Saturday, October 29, 2011

Court Case Update

The other day, I wrote about a trial going on outside of Cincinnati about a teacher accused of having sex with several of her students.  I wrote about it because the teacher was pleading guilty by reason of insanity, and her lawyers contended that she had bipolar disorder.  At least, I think that's what they were contending.  One article from ABC News had this quote:
[Her] lawyers defended her actions with explanations ranging from her vegan diet, the use of the antidepressants, blackouts from alcohol and even irritable bowel syndrome, claiming it rendered her unable to determine right from wrong.
An article in the local paper indicated the same thing, even saying that the lawyers cited Polycystic Ovary Syndrome (link goes to info about PCOS - I can't find the article now) as part of the problem.  It all seems very confusing, and appears the lawyers were throwing about anything they could think of out there as evidence (but that's just my opinion).  I mean, come on -- irritable bowel syndrome? 

After I wrote my post, I started thinking that maybe I was being short-sighted and judgmental.  I did a search about bipolar disorder and an insanity plea, and found this interesting editorial from the New York Sun, which basically says that bipolar disorder is a "mood disorder," rather than one of "cognition."  When a defendant pleads insanity, her lawyers must prove she didn't know right from wrong -- and that's something that bipolar disorder doesn't do.

I guess the judge in the case agreed, because she found the teacher guilty and sentenced her to four years in jail, with possibility of parole in six months.  Even though what she did was wrong, I think it's kind of stupid to send her to jail.  A few weeks ago, a local businessman who was found guilty of accounting fraud and bilking customers and employees out of money was sentenced to seven days in prison.  The difference in prison terms doesn't make sense to me at all -- but maybe that's why I'm not a lawyer.

On another note, my attempts to stave off my impending depressive crash after a few weeks of hypomania were futile.  The bottom dropped out on Thursday, and I'm still trying to recover.  I guess I'm more of a slave to my chemicals than I want to believe.

Wednesday, October 26, 2011

Bipolar Disorder and a Weird Court Case

Right now, a big story in this area is the trial of a high school gym teacher accused of giving alcohol to and having sex with five football players from her school.  As the trial progresses and more stories come out, the whole situation gets weirder and weirder and more salacious -- which, of course, makes for great news.

For various reasons, I had a morbid interest in this case from the beginning.  I got really interested, though, when this summer the teacher switched her plea from not guilty to guilty by reason of insanity.  I wondered what kind of mental illness would make her give her students vodka and then have group sex with them -- nymphomania?  Some kind of psychosis?

Oh, no.  It turns out, it's bipolar disorder!  This is what the local newspaper had to say (and, admittedly, it's not exactly the gold standard in hard-hitting journalism):
[Her] attorneys, Charlie H. Rittgers and his son, Charlie M. Rittgers, said [she] has a bipolar disorder and doesn’t recall the incidents.
So it's not only bipolar disorder, it's "a bipolar disorder."  I'm assuming he's referring to the different types of bipolar disorder (see the list here), but the way it's quoted, it just sounds weird. It's like saying, "she had a cough," like it was an isolated illness.  I don't know about anyone else, but I would never say, "oh, yeah, that's when I had a bad bout of bipolar disorder."

The teacher also claims to have no memory of the incidents.  I have no idea if bipolar mania (which I'm assuming is what the attorneys are referring to for the insanity plea) causes blackouts, but I did find this article on bipolar disorder and memory loss. It turns out the two are related -- but bipolar disorder causes problems with recall and details, which is way different than forgetting entire events.  I suppose alcoholism can cause blackouts, but I'm not sure that alcoholism would fly when trying to plead insanity.  This article indicates that alcohol intoxication alone is not grounds for an insanity defense, but it can affect the intent of the person accused of the crime.

I find it interesting that the only drug (other than alcohol) that's been mentioned that she was taking was Zoloft.  It seems to me if she had serious bipolar disorder, she would be on other meds in addition to Zoloft.  On the other hand, taking an antidepressant alone can cause a bipolar person to cycle into mania, so maybe if she was just on Zoloft, it was causing mania -- which can lead to reckless behavior, including drinking and reckless sex.

So, maybe she was in some sort of acute bipolar mania phase when having sex with these guys.  On several different occasions.  The only problem is, it seems like she knew it.

The prosecution presented several witnesses who testified the teacher admitted that she was having sex with the boys, and that if she was found out, she'd plead insanity.  Uh-oh.  This, for me, is where the story falls apart.  There's that old adage that if you think you're insane, then you're not -- when you're really far gone, you usually think you're fine.  If she was going around telling people she was doing these things and she'd just plead insanity, that kind of makes me wonder.

