Month: March 2014

Comorbidity

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As a child, Ruby spent most of her days alone in her room smoking, giggling one minute and then crying in despair the next. Even though her main diagnoses was Schizophrenia, I can’t help but feel that depression was another illness that affected her. Also, I had never heard of the term “comorbidity”- that is, to be diagnosed with more than one mental illness. So Schizophrenia was all I knew. I didn’t know how ignorant I was until I spoke with a friend of mine whose mother was also diagnosed with Schizophrenia.

His mother would get dressed, leave the house, and be social despite her illness. I wondered about that when he told me. Was she that woman? You know, the one who walked the streets mumbling to herself, crazed look in her eyes? Did she have moments of clarity where she interacted with people out there on the streets? I never asked.

One reason that Ruby was so antisocial is she hated her appearance. After four children she went from a brickhouse to a mini-mansion. Her skin was pocked with acne. Her wardrobe consisted of house dresses/muumuus that she wore day in and out. She never bothered to fix her hair and instead wore it under a scarf.

I know now that some psychotropic medications can have side effects such as making you gain weight and other effects. This is truer with the medications of the past forty years.

Nevertheless, her self-hatred led to isolation that was unbroken. If I wanted to see my mother, I had to walk into her world; that room that was so filled with smoke that the walls were covered in tar. I would sit with her breathing it all in. Sometimes she would talk or ask me to sit on her belly to flatten it and I would comply. That was as close as she would come to a hug or any type of affection.
In reflecting on these memories, I can you that serious mental illness affect everyone in the family and when you’re a child that does not understand “mommy’s strangeness,” you tend to blame yourself.

 

Reflecting on the Past Week

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I was asked recently how could I sympathize with someone like Ebony Wilkerson ? She didn’t have to take her children with her into the ocean and could  have just taken her own life. I shrugged in response because in the face of the overwhelming universal truth that most of us believe, “Mothers are supposed to protect their children-not hurt them” we truly become the persecutors of anyone who doesn’t uphold motherhood ideally.

In truth I definitely feel two ways about it because of my own experiences with my mother while at the same time acknowledging that an injustice has been done to the children and that Ebony needs compassion.

I may have written this previously but I will rewrite it. One of the final straws that led to Ruby (our mother) being diagnosed was that my younger brothers and I were woefully neglected-unfed and dirty. We were one infant and toddlers with no control over our circumstances. Not even my eldest brother who was approximately 11 at the time knew what to do. Her actions were not done as a punishment to us or to herself. When your loved one loses their mind, they truly do not know that they have lost it. That is what makes convincing them to go to get help difficult and to remain on their medications a constant battle.

Now that Ebony is in custody, she may be offered the help she needs. She also has a choice not to accept help for her psychiatric issues and in most cases she has that option. I believe that individuals who commit a crime of this nature should serve time because it may be the only way for them to acknowledge that they need help and that without it, worse could happen again. Incarceration of the mentally ill who have committed a violent crime should include mandatory medication and ongoing counseling otherwise, it does no one justice to sentence the insane because it is hard to be accountable for your actions if you’re not all there.

The children will have the most difficult road to recovery and will have their own issues to deal with. Hopefully, they are also receiving counseling. I hope that the family does not denigrate Ebony in front of her children because living with hatred of one’s mother is harder on the children than it is on the person being hated. One day, I hope that they are able to understand-they may never forgive or reconcile with her but forgiveness does not necessarily mean reunification. It is coming to a place in one’s life where you accept the past with its ugliness and flaws and choose how to continue on.

 

Wall of Voices and Sound

This collage is how I saw Ruby’s struggle with auditory and visual illusions.

When an Almost Tragedy Strikes Due to Mental Illness

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I do not want to post another report of the incident in Florida involving Ebony Wilkerson who drove from South Carolina to Daytona, Florida with three children in tow to drown them all by driving her van into the ocean. But, I do have to comment on this case because it requires something from us that is most difficult; compassion. Compassion for Wilkerson’s children and most of all, for Ebony herself. I do not personally know any of the people involved; however, I do not believe that under normal circumstances that Ebony would have made this decision to end her and her children’s lives. She was in both a spiritual and emotional crisis.

