"Criminally Insane"

We have a facility in the city where I live, called James Nash House. To use an outdated expression, it's a place for the "criminally insane". What I like about the expression is the fact that it uses the adjective, "criminally", thereby making a distinction between someone with mental health issues and someone with mental health issues that make them commit criminal acts. Not everyone with a mental health issue is a criminal. In fact, the number of non-criminals among the mentally ill is higher than that of criminals. Furthermore, if the only people committing criminal acts were the mentally ill, there would be no need for other prisons.

Despite that, the mentally ill can be stigmatised and misunderstood when it comes to crime - particularly homicide. Several months ago, the high profile coach of one of our local football teams was stabbed to death by his twenty-something year old son. The young man, Cy Walsh, was arrested, assessed and put into James Nash House. There were various responses on social media. They tended to fall into four main categories:

1. The poor Walsh family. What a disturbed young man Cy must be. I hope he gets the help he needs.

2. More money really must be put into mental health services.

3. People with mental illnesses are dangerous and should be institutionalised.

4. Cy Walsh is taking the soft option going into James Nash House.

Three and four were ignorant and judgemental, as well as stigmatising to anyone with mental illness. The idea that everyone with a mental illness is dangerous and should be institutionalised is ludicrous. It's not based on fact, at all. Yes, sometimes someone with a mental illness commits homicide. More often than not, however, homicides are committed by those deemed to be well. 

I've never been to James Nash House but I know that it's a prison, not a soft option. It's simply a different prison. One does not simply spend a year or so there and announce that they're better and waltz out the door. To even be put into there requires a thorough psychiatric assessment. I read a comment which said that pleading insanity was "the easy way out." I'd challenge that person to spend an extended period in James Nash House and see for himself how "easy" it is.

The controversy over the Walsh murder died down. Recently, however, there was another mass shooting in the U.S. This time, instead of using the tired slogan that guns don't kill people, people kill people, the gun lobby added mentally ill to the word, people, making their followers believe that only the mentally ill or criminals shoot people. 

To be honest, I tend to think that anyone who kills another isn't in their "right mind". That, however, is quite different to having a mental illness. With this change in slogan by the gun lobby, I'm concerned that the mentally ill, who are already marginalised and stigmatised, will find that life is even harder for them. Social media is currently rife with posts about how it's only crazy people and criminals who kill people. Define crazy. I suspect the gun lobby definition has nothing to do with the textbook definition of a mentally ill person.

I'm writing this post during Mental Health Awareness Week. It's great that so many positive posts are circulating on social media and that our national broadcaster has programmed many shows about mental illness and living with it. Given the Phil Walsh murder and the posts circulating in the wake of the Oregon college shooting, however, I think we still have some distance to go.

My form of mental illness is mild. I know others who have more severe illnesses. I can write quite categorically that the people I know with mental illnesses - myself included - are far more likely to kill ourselves than others. I suspect that the stats would probably reflect that, too.

The week is nearly over but, if you're able please watch or listen to one of the many shows on the ABC about mental health. We're really not gun and knife toting killers; we're quite nice people, actually.

What My Mother Taught Me

My sister recently tagged me in a Facebook post that read, “My mother taught me everything except how to live without her.” My sister and I were both very close to our mother so I fully understand the spirit in which it was posted. We have both grieved and struggled without her in our lives. My sister, being my mother’s “baby”, may well have been hit harder than me, and that seems unimaginable.

Be that as it may, I disagree that my mother didn’t teach me to live without her. The job of a good parent is to make oneself redundant. That is, to raise independent, fully functioning adults. My mother fulfilled that role, not only with me but with my sister. Emotionally, we miss the hell out of our mother. We can, and do, however, live without her every day and have done so for nearly nine years.

Being the older child, I’m sure my journey has been different to that of my sister but these are the lessons that I learnt from my mother, which have enabled me to live without her.

Ironic as it seems for someone with Panic and Anxiety Disorder, my mother taught me to live and explore without fear. She allowed me freedom from a very young age and I spent lovely long hours of my childhood on solitary bike rides. That freedom extended to walking to and from school alone from the time I was seven. Furthermore, as much as it must have stressed her, she allowed me to visit New York City by myself when I was just 18.

My mother taught me that a woman can be a mother and love her children without making her whole life about them. She had a full work and social life both when my sister and I were growing up and after we’d left home. I know she suffered when we’d both left home but she was also busy following her own pursuits.