I want to stress here that I'm not saying she's not insane, or had some seriously impaired judgement.  And, there's no guarantee that the witnesses are telling the truth, or interpreting events truthfully.  And, frankly, to send her to jail seems to be stupid, as there are a lot of violent, repeat offenders who should be in jail and aren't (or aren't in jail for long enough).  I feel bad for her, I feel bad for her family, I feel bad for the "victims," and I feel bad for their families.

I also want to stress that information I'm getting is from the local paper and news stations, so I don't know how heavily I can rely on the entire story being told in 30-second sound bites and a few columns of newsprint.

What ultimately annoys me, though, is the idea that the lawyers are asserting that she has bipolar disorder, so she should be excused and absolved of responsibility for her actions (which is ultimately what the lawyers are trying to get the judge to buy).  Maybe she does have bipolar disorder; maybe she even had untreated mania.  But to say that those things caused her to drink alcohol, stand around naked, and have group sex with high school boys on at least five different occasions, seems to be a little shaky.  From what I know about bipolar disorder, it just doesn't work like that.

It will be interesting to see what the "experts" (psychiatrists, I assume) say when they take the stand, which should be later in the week.  Maybe I'm wrong; maybe bipolar disorder could cause this kind of behavior over a lengthy period of time. 

Man, if that's true, remind me to keep taking my meds!

Monday, October 24, 2011

Knitting for the Holidays...and to Avoid a Crash

Since I'm back on the knitting train now, working on my entrelac scarf and another cool zigzag scarf, I was thinking of trying to knit some gifts for Christmas.  Last year I did a couple of scarves for my sister-in-law and for my mom (I'd post the patterns but I have no idea where they are), so I was thinking of doing some cute amigurumi dolls for my kids and for some other small family members.  I got one kit and I'll see how it goes, and how long it takes to make.  I made a cute "Sheldon" turtle a few years ago for one of my girls, and it took FOREVER.  I don't want to be too ambitious.

When I get in phases like this and have about sixty-seven different projects going, I really feel the brunt of my bipolar disorder.  One sign of bipolar disorder is having lots of unfinished projects.  Of course, lots of people have lots of unfinished projects and aren't bipolar, but I think with bipolar disorder, in a manic or hypomanic phase there's a certain urgency to start different things, all at one time.  I know I often start to feel pressured, and want to get lots of things done as soon as I can.  The problem is that after a little while of this kind of behavior (a few days, a week), I crash out and sink into a depressive phase.  This is a pretty common trait of bipolar disorder, too.

I'm trying to avoid that this time by pacing myself, doing a lot of deep breathing, and limiting my caffeine.  One of the most important lessons I learned the last time I had a serious depressive phase is that caffeine is NOT my friend.  I can have maybe one Diet Coke (my Achilles' heel) and a cup of coffee a day, and that's it.  It's better if I have none at all, but when my kids are demanding stuff and the baby is crying, I could do a lot worse coping-wise than grabbing a Diet Coke.

And I'm trying to make my knitting urge work for me, instead of against me.  Instead of getting frantic about finishing all these projects at one time, and starting sixteen new ones for Christmas/birthday/Tuesday gifts, I am trying really hard to focus on one (or two - let's be realistic here) things.  And if I can focus on a few things, maybe I can thwart the pressured thinking and thus thwart the coming depression. 

I guess what I really wonder is:  is the crash unavoidable?  Most of the stuff I look up online seem to just assume that after a manic or hypomanic phase, a bipolar person will inevitably fall into a depressive phase.  How much can I control, and how much does the bipolar disorder control me?  I guess we'll find out.

Thursday, October 20, 2011

Oh, Oh, Where'd You Go, Psychiatrist?

[Warning:  self-reflective diatribe ahead]

In looking back over previous posts, it occurs to me that way too many of my titles are in the form of a question.  Maybe I watch too much Jeopardy!, but I think the larger reason is that a lot of my posts are, indeed, questions.  When I teach Freshmen Composition, we learn that one way to "enter a conversation" about a specific topic is to raise questions about what has already been said in that conversation. For example, if you wanted to write a research paper on inane children's TV programs, you could say, "Experts believe that The Fresh Beat Band helps children learn about music and friendship.  But who are these experts?  And why isn't anyone beating them with a sock full of pennies?"
He he he -- guess someone else hates Twist too!

(Sorry, I hate The Fresh Beat Band.)

Anyhow, that's how I sort of view this blog:  an attempt to enter the conversation about mental health care and mental illness (and knitting) through question-raising and providing jumping off points for new conversations.  Of course, that's very ambitious, and I know that it takes a lot more than one loser posting random rants about Nick Jr. TV shows, but I'm trying.