Ebony’s family were very concerned about the state of her mind and called police for assistance prior to the incident. Law enforcement responded and found her sound enough to allow Ebony to proceed to what they thought would be a women’s shelter because of the tumultuous relationship she had with her estranged husband.

Each day something new is revealed about this story but so far, it seems that everyone did all that they could. In most states in the U.S. it is very difficult to have someone committed to a psychiatric ward unless they pose an immediate danger to themselves or others. Obviously, Ebony Wilkerson was both but there was insufficient evidence to proceed in having her committed.  This is one of the frustrating factors for people whose family members are mentally ill until it is too late. The burden of proving that your loved one is mentally ill rest on your assessment which is often not valid enough, until after a mental health professional has made an official diagnoses. Whenever I hear about these situations, I wonder; “What could the family have done to prevent this?”

Now Ebony Wilkerson will become a part of the largest statistics to date; African American and incarcerated (Munetz et al, 2001). She will face charges relating to trying to commit an act of murder-suicide. If convicted, she will spend time in prison and “maybe” she will receive the help she needs.  There are folks out there who say, “She needs to go to prison! She should’ve ended her own life and left her children out of it!” However, I have found that these same critics would have dissuaded her or have dissuaded their own mentally ill family members because, “Black folks is always stressed-you don’t need to be seeing no psychiatrists!” Again, Ebony’s family followed the right course of action which shows that there are no guarantees even in an idea situation. In Ebony’s case, it was good Samaritans that rescued them all.

Munetz, M.R., Grande, T. P., Chambers, M. R. (2001).  The incarceration of individuals with severe mental disorders.

Community Health Journal,  37(4), 361-372.

 

 

 

Drugs and Medication

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Psychotropic medications have their positive and negative aspects; nevertheless, I believe that each generation of psychotropic meds improves.

In the seventies, Ruby took Melarill and to this day, I am not sure how much it helped her. She still remained in bed all day laughing, crying and chain smoking. Maybe it left her without energy as she did not roam the streets like the other mentally ill folks in the neighborhood. She was our embarrassment kept behind closed doors. Over time, the medications she was prescribed changed but each one of course has its side effects that can affect the individual physically and/or mentally.

Prescribing psychotropics can be a tricky business as it affects individuals differently especially if you are prescribed more than one medication. Sometimes the mix is beneficial-i.e. decreases their symptoms and allows the consumer (patient) to function “better” even to the point of being able to fully participate in life. Other times, the consumer can have a bad reaction to the medication and/or the combination of medications prescribed. Sometimes, the consumer can end up in emergency and even to a psychiatric ward if the reaction is bad enough. This is why many consumers do not like to take their medications.

The other half of that is that sometimes the medications work so well that the consumer misleads themselves into believing that they do not need to take the medication anymore and stop. This of course can result in the consumer being hospitalized and is one of the main reasons behind repeated admittance into the psych ward. Then, there are those who self-medicate via alcohol abuse and illegal street drugs to alleviate their symptoms.

With Ruby, she was very, very thorough in taking her medications from the seventies until about the mid- 1990s. In fact, she kept a daily calendar book and would record the medications and times that she took them which is how it was easier to figure out when she stopped taking her meds. Later, I found out why.

My eldest brother had gotten addicted to crack cocaine. It was one of the worst blights to hit the African American community since the times of lynching and Jim Crow laws. It decimated families in a way that nothing had ever done before. Ruby had decided that her daily meds were an addiction akin to taking crack and stopped. That was the first time that she had been hospitalized during my adult years. The psychiatrist finally convinced my mother that her medications are an essential part of her well-being and like the diabetic who needs insulin, she needed her psychotropic meds. By this time, she was on Thorazine which left its own physiological side effects but that is another post.