By having a life apart from my sister and me, my mother was often out in the evening. This meant that, from my early teens, I was often responsible for organising dinner and clean up, and making sure my sister was bathed, teeth brushed and in bed. My mother groomed me well for my eventual transition into motherhood. The trust she had in me was illustrated by the fact that, when I was only nineteen years old, she made me the executor of her estate and gave me power of attorney.

The fact that I can and do live without my mother doesn’t mean I enjoy doing it. I miss her voice at the end of the phone line. I miss dropping in on her and having a chat over coffee and biscuits. I miss asking her family history questions. I miss telling her about the minutiae of my life. I miss her cooking. I hate the fact that she hasn’t been a part of her grandchildren’s lives. There are so many moments in all four of their lives, I know she would have loved being a part of. I wish that our new “surrogate daughter” could have met her. I wish that, as I went through all my gynaecological issues, she’d been around to tell me about her own experiences and been a sounding board for me to bounce ideas off of. Not a day passes that I don’t miss some small thing about her.

My mother lost her own parents within nine months of each other. I saw her grieve for them. I also saw her pick herself, dust herself off and get on with the business of living. She taught, by example, how to eventually live without her.

Another Reunion

Quite some time ago, I wrote about our annual "Old Girls' Conversazione" at the high school I attended. Here is the link. In it I wrote about why I enjoy attending and the effect it has on me.

Yesterday I attended a reunion of my former ballet school. I hadn't been in that studio or seen many of those people for thirty six years. These days I'm in touch with two friends from my ballet days. One, J, I also went to school with; she left school at the end of Year 10 to pursue a career in dance and we stayed in touch, lost touch and then reconnected on Facebook. She was the one who invited me to the reunion. I invited the other one, S. (She knew about it already but I think my invitation sealed the deal for her.) We also lost touch, ran into each other and learnt we lived near each other and have spent the past ten or so years running into each other locally and saying we must catch up for coffee. We're also Facebook friends.

S drove me in so we spent nearly an hour bonding and sharing our stories in the car. We were both excited. I was also nervous that no one would remember me. As soon as we got there, we saw J, who had brought her mum, and the four of us had a great time catching up and reminiscing.

S had spent about ten years at the ballet school; I'd only spent three, having come from another one, and we both stopped around the same time. J, of course, stayed on longer than us so she knew far more people and was comfortable and confident walking around and chatting to people. S and I talked to fewer people but still had a great time.

J confided in me that she didn't want to come to any school reunions because she felt like she barely knew people from school. It hit me later that our positions were reversed. I love school functions. The people I met in my school days had a profound effect on who I was and who I became. The teachers and the older girls were my inspirations when I was at school. Our school motto was, "Not for School but for Life," and that has held true for me.

As I watched J in her element at the ballet reunion I understood that the people she met in her ballet days were the ones who had the effect on who she was and who she became and it was our ballet teacher and the older ballet students who were her inspirations.

I had fun being in the old studio, looking at the photos, seeing my former teacher (who has not aged one bit) and catching up with old acquaintances. I enjoyed the nostalgia of seeing the colour ice blue everywhere, hearing my former teacher ring her old bell to get our attention and walk the floor I'd once danced across. Over the years, I've sometimes wondered if giving up ballet was a mistake. It was clear to me, yesterday, however, that I have no regrets. It was an enjoyable afternoon and it gave me some closure.

Eulogy for a Tender Hearted Friend

A few days ago, one of my friends had a headache and took a nap. She suffered from debilitating headaches so this was not an unusual thing for her to have to do. Sadly, she never woke from her nap. It would seem logical to assume she was taken by a blood clot to the brain or an aneurism but that's not what happened.

K was 35 years old and the fittest and healthiest she'd been in the twelve years that I've known her. Yet, she died of Spontaneous Coronary Artery Dissection, an extremely rare cardiac event. It's an event that doesn't fit your "typical" heart patient; it can happen to anyone. And it happened to K and her family and friends are lost for words at the shock of it all.

It's an absolute truth that, no matter how unpleasant someone has been in life, we canonise them after they die. It's also an absolute truth that K deserves every wonderful thing that has been said and written about her. She was one of those people the world needs more of. She was kind, tender hearted, generous and loving. She took great care of her family, friends and animals. And she did it quietly. One really had to get to know her to fully grasp how much she did for other people because she was not one to seek attention. Her family and friends knew, however, and loved her for it. Her husband and two sons adored her. Their love for her was palpable and it was returned tenfold.