ANYHOW, on to the real topic of this post.  I got a letter in the mail this week informing me that my psychiatrist -- the one it took me months to find and get an appointment with this past winter -- is leaving private practice to work at a local University.

Well, shit.

Good for her and all, but what the hell do I do now?  This winter, when I needed a doctor, I honestly asked anyone that would listen who I should go to for psychiatric care, and nobody (read:  NOBODY) had any good suggestions.  I've been through several therapists and psychiatrists already, and have heard various negative things about more doctors in the area. Let me say, pickings are slim.  For heaven's sake, my OB-GYN's office was calling me to recommend a psychiatrist for a patient a month ago.  That should speak volumes about the number of doctors in the area.

I went through a lot of blood, sweat, and tears to try to find a doctor this past winter, and now it seems I have to start the whole process over again.  Not only am I unhappy about it, I'm a little overwhelmed.  And pissed.  I know there is no benefit to being angry and upset, but I can't help it.  I'll get myself together and try to start making calls in the next day or two, but right now, I'm just going to let myself wallow in the injustice of it all.

Okay, that's a little dramatic -- how about if I just let myself rant?  Damn you, doctor!  Damn you, mental health care system!  Damn you, Dayton, Ohio!

I feel a little better now.  On with the show.

Tuesday, October 18, 2011

Surgery anxiety? Knit it away!

Last week, I mentioned that I had to have my gallbladder removed.  Because I was getting stressed about the surgery (I also mentioned in a post that I was diagnosed with medical PTSD a while ago), I started knitting.

I haven't really poured myself into a project in a while.  Maybe it's because I have three little kids running around, who are fascinated with pulling the stitches off the needles (or "noodles," as my two year old calls them).  Or maybe I've just been lazy.  Or whatever. 

No matter.  To deal with the anxiety, I started a cool knitting project.  I wanted to make a scarf, but I have about a billion scarfs, so I wanted something different.  I found this pattern on, which is an ultra-cool site that has a lot of nifty patterns. The scarf is worked in entrelac, and I've never worked a pattern in entrelac, but it's not nearly as difficult as it looks.  

The pattern also works great with some yarn that I bought that had no specific intention for, a new line of yarn (I think it's new) by Vickie Howell, the host of the show Knitty Gritty.  I can't find the wrappers for the yarn, but I think it's the "Love" line.  I got it at JoAnn Fabrics for like, $4 a skein, so the price was right.  I'm not sure yet how many skeins I'm going to need, but I don't think it'll be more than 6 or so.

The gallbladder surgery went well, so hopefully my anxiety will start to abate.  Til then, though, I'll just keep working on my scarf.

Thursday, October 13, 2011

Mental and Physical Illness: What's the Link?

Tomorrow, I am to have my gallbladder removed because of some serious pains I've had over the past two or three months. I'm not looking forward to it -- let's face it, who looks forward to surgery? And in light of the surgery, I've been thinking about the link between mental and physical health.

A happy little green gallbladder
Doing a little research on the internet, it looks as though quite a few studies have been conducted on the topic of physical health in patients with schizophrenia. This article concludes that schizophrenic patients have more physical illness problems than those without schizophrenia.  It's not clear from the article, though, if schizophrenia causes the physical illness, or the other way around.

This web page from the UK talks about the link between depression and physical illness, discussing how physical illness can cause mental illness.  There's an entire book which is a collection of essays about the link between the two, called Depression and Physical Illness ( has it listed at $108, so I wouldn't recommend picking up a copy).

Anybody that watches TV knows that there's also a link between depression, anxiety, and fibromyalgia.  Doctors consider depression and anxiety to be a symptom of fibromyalgia, And this study discusses a link between rheumatoid arthritis and depression.

I guess my question is, which comes first?  Is mental illness (depression, bipolar disorder, schizophrenia) more likely to cause physical problems, or vice versa?  With depression, it seems like it could be obvious:  you feel like crap physically, so mentally you start to feel like crap. In my post about World Mental Health Day, I mention that doctors estimate upwards of 50% of cancer patients suffer from depression.  Well, I'd be depressed, too, if I had cancer.  

Of course, physical illness isn't the only reason people suffer from depression (and sometimes, there is no reason -- it's an illness all to itself).  But is is possible for chronic mental illness to cause chronic physical illness?

I know in my own experience, when I am in a bad phase, I definitely tend to neglect myself.  I don't eat right, I don't exercise, I sleep a lot, I avoid doctors (and pretty much everyone else).  Inevitably, this kind of neglect leads to physical complaints.  I usually get headaches, muscle aches, and stomach problems associated with my depressive episodes.

