Beautiful Minds, Anguished Minds

William Styron, one the finest American authors of the 20th century, gave words to an unspeakable condition---depression---in Darkness Visible: A Memoir of Madness.

William Styron, one the finest American authors of the 20th century, gave words to an unspeakable condition—depression—in Darkness Visible: A Memoir of Madness.

Can you see in the dark—in the silent night of a new moon?

William Styron saw it. Although acclaim followed the brilliant author of The Confessions of Nat Turner and Sophie’s Choice, a shadow stalked then swallowed him. Depression. Styron movingly penned his descent into hell and struggle for peace of mind in Darkness Visible: A Memoir of Madness:

. . . a patient who felt similar devastation would by lying flat in bed, possibly sedated and hooked up to the tubes and wires of life-support systems. . . .  His invalidism would be necessary, unquestioned and honorably attained. However, the sufferer from depression has no such option. . . .  There he must, despite the anguish devouring his brain, present a face approximating the one that is associated with ordinary events and companionship. He must try to utter small talk, and be responsive to questions, and knowingly nod and frown and, God help him, even smile. But it is a fierce trial attempting to speak a few simple words.

One in four American American adults---approximately 61,5 million people---experiences mental illness in a given year (National Alliance for the Mentally Ill). Depression is the most common type of mental illness, affecting more than 26% of the U.S. adult population.3 It has been estimated that by the year 2020, depression will be the second leading cause of disability throughout the world, trailing only ischemic heart disease. (Centers for Diisease Control and Prevention).

One in four American adults—approximately 61.5 million people—experiences mental illness in a given year (NAMI). Depression is the most common type of mental illness, affecting more than 26% of the U.S. adult population. It has been estimated that by the year 2020, depression will be the second leading cause of disability throughout the world, trailing only ischemic heart disease (Centers for Disease Control and Prevention).

It is all too easy to turn away from stark facts.

In March 2014, the National Alliance on Mental Illness (NAMI) released figures on this epidemic:

—Approximately 60 percent of adults and almost one-half of youth ages 8 to 15 with mental illness received no mental health services in the previous year.

—Although military members comprise less than 1 percent of the U.S. population, veterans represent 20 percent of suicides nationally. Each day, about 22 veterans commit suicide.

—The numbers are staggering for mental health issues affecting the homeless, addicts, juveniles in detention, and prisoners in the criminal justice system.

—Serious mental illness costs America $193.2 billion in lost earnings per year.

Approximately 20 percent of youth ages 13 to 18 experience severe mental disorders in a given year. For ages 8 to 15, the estimate is 13 percent.

Approximately 20 percent of youth ages 13 to 18 experience severe mental disorders in a given year. For ages 8 to 15, the estimate is 13 percent.

Already overwhelmed emergency rooms are often the only refuge for some stricken Americans. A temporary fix—and then the insidious cycle renews.

The 2008 recession hit hard, according to Medical News in 2008. Alarmed by “recession depression,” NAMI partnered with Mental Health America to survey adults nationwide. “The unemployed were found to be four times as likely as those with jobs to report symptoms consistent with severe mental illness.”

It is hard to live alone in this nonphysical paralysis. It is hard to live with someone in the throes of agony.

It is hard to live alone in this nonphysical paralysis. It is hard to live with someone in the throes of this agony.

Depression rips apart families and communities, with relationships often unrepaired. Anger, ignorance, intolerance, neglect, denial, isolation, fear, sorrow, and anxiety affect both the depressed and their loved ones.

Nonetheless, courageous Americans speak through action. Mere lip service is a mockery.

On November 19, 2013, in Millboro, Virginia, an American tragedy played out. Twenty-four-year-old Austin “Gus” Deeds stabbed his father, Creigh Deeds, before taking his own life. Only hours before—after a psychiatric evaluation—an emergency custody order expired. There was no bed space for Gus.

Passed in March, 2014, Omnibus bill SB260 extends emergency custody for Virginia citizens in mental health crisis---a window for evaluation and psychiatric bed location.

