to the question of why I struggle with my mental health.

As we talked, my mother told me that she would get up with my dad, make his lunch and eat breakfast with him. When my father left for work she crawled back into bed and spent hours there. She would get up in time to clean their apartment and prepare supper before my dad got home from work. But why was she depressed? After all,, she was a newlywed, expecting her first child - what did she have to be depressed about?

The reality was that she was isolated, with very few, if any, supports. She was alone, a new immigrant, separated from her family by half a continent and the Atlantic Ocean. She spoke no English, her husband didn't want her to work (she was a qualified pediatric nurse) and didn't like her going out anywhere while he was at work.

So was she depressed because she was isolated? Or because she was homesick for her family? Maybe it was because she couldn't work in the field she had trained in?  Was it psychological? Situational?

For those of us who have a personal connection with mental illness, be it as someone with a disorder, or a family member, or a mental health care provider, the questions of why and how are very familiar to us.

Some would have you believe that mental illness is because of sin, a lack of faith; that it's a sign of demonic presence. These people piss me off! They shouldn't be allowed to speak. While there may be a spiritual aspect or underlying cause to someone's mental health issues, it is absolutely essential to know the person, their history, and their culture before even thinking about making that kind of judgement. Eleven years ago I met a young woman who was given a diagnosis of schizophrenia. She had a history of discontinuing her medications and experiencing psychosis in a fairly short time afterwards. This young lady was of Jewish background and lived with her mother and brother. Because of her history of med non-compliance and subsequent hospitalizations, her mother and brother monitored her use of medications very closely. She became a Christian and started attending a church where she was told that she did not have an illness; the voices she was hearing were of the devil. What she needed to do was renounce Satan in the name of Christ every time she heard these voices and Satan would have to leave her alone. Now she was put in a position of either obeying her mother  and brother and taking her meds as prescribed, or following what she was being told by the people "discipling" her at her church. (Imagine the inner conflict - her mother and brother were opposed to her conversion to Christianity - now she had to choose between lying to her family or her 'Christian mentors'). She chose to follow the direction given to her at church and pretended to take her medications; she threw them down the drain in the bathroom.  It didn't take long and this young woman had to be hospitalized involuntarily. It was five or six years ago before I saw her again and she had become an empty shell; barely able to communicate. She looked devastated and completely hopeless. I still get angry when I think about what happened to her. People who make judgements, and give direction and advice based on nothing more than their complete and absolute ignorance need to be put on a very short leash and permanently muzzled. (I actually had something much more severe in mind, but I restrained myself).

Excuse the rant!

Getting back to causes. There are so many studies and theories. There are the champions of the biological argument - but a strictly biological argument fails to explain why some people recover without medical and pharmaceutical intervention.

There is evidence to suggest a genetic component to mental disorders. I know that my maternal grandfather got severely depressed at times. One of my mother's sisters and one of her brothers struggled with depression, anxiety, and alcoholism. Her other brother has unbelievable anxiety and is also a very heavy consumer of alcohol. My mother had a cousin who was committed to a psychiatric institution, and her maternal grandfather committed suicide at the age of 87. Those are just the relatives I know about - there may be more.

Mental illness can also be caused by situational stressors, sociological issues, trauma, and lack of sunlight. A psychiatrist, Dr John Toews, presented an image of a cube inside a sphere to illustrate his theory of the cause(s) of mental illness. Each of the three visible sides of the cube had a one word label.  The three labels were 'biological', 'psychological', and 'social'. The cube was immersed in a sphere labelled 'spiritual'. It's a helpful image, but I think it fails to fully address the complexity of the issue.

I called my mother yesterday and asked more questions. I learned that the depression when she was pregnant with me began after Christmas and lifted in the spring (late April or early May). Maybe it was an episode of Seasonal Affective Disorder. Then she told me she went through another episode in the early 1970s. She said she just couldn't handle my dad's rages, his verbal assaults and physical beatings of his kids anymore.

She explained her question (regarding the cause of my illness) lay in the evidence that suggests that the fetus is affected and influenced by the mother's experiences during the pregnancy. We know many mothers sing and talk to their developing baby throughout the pregnancy. There is a story told of Mstislav (Slava) Leopoldovich Rostropovich, one of the best cellists of all time. His musical gift was supposedly influenced by his parents beginning when he was just a fetus. His mother was a concert pianist, his father a cellist - his mother's rehearsals supposedly impacted him to the point that piano was his first love. Even when he was a world renowned concert cellist, he would start learning a new cello work by playing it on the piano first. So is there an in utero influence that contributes to an individual developing a mental illness? I don't know. I've never researched that.

I've often wondered how much, if any, of what we label mental illness, such as depression and anxiety, is a learned response to stressors. If there is a generational pattern of anxiety and panic, or withdrawal into depression when subjected to the pressures of stress, I think it is reasonable to suggest that part of the response is learned behaviour. I don't know. But I do wonder about it.

What causes mental illness? Only God sees the whole picture and knows the true and complete answer.

For myself, I believe it's more important that I focus on how I respond to my illness rather than bogging down in finding cause.

Some people feel guilty about their anxieties and regard them as a defect of faith but they are afflictions, not sins. Like all afflictions, they are, if we can so take them, our share in the passion of Christ. 
~~ C. S. Lewis

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