I wonder, though, can the mere fact of having a mental illness can be linked to physical illness?  Like, are people with chronic depression more sensitive to pain?  We always hear about neurons in the brain being blamed for depression -- is it possible these neurons that are "faulty" could be causing physical pain, too?  Or, if I'm bipolar, could my weird chemical shifts that cause it also cause shifts in my physical feelings as well? 

Admittedly, I could probably do some deeper research to answer these kinds of questions right now.  And maybe later I'll look into it.  But I feel kind of lazy at the moment, so I'm just sort of reflecting. 

And, for the record, I don't think my anxiety or bipolar depression caused my gallbladder problems. 

I blame my kids.

Monday, October 10, 2011

World Mental Health Day: Where's My Ribbon?

Happy World Mental Health Day! 

Yep, today is World Mental Health Day, designed to "raise public awareness about mental health issues" (per the World Health Organization).  Incidentally, it is also Columbus Day and World Homeless Day.  And, unless you live under a rock, October is Breast Cancer Awareness Month, designed to raise awareness (and raise funds, and sell pink crap) for breast cancer.

I'm not saying these other issues aren't important -- well, maybe I am saying that Columbus Day isn't that important, except to people who get off work and school because of it -- because, let's face it, cancer and homelessness are both major concerns in our society today.  In fact, if most people had to prioritize, I'm sure that cancer would be number one, homelessness number two, and mental health number three.  And I understand that.  But let's look at statistics.

According to the American Cancer Society (, almost 570,000 people died of cancer in America in 2010, and a little over 40,000 of those deaths were from breast cancer.  Incidentally, lung cancer comprised 157,000 of those deaths, and I don't see a month dedicated to that.  You can see all the statistics here

Turning to look at the stats on mental health, this interesting article from the founder of, Dr. John Grohol estimates that around 33,000 people die each year in the world of untreated mental illness.  That statistic may be low, too, because there's little information from third-world countries about mental illness mortality.

Though it's hard to find hard statistics on homelessness and mortality, it isn't hard to find statistics on the link between homelessness and mental illness.  According to the National Coalition for the Homeless, as many as 25% of homeless people are mentally ill -- compared to 6% of the general population.

Lastly, in a big "well, duh" statistic, this snippet from the National Alliance on Mental Health reports that experts estimate upwards of 50% of cancer patients suffer from depression, anxiety, and other serious mental health issues.

That's a lot of statistics, and it's obvious that cancer kills a lot more people a year than mental illness does.  But we also have consistent, pervasive awareness of cancer, and a buttload of funds going to cancer (well, at least some types of cancer), every year.  And if someone learned they had cancer, I can guarantee that it wouldn't take them three months to get in to see a doctor, and they wouldn't have family members telling them that it's all "in their head."

Out of curiosity, I did a google search for "October 11, 2011" and nothing about World Mental Health Day came up.  A lot of stuff came up about Judgement Day (should that be capitalized?) and the end of the world, which I'll have to read about later.  But as far as awareness goes, I think the US has a long road ahead.  Mental illness isn't sexy.  Nobody has a "Bipolar Disorder 5k Fun Run."  Very few people, if any, have a "Mental Illness Awareness" ribbon stuck to their car -- let alone their water bottles, wrist bands, or Swiffer Sweeper refills.  In fact,  I'm not even sure there is a mental health awareness ribbon; a google image search for "Mental Illness Awareness Ribbon" comes up with multiple colored ribbons -- some blue, some green, and hey, even a pink one comes up. 

Just because there are no ribbons, no fun fund-raising events, and no pervasive marketing for it, mental illness is still a very real problem in this country and world-wide.  I guess we don't need a ribbon to understand that fact.
I blog for World Mental Health Day

Wednesday, October 5, 2011

Postpartum Post-Traumatic Stress Disorder

When I was pregnant with my first daughter, I dutifully read my baby and pregnancy books.  Anyone who has read any of these books knows that they totally freak you out -- in the "potential complications" chapter (or whatever the chapter is called) the book always details horrible problems that could occur during and after delivery for both mom and baby, like "your uterus will rupture and then attack the nurse" or "your baby will be born with a full set of teeth you'll need to diligently floss."  And, even though these complications were rare, like most first-time mothers, I visualized all these scenarios with horror.  I began to think maybe the old-fashioned method of just knocking the mother out during delivery was not a bad idea.