Passed in March 2014, Omnibus bill SB260 extends emergency custody for Virginia citizens in mental health crisis—a window for evaluation and psychiatric bed location.

Deeds, a Virginia state senator, went public and pushed for legislation. Omnibus bill SB260 unanimously passed the Virginia Assembly this past March. State hospitals must provide a “bed of last resort” space for temporarily detained patients when deemed necessary. SB260 mandates the completion of a web-based psychiatric bed registry.

It is a modest start, “the tip of the iceberg,” Creigh Deeds said.

Gus Deeds was a son, a brother, a friend, a classmate, a musician—not a faceless statistic.

Dr. Kay Redfield Jamison eloquently speaks for those who have no voice and cuts through the vague noise about stigma. However, she stresses a two-way process: "We will not tolerate you not getting treatment."

Dr. Kay Redfield Jamison cuts through the vague noise about stigma. However, she says, “We will not tolerate you not getting treatment.”

In her groundbreaking book—An Unquiet Mind: A Memoir of Mood and MadnessKay Redfield Jamison, Ph.D., charted the disruptive illness that threatened her life. Diagnosed early with bipolar disorder, she found a rich path and career in the Department of Psychiatry and Behavioral Sciences at Johns Hopkins Medicine.

Attention must be paid. No more whispers in the dark.

*****

Folk singer Dar Williams tells a too-familiar story about pain, withdrawal, and joyless getting by.

Parity and Crisis: Quotes of Note

“We have replaced the hospital bed with the jail cell, the homeless shelter, and the coffin. How is that compassionate?”—Representative Tim Murphy, Republican, Pennsylvania. Source: “The Cost of Not Caring: No Place to Go,” Liz Szabo, USA Today, May 12, 2014

The National Coalition for the Homeless states 20 percent to 25 percent suffer some form of mental illness.

The National Coalition for the Homeless states that 20 percent to 25 percent of the homeless population suffers some form of mental illness. Veterans make up one-third of the homeless. On returning home, they receive a flag-waving welcome—but are often forgotten.

“Some of our instincts on treating mental health are good, but our implementation is a failure.”—State Senator Creigh Deeds, Democrat, Virginia. Source: “Out of Sight, Out of Mind,” editorial board, Newsleader, April 5, 2014

As of January 1, 2014, more Americans can purchase insurance that covers mental health and substance abuse disorder. As of April 29, 2014, 21 states refused to extend Medicaid coverage for citizens. Source: “Mental Health Now Covered under ACA, but Not for Everyone,” Susan Brink, U.S. News and World Report.

In 2011 a three-judge panel of the 9th U.S. Circuit Court of Appeals in San Francisco concluded that the Department of Veterans Affairs’ treatment of mentally-ailing vets is so poor it is unconstitutional. Source: Mark Thompson, Time

In 2011 a three-judge panel of the 9th U.S. Circuit Court of Appeals in San Francisco concluded that the Department of Veterans Affairs’ treatment of mentally ailing vets is so poor it is unconstitutional. Source: Mark Thompson, Time

“In the past few weeks, serious allegations of misconduct have arisen from several VA medical facilities, indicating that records are being intentionally doctored in order to falsely portray patient wait times as reasonable and satisfactory. Recently, several VA employees have come forward and alleged what Iraq & Afghanistan Veterans of America (IAVA) members have been reporting anecdotally for some time: that wait times at some VA medical facilities are far longer than reported.

“Disturbingly, long wait times are alleged to have resulted in the deaths of 40 veterans who perished while waiting for care at the Phoenix VA medical facility alone. It has been alleged that those and many other veterans at the Phoenix VA were placed on a ‘secret waiting list’ in order to hide actual wait times so VA officials could report that department goals were being achieved. Since the Phoenix VA story broke, more allegations of misconduct by VA personnel at other facilities from coast to coast are painting a similar picture. Unfortunately, these types of incidents are not new, nor apparently are they unique. “

How long will they wait after coming home?