I know a handful of people and K was one of them who just cannot see their own worth and value. If she could read all the tributes to her, she would probably say, "Pffft!" I wish she could have seen herself through the eyes of her family and friends who loved her so much. I wish she could see the emotional devastation her passing is wreaking on her family and friends. I know, however, that she wouldn't have been who she was if she could have. And we loved her just the way she was and will continue to do so.

When a loved one is taken - particularly suddenly - we examine our own lives and wonder how we can make better use of our time. We wonder how we can honour that person and incorporate some of their spirit into ourselves. We tend to agree that we must savour every moment. For me, in the wake of K's passing, I want to be fully present in every moment, especially when I'm with others. I don't want them to feel like I'm planning my response to what they're saying or even what I'm going to cook that night. I don't want them to feel like I prefer my phone to them. I want to express my love and appreciation for my family and friends more often in both words and deeds. And most of all, I want to try to follow K's shining example of how to treat people. That's how I feel I can best honour my friend, K.

Rest in peace.

Way Back at Easter

This year the first night of the Jewish Passover fell on the evening of Good Friday. We were invited to first and second night seders on Friday and Saturday nights and lunch at the home of friends of my husband’s family on Sunday. I was looking forward to our somewhat busy and social weekend.

In the lead up to the Easter long weekend my throat began to feel scratchy, which was no surprise because others in the family had colds. Friday I woke up feeling bad: sore throat, cough, fatigue and a nose that wouldn’t stop running. I rested as much as I could, hoping to feel better by the evening. I also filled myself with vitamin C and olive leaf.

Friday evening rolled around and I still felt no better. I decided, however, to go anyway. That, in and of itself, was a big decision for me. Going out when I feel unwell challenges my anxiety and puts my body on high alert, “Flight or Fight”. Furthermore, I would have felt embarrassed to have left a seder before it ended (unless I'd been very unwell.) Those thoughts increased my anxiety. After we arrived, there was a delay and the seder started forty five minutes late. All this made me more and more anxious. All through the evening waves of fear washed over me, as I read, as I ate, as I talked. I stayed put and tried to exercise distraction by mindfulness, concentrating on the passages being read and the conversations I was having. The seder concluded and I survived, exhausted, unwell but also triumphant.

I woke up feeling worse on Saturday so, again, did as little as possible. The friend’s house where we went for second night is a different design from the one we’d been at the night before. That’s just as well because my nose was much much worse. Fortunately, I was able to discreetly slip out to blow my nose and cough as needed. Surprisingly, although I felt worse, I was less anxious. Maybe I just didn’t have the energy to fight or flee or maybe it was because I knew I could get through the night, having done so the previous evening.

Sunday lunch was much further away than the two seders had been so it was a tiring drive just to get there. I spent a good deal of the time there coughing, blowing my nose and just generally feeling bad. Despite all that, I had no anxiety at all.

I spent Easter Monday in bed all day.

The weekend was great fun. I had a ball at both seders and lunch. I attribute part of my success at “getting through” all three to the fact that I was interacting with great people. Ultimately, it was more than just a fun weekend. It was another step forward for me in managing my anxiety.

Health Anxiety, White Coat Hypertension and Hospitals, Oh My.

In my last post I wrote about why I had surgery and the impact it will have. What I didn’t mention was my anxiety. Ironic considering this blog is about anxiety.

It would be “normal” to be anxious about any procedure in which one is put under general anaesthetic. Interestingly, the anxiety I had about the operation itself I would classify as normal.

One of my areas of intense anxiety is health. I’m a germaphobe and, thus, a chronic hand washer. If I’m near someone who is sick I become anxious that I’ll catch it. I’m particularly frightened of stomach bugs. My fears in this area are not “normal”. That being the case, I was very anxious prior to surgery that any number of the drugs used could make me feel or be sick. I was mildly anxious about waking up on the table or never waking up but far more scared of becoming nauseated from morphine. I was also worried about the post-operative pain I knew I would have from the carbon dioxide pumped into my body during surgery, not to mention the pain from the actual surgery.

