People who come across this blog entry will probably know that suicide among teens, veterans, and those in the throes of some disastrous mental state is prevalent. There is no need to substantiate this fact with statistics here. It is important to note, though, that there are ways to counteract it, which takes time.
But first, before you read this entry, I want you to know that there is always hope and other useful tools that one can utilize to counteract suicide. I suggest that you become familiar with Mary Ellen Copeland's Wellness Recovery Action Plan (WRAP)*. Her mother was in an institution for several years and evolved out of it because of this program. I think the one concept that I could include in this area is that of self-realization. In the situation of succumbing to mental illness, initially, one must become aware of what is happening to them. This personal growth of "seeing" the shades of gradation that are becoming more apparent as time goes by is a strength while grappling with an illness. There is also the gradual process of securely establishing a kind of resiliency from a mental health relapse. *
The five key concepts are as follows:
Hope
Personal Responsibility
Education
Self-Advocacy
Support
*Notation: This is not an advertisement. I have no formal or informal agreement with the Copeland Center to earn money in bringing up this strategy.
Let's look at Nick Traina's circumstances. The lack of a proper diagnosis, before the age of fifteen, became very detrimental to his well-being. He was fighting an uphill battle his entire life, which he did not win. It is essential to note, though, that Nick Traina did not seem to have a social (peer) support system, within his circle of friends that did not suffer from a mental health issue.
When first introduced to Danielle Steele's books, I was in the throes of depression – miserable, in need of any easy read. I sought refuge in them, as they were well-researched and always had happy endings. In the prefaces, from a specific date forward, one book entitled "His Bright Light" was usually mentioned, but it wasn't sold in any bookstore. I had no idea of its contents, and an online search revealed that it was available on Amazon. The short synopsis opened a plethora of information as to its subject matter; the proceeds of each copy sold would go towards The Nick Traina Foundation in San Francisco, California.
I consider the biography of Nick Traina, Danielle Steele's son, both heroic and heart-wrenching. Although the DSM-V now encourages diagnosis at a young age, Danielle Steele did not have that option for her long-suffering son. His story details the battle against one of the most devastating mental illnesses, Bipolar-1, also known as manic-depressive disorder. Suffering from the age of two or three probably took a toll on him and re-arranged his brain chemistry to the most distressing point of relying upon self-medication, claiming a clear stake for most of his teenage years. This is in contrast to someone who becomes ill later in life and is diagnosed in adulthood – such a person may be able to compensate, in part, by drawing upon previously developed skills. There is also the added advantage of seeking an environment that will put minimal stress on their psychiatric inadequacies.
Nick Traina did not have that option since he had no such choice – he was too young – so he regressed to a lower level of functioning. When he reached the later elementary years, concessions were made to allow his behavior to naturally mature. Eventually, however, he faced school situations in which they tired of his disruptive behavior in the designated classroom, though he was unable to comprehend why the difficulties were taking place. It was decided by the school authorities that his unstable state, although not persistent every day, could be rectified by him merely trying harder. Unfortunately, this therapeutic approach and environment self-perpetuated his behavioral inadequacies.
By his eighteenth birthday, although there was a diagnosis at hand, the difficulty of trying to deal with his illness caused him to take his leave by over-dosing on a "street" drug. At that time, an unprecedented amount of social support was available to him: nurses, an unbelievable therapist with whom he lived, and a solid-state psychiatrist. His mother believed that he chose suicide because of a personal realization and belief that he would not be able to assume the stresses of his chosen profession of being a musician. The fact that he felt forced to take a detour home on the last phase of a tour depressed him significantly. The yo-yo nature of the illness itself allowed for very energetic performances but also a time in which his coping skills were very impaired.
I encourage you to read this book to find out the full story. Nick Traina's resting place is in Colma, California, amidst lovely trees and benches.
How a diagnosis may play out over time; complications may occur.
Many people hit the hospital running straight through a center, without a team. As it turns out, the person is the team. All sorts of psychiatric terms and treatments can follow their path – they suffer from this; they ought to take that. However, when medication arrives on the scene with a quick central fix in mind, it will probably not work unless it is a prescription for a common headache. People can be prescribed different medicines, for example, each of which may strike the same chord from a different angle. It takes time to glean how they both interact, especially in determining a precision-oriented diagnosis.
This next point is difficult to discern. Although it has referenced previously, it deserves an additional comment: what is not addressed initially can compound into a more difficult situation. At this juncture, we are speaking in terms of years.
Then there is another matter: Diagnosis "A" may exclude an underlying issue, factor "B." Factor B may begin to take on a different form and becomes a stronger undercurrent. This situation is a variance on the "three plus a three" diagnosis example. Although there is room for further discussion of what may be happening to a person, the dialogue does not seem to continue.
An adjunct to all of this is the role of a personality disorder. The motion of a personality disorder -- somewhat like some pinball as it springs to a starting point -- is kept going by the interplay of certain kinds of family dynamics. It is thought to be systemic in origin and reveals itself within a genetic blueprint or map. The stronger the pressure, on a person, within the family mix, the more likely that certain parts of it will accentuate and form what the person uses to cope. Subtle in nature, it is difficult to discern how it shapes a diagnosis.
***
Remission does not mean a cure; psychiatric breakdowns may occur at any time. This doesn't mean that a person cannot develop at type of resiliency to grapple with mental health issues.
Some people can experience a one-time episode of an illness, although that is very rare. Alternatively, a mental illness may be thought of a state of mind, something that will pass with no treatment – whatsoever. Often, however, the disease is persistent. A respite phase does not exclude a susceptibility to another experience. It is like saying that a person can erase the medical consequences of not treating diabetes, for example, no matter how severe the symptoms. If a problem should reoccur, the experience is usually more intense and more complicated to manage. Also, the effects of a diagnosis can compound the impact of the subsequent symptoms, that is, make coping with an illness more challenging.
There are ways to cope, however, no matter how challenging the situation. Cognitive Behavior Therapy (CBT), even for Post-Traumatic Stress Disorder (PTSD), is available. There is also Dialectical Behavior Therapy (DBT) and the Wellness and Recovery Action Plan (WRAP). All develop coping skills, which can minimize the amount of medication a person may need.