One potential problem that I remember reading about, though, was postpartum post-traumatic stress disorder (PTSD).  I remember thinking, "How the hell could having a baby be so traumatic?  People have been doing it for a long time."

Oh, how very innocent I was.

I had a traumatic birth, but I'll omit the gory details.  And I didn't realize till maybe a year later that I did have PTSD as a result.  Every time I'd drive by the hospital where my daughter was born, or come anywhere near the office where my (I-can't-stress-enough former) OB-GYN was, I'd have panic attacks.  I also had serious postpartum depression, and I do, in retrospect, attribute at least some of the cause to PTSD. 

It turns out that an estimated 1-6% of women have postpartum PTSD, according to Postpartum Support International.   Some of the causes could be unplanned c-sections, forceps or vacuum extraction (both of which I had), and/or problems with the baby.  (See the NIMH page on PTSD here.)

Most people associate PTSD with people who have been in war zones, or victims of violent attacks.  That's what I thought.  I honestly never thought, when I was looking through all those "potential complications" in the baby books, that I would end up with PTSD from childbirth.  (Neither did this woman, whose story on is engrossing).

Recently, a psychiatrist suggested I had medically-induced PTSD, as a result not only of my birth experience, but other hospitalizations since then.  In my last pregnancy, I was hospitalized a whopping four times, once in the psychiatric unit and three times in the perinatal unit.  And if you were wondering, the perinatal unit had WAY better food -- and, surprisingly, a lot less moaning. 

A google search for "medically-induced PTSD" doesn't really turn anything up, so I'm not really sure if this is a legitimately recognized condition, or if it's more like saying "you have chicken-induced PTSD," if you were attacked by a chicken.

Regardless if it's a real condition or not, though, I've seen a lot of doctors lately -- body ones, not brain ones -- and my anxiety level is definitely starting to go up.  And, frankly, I'm annoyed.  I have a lot of other sh*t to deal with, but medical PTSD isn't one I need.  I'm starting to wonder if it's too late to go back and sue the doctor that delivered my oldest daughter.

But then I'd probably end up with "legal PTSD," and I really couldn't handle that.

Monday, October 3, 2011

Antidepressants and anger

About a month or six weeks ago, I had the opportunity to join a DBT (Dialectical Behavioral Therapy) session at a nearby hospital.  I went in for the initial assessment, but ultimately decided not to do it.

There were a few reasons why I decided not to participate, not the least of which is that I'm lazy and have commitment issues and couldn't see myself hauling across town every single Tuesday for the next six months.  There was another, more specific reason, though, that doesn't have anything to do with my personal shortcomings.

During the assessment, the therapist was asking about anger, and what happened when I got angry, and how I coped.  One of the most significant and consistent benefits I've noticed about antidepressants and mood stabilizers, essentially since I started taking them almost ten years ago, is that my anger episodes have all but disappeared.  I still get angry, but it's more mild irritation than blinding rage (except when we're talking about the people putting the new roof on my house, but that's another story).

I used to get so mad, it would be hard to see; I'd stammer and get all shaky.  I'd throw things (shoes were my favorite thing to throw, I don't know why) and slam doors.  It was ugly.  And, seriously, when I started on medication, those episodes sort of floated away.

This brings me back to the DBT assessment.  The therapist asked what happened when I got really angry, and I told her I used to have serious anger problems, but since I started antidepressants and mood stabalizers, those episodes went away.  She looked at me in a kind of condescending manner and said, "Well, I can tell you, medication rarely helps manage anger.  But therapy can."  She then moved on to the next part of the interview.

Now, I'm sure she's much more well-versed in all this kind of stuff than I am, but I know for a fact that my anger has lessened a lot since I started my meds. I guess it could be a coincidence, or maybe just mellowing out with age, but it seems awful odd that the two would coincide so completely and not be related. 

That's about the point I lost a lot of confidence in the DBT program.  I got the feeling it was going to be a "meds are bad, therapy is good" kind of situation, which isn't totally a bad thing; but what's more, I got the impression that I was going to be told my perceptions of my situations were "wrong," and that the therapists and facilitators are "right."  And let's be honest; if I wasn't wrong about a lot of my perceptions, I probably wouldn't need DBT.  But I'd like the facilitators to at least listen to me and not dismiss my ideas out of hand because they didn't fit with their notions of therapy or treatment.

In retrospect, maybe I was too quick to judge the situation.  I have learned, however, if I get a certain "vibe" or feeling about something, it's often right -- no matter how quickly I get that feeling. 

I think I made the right decision.

Or maybe I am just really lazy and didn't want to haul all the way across town every week.  Whatever.  At least I'm not going to get mad about it.