Being hungry and/or thirsty makes me feel weak, which makes me more vulnerable to anxiety, which intensifies the physical symptoms of the hunger/thirst, and so the cycle goes on. Before my procedure, I had to stop eating at midnight the night before, stop drinking at 6am and be at the hospital by 7am. My surgery wasn’t scheduled until late morning so I was also anxious that I’d faint during those hours between my arrival and my surgery.

Having had two day surgeries in the past nine years at the same hospital, I expected, after admission, to be put in a bed in a waiting area. My plan, once I got there, was to sleep. Admission took quite some time and, when I finally made it to the surgery waiting area, there was very little space. Consequently, I was put in a small room that had a sofa and two armchairs instead of a bed. There were three other women there, too. I was barely there when I had to leave to meet with my anaesthetist. Following that, I had to give blood. When I got back to the small room, one woman was leaving for surgery and the other two and I began to chat. Something went wrong with my blood so I was called to give another vial. I then went back to the room and we continued chatting. The next woman was called and we were down to two. Eventually, I was also called. The time had flown by and I’d barely realised I was hungry and thirsty. There was no weakness or faintness. Distraction is a wonderful thing.

Having health anxiety causes one to do body scans. That’s when one mentally scans one’s body – usually without even realising – for pain, discomfort, illness, anything out of the ordinary. I don’t set out to do them but I’m aware when I do. That was the first thing I did when I woke up in recovery. Body scan. No nausea, a little pain. Good outcome.

The power of suggestion is a curse for those of us with anxiety. As I was wheeled to the ward, I remembered a friend of mine saying she felt sick after her trip to the ward. I madly body scanned all the way to the ward and as the bed came to a halt. I was relieved that I felt fine.

I spent three nights in the hospital and never felt sick. The pain was there but it was managed by regular doses of paracetamol. Sleeping was uncomfortable due to both internal pain and pain from my “stab wounds” (from laparoscopic surgery) The first night I had sharp upper stomach and neck pain from the carbon dioxide and an extremely sore throat from the tube.

It will take several weeks before I can conclusively say that I’m glad I had the procedure done. What I can say now is that I have spent all of my adult life suffering from anxiety – some times worse than others – and I’m happy to be at a point where I can manage it to the extent that I can go in and have surgery without suffering too badly from my irrational fears.

Surgical Rites of Passage

Off the top of my head I can tell you the year in which I got my first period and how old I was. If I were to go hunting through my old diary of that year, I could even tell you the date. It’s important to me because it was a rite of passage. Even though I was still a child emotionally, technically it meant I was a woman and could have children of my own.

I can also tell you the date my last period started. It was 21 July 2013. That should mean I’ve been menopausal for some months now. Not so. You see, it never stopped. Since September 2013, I’ve been on hormones, had a Mirena, been on more hormones and been on antibiotics. None of them, however, could stop the bleeding for more than a couple of weeks. At the beginning of this year I went four weeks without a bleed and began to feel optimistic that it was all over. And then it came back.

So, on 7 May I had a hysterectomy. I didn’t just have my uterus out, however; I also had my ovaries and fallopian tubes removed. There was no medical reason for that choice. I chose that option for peace of mind. My mother was in a very low risk group for ovarian cancer and got it. Ovarian cancer is insidious. For the most part, diagnosis occurs at the advanced stage so the mortality rate is high. Some women are “lucky” in that they have pain or bleeding that allows an earlier diagnosis but my mum wasn’t one of them. It was more likely that I wouldn’t get it but I wanted to remove the risk.

That means I’m now in “surgical menopause”. One day I was peri-menopausal. I was put under general anaesthetic and, a few hours later, I was menopausal. No slow petering out of the ovaries for me. No last period, no counting down of months to officially mark the occasion. I’m here already. Of course, if I’d only had my uterus removed, I’d be in a similar position but my ovaries would lead me slowly into menopause. I haven’t slowly glided into it; I’ve crashed headlong.

And so, I’ve been through another rite of passage. My childbearing years are over and I’m menopausal and it all happened in a few short hours. This time it was done surgically. I can tell you the date, how old I was and even give you an approximate time.

I like things clear-cut and am not good at going with the flow. I wonder if any of us who suffer from anxiety are good at it. Consequently, I’m glad it’s done and dusted. I know I have a can of worms waiting to be opened and that it may be a rough ride. Nevertheless, I’m here on the other side now and that works for me.