How long will they wait after coming home?

Source: Statement of Tom Tarantino, Chief Policy Officer of IAVA before the Senate Committee on Veterans’ Affairs for the hearing on the State of VA Health Care, May 15, 2014

Where to Turn

NAMI resources

National Suicide Prevention Lifeline (with Veterans Crisis Line), 1-800-273-TALK (8255)

Iraq & Afghanistan Veterans of America (IAVA)

Cry for Help: Teenage Mental Illness and Suicide (a PBS documentary)

Bring Change to Mind (Glenn Close founded this organization to fight stigma. Her sister Jessie, a poet, lives with bipolar illness. Her nephew, Calen Pick, leads a productive life as an artist and furniture maker, although he has schizoaffective disorder.)

Out of the Darkened Room: When a Parent Is Depressed by William R. Beardslee, M.D.

Judge Baker Children’s Center (An affiliate of Harvard Medical School, the center focuses on children ages 3 to 17.  The organization promotes the best possible mental health by integrating research, intervention, training, and advocacy.  Parents can access treatment programs and resources on the website. Dr. William R. Beardslee directs the Preventive Intervention Project and the Prevention of Depression Study.)

Veterans on Trial: The Coming Court Battles over PTSD by Barry Shaller and Todd Brewster (Note: The book includes a history of PTSD in previous wars.)

Credits

Nocturne in Black and Gold by James Abbott McNeill Whistler, Detroit Institute of Art

In the Corner by Carl Larsson, National Museum, Stockholm, Sweden

Femme Assise (Melancholy Woman) by Pablo Picasso, Detroit Museum of Art

Entombment of Christ (Lady with Tears), Saint Martin Church in Arc-en-Barrois (Author: Vassil. User: AnkhMorPork)

Sketch by Vincent Van Gogh to his brother Theo, Van Gogh Museum, Amsterdam

The Sick Woman by Jan Steen, city of Amsterdam

Homeless Man in Los Angeles by Terabass

 

 

15 thoughts on “Beautiful Minds, Anguished Minds

  1. Hard to hit the “like” button given the sobering subject of this post, but I do like that you are shedding light on this serious, and often seriously neglected topic, Catherine. I’m currently watching a friend go through the struggle to get adequate mental health treatment for a family member. It’s an exhausting uphill battle that is draining the family physically, emotionally and financially.

  2. I appreciate your sensitivity, Lori. Not all is sweetness and light–or glib and clever–in blogging. However, if one person reads this post, I thank that person for caring. Mental illness is treatable.

    The emotional and physical drain is distressing enough. The personal financial burden is unspeakable (as in the case of other serious illnesses).

  3. I agree with your data, the direness of the diseases and the help that is needed. Too bad if you live in a State that refused to expand Medicaid and you are otherwise unable to address your dilemma. The far-reaching implications to our Country’s health of ignoring/refusing to fund treatments are staggering. Family and Community costs are seldom discussed but the decay and degradation are there for those willing to see. Public awareness begins in the schools and at the dinner table – if your are lucky enough to sit down and eat in a Family setting. Social services are thrown around in campaigns and quickly forgotten after elections, in my opinion. There needs to be a turning of the tide.

  4. Lewis, thanks again for taking time to write. I follow all your FB posts with great interest. You have great wit and content, which we all enjoy. But you are on top of serious events and concerns. You direct me to thought-provoking issues every week. Thank you for caring and enriching. Best, CH

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  6. I highly recommend one of my client’s books (she’s a multi published writer who happens to be the mother of a son who has long suffered with schizophrenia. She not only won the CO Golden Quill award for the book and her activism, she’s a wonderful writer and her son, Max, has got to be one of the great (despite being untrained) voices I’ve read. He’s also a gifted writer. The book is called Walks on the Margins. I think you’d find, especially his every-other-chapters fascinating.

    I just returned from teaching on the cruise and snorkeling in the Great Barrier Reef, etc. Need to put my nose to the grindstone again with my clients. Hope your new job is going well

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