When it comes to mental illness, everyone involved learns there’s a fence called “Us and them.” There are those with mental illnesses, and those without: us and them. You’d think it would be different with mental health professionals, better somehow. In some ways it is, of course: pros know the real scoop about psychiatric diagnoses, and are less prone to all the ignorance and hysteria so prevalent among the public at large. When it comes to stigma, though, professionals often show more of it than average, a higher, firmer, more forbidding fence. What’s worse, they often automatically blame illnesses for completely normal reactions. People get angry, feel disrespected or mistreated, distrust or trust others, cooperate or decline to do so as they see fit. Patients are people, yet anger becomes “irritability” or “agitation,” distrust becomes “paranoia” or “poor judgment and insight,” noncooperation becomes “noncompliance.”
I’m something of a double agent: I live on both sides of this fence. I’ve a serious history of depression, committed suicide in a reliable fashion, but somehow survived – blind luck for which I am thankful. I have been admitted, I’m not sure how many times – six perhaps? It’s been some years since the last time: my last? Perhaps.
As for the other side of that fence, I work as a nurse on various inpatient psychiatric units, I teach psychiatric nursing, and I blog. I’m train nurses in people skills, do my best to help them break down that fence and work with people, not problems of labels. I’m writing a book on it too. It’s my life mission, this work.
Do I tell patients of my experiences with depression? No, regrettably. I doubt my colleagues would tolerate such a radical act, “poor boundaries” they would call it. I do teach patients about all the millions of hidden, secret cases walking around everywhere, that they’re hardly alone or unusual. I do offer frequent insights earned the hard way.
Do I tell coworkers? Usually not: stigma remains too powerful. I had to leave a job once because of managerial bias after a sick leave. An experienced psychiatric nurse, this manager plopped onto the other side of the fence in her mind: a patient. I thank her: it led me to a much better job.
Do I tell strangers? Clearly I do – I’m doing it now! – But only after many years in hiding and long, hard consideration. It helps: no more dark secret, no more shadows. It gets easier each time: I get better. Stigma and secrecy account for a large portion of the suffering and the lethality of mental illnesses: attacking stigma therefore eases these burdens. This reasoning is my primary reason to raise my voice: stigma must recede, if only a little, every time mental illnesses come up in casual conversation, in daily routines, in public. I don’t fight stigma as much as shine light on it. You can’t fight darkness, but you can eradicate it. We can all help each other that way. I like that.
I wrote publicly about my suicide attempt last fall. It was a propitious time, soon after Robin’s Williams’ death. It turned out to be my most popular piece to date, but when I hit the “Publish” button it terrified me. It still gives me concern. Stigma does that. I wrote then that “depression is a social disease, in a sense. The death rate reflects our isolation, our distrust, our unwillingness to share uncomfortable vulnerabilities. Our culture, in this sense, is all too often lethal. Suicide mostly happens in isolation.” Stigma kills many, many people.
Depression cost me an awful lot of money and time, and a career: it forced me to leave Harvard Medical School three years in, where I was successful and quite often suicidal. In time I found nursing, far more user-friendly and I make a difference. I’ve largely made my peace with that transition, after decades. It was hardly easy on my ego, especially when so many people ask, so often, “Why aren’t you a doctor?” Why indeed. Try dealing with such a question when the real answer seems off the table. It’s still not something I enjoy. I’m the most overeducated nurse I know: my Board Scores put me ahead of 9 out of 10 physicians in practice. The knowledge does come in handy.
While I struggled to find my way after Harvard, I took work in a Group Home. Psychiatric work was a great fit, and the rest, as they say, is history. I was quite certain for a long time I was finished, doomed, washed up, done. Happily, I was mistaken. I’ve had my ups and downs with depression, but each time I got a little better at seeing bad times coming, taking care of myself. These days I’m doing pretty well. I even found meds I can easily tolerate, and they work! Persistence pays off, trial and error, in time.
We shape life events’ meaning by our responses to them. I do my best with my responses. It helps.
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I’m an experienced Psychiatric Nurse and Educator. I’m an adjunct professor, and have taught NCLEX prep with Kaplan. I train Nurses and others in MALS, CPR, and GRC. I came to nursing by an unusual path: unique, actually, via Cornell and Harvard Medical School. I’ve also experienced serious depression more than once, which has deeply informed my practice and teaching. Experience is the best teacher of all, don’t you think?
Wait a minute. I mentioned teaching GRC. You way well wonder what that is – not surprising, as it’s rather new. “GRC” stands for Golden Rule Care, a training program I created for nurses that makes work easier and more efficient and fun. I’m working on a book about it; in the meantime, I offer related tips and tools in this blog’s Care Tips category.
I hope to offer more formal lectures and training sessions, and eventually integrate GRC ideas into Academic curricula, maybe even an independent school, analogous to CPI or AHA training programs.
I live in the Boston area.
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