Peer Support & World Mental Health Day

Peer Support & World Mental Health Day

Happy World Mental Health Day! Given the topic we’re celebrating today, the basis of my project, and that I’ve made the decision to pursue my degree in social work, I feel like it’s a great day to talk about one way we can help the world improve mental health: peer support.

I recently read an article on peer support that I found fairly accessible to the average mental health consumer. Namely because it’s not a clinical paper written by doctors, it’s a theoretically-based paper written by educated people who have spent years working in the mental health community within the peer support space. That means you’re automatically spared the medical jargon in favor of more humanistic characterizations of the deeper levels upon which mental health recovery should be based, and why.

I’m going to be doing a lot of direct quoting from the article because I like the way they represent their perspectives, starting with their abstract, followed by a definition of peer support.

Abstract

“This article offers one theoretical perspective of peer support and attempts to define the elements that, when reinforced through education and training, provide a new cultural context for healing and recovery. Persons labeled with psychiatric disability have become victims of social and cultural ostracism and consequently have developed a sense of self that re-enforces the “patient” identity. Enabling members of peer support to understand the nature and impact of these cultural forces leads individuals and peer communities toward a capacity for personal, relational and social change. It is our hope that consumers from all different types of programs (e.g. drop-in, social clubs, advocacy,support, outreach, respite), traditional providers, and policy makers will find this article helpful in stimulating dialogue about the role of peer programs in the development of a recovery based system.”

Definition of Peer Support

“Peer support is a system of giving and receiving help founded on key principles of respect respect, shared responsibility, and mutual agreement of what is helpful. Peer support is not based on psychiatric models and diagnostic criteria. It is about understanding another’s situation empathically through the shared experience of emotional and psychological pain.

When people find affiliation with others they feel are “like” them, they feel a connection. This connection, or affiliation, is a deep, holistic understanding based on mutual experience where people are able to “be” with each other without the constraints of traditional (expert/patient) relationships.

Further, as trust in the relationship builds, both people are able to respectfully challenge each other when they find themselves in conflict. This allows members of the peer community to try out new behaviors with one another and move beyond previously held self-concepts built on disability and diagnosis. The Stone Center refers to this as “mutual empowerment” (Stiver & Miller, 1998).

Peer support can offer a culture of health and ability as opposed to a culture of “illness”and disability. (Curtis, 1999) The primary goal is to responsibly challenge the assumptions about mental illnesses and at the same time to validate the individual for whom they really are and where the have come from. Peer support should attempt to think creatively and non-judgmentally about the way individuals experience and make meaning of their lives in contrast to having all actions and feelings diagnosed and labeled.

Many people have learned roles that build a strong sense of identity as “mental patient.” Because this becomes a primary identity we find affiliation with others who have also been labeled. Zinman (1998) refers to this as “client” culture. This “identity” leads us to the assumption that the rest of the community can’t understand us and creates an “us/them” split with others.

An imbalance of personal and social power lies at the heart of mental illness and is the cornerstone of the theory of recovery that we wish to present. Recovery lies in undoing the cultural process of developing careers as “mental patients.”

We undo this by practicing relationships in a different way. Peer support, therefore, becomes a natural extension and expansion of community rather than modeling professionalized caretaking of people defined as defective. As peers feel less forced into their roles as “patients,” they naturally come to understand their problems in the larger social and political context from which they emerge, rather than pathologizing themselves.

Peer support is a simultaneous movement towards autonomy and community building. It is not based in deficits model thinking. It is a model that encourages diversity rather than homogeneity, and recognizes individual strengths.”

Well put, right? Are we getting this out of our current mental health care system? Hardly.

Anyone who’s been processed through modern medicine’s modus operandi can clearly see the disparity between it’s approach to mental health treatment and recovery, and the peer-support approach. The former being a one-sided approach, and the latter being a two-way street of acquiring treatment and maintaining recovery.

Peer support creates an environment that allows consumers to dissociate the pejorative of clinical mental health patient, and identify it from a more human perspective that transverses across more planes of society and will basically fly under the stigma radar a little more easily given it’s peer-to-peer foundation.

I see it as reframing mental health care in a manner that allows for more accessibility, utilization, understanding, acceptance, safety, cost-effectiveness, hope, community, retention and recovery, and minimizes stigma, attrition, and relapse. I see it as a whole-person approach rather than a symptom-based approach.

I also believe that to have peer support in the role of advocate or liaison for a consumer of mental health care between their community and the clinical side of treatment makes the entire process, as I keep saying, more human. As it is in America, it feels like a machine; not easily navigable, approachable or very caring. Placing a human being in all those voids, one who can actually relate to the traumatic experience of the consumer, seems like an easy answer to me. A wise choice for the attempt to correct the imbalance between personal and social power, as the article states. I’ll go ahead and make the obvious statement that all of that, to me, adds up to more efficiently utilized health care with better outcomes for consumers.

Also, I couldn’t help myself with the image I used for this post 🙂

Peace, love, and wellness.

The Norm

The Norm

Where is the line drawn when things have gotten bad enough to need help, and how do you define that? When I look at other’s experience with mental health challenges, when they describe their symptoms and how it made them know something was wrong, I always try to relate it my my experience. The easiest way to assimilate something is to make it relatable to you.

So when I hear about things like a constant separation of mind from body, uncontrollable racing thoughts and rumination, paranoia, extreme moodiness, uncontrollable emotional reactions and episodes, dissociation, insomnia and oversleeping, panic, hysteria, a feeling of heaviness, body aches and pains, fatigue, feeling angry, sad, edgy, burdened, hopeless, worthless, powerless, afraid, and waking up daily to life generally being a drag, it always hits me with such familiarity because all of that was always so normal for me. As well as all of those factors infiltrating my actions, words, my whole life.

Imagine all of that being your daily norm. My problem was that I didn’t know any better, yet somehow I was still able to eek some satisfaction and happiness out of certain aspects of my life. Otherwise it was perpetually existing in fight or flight mode feeling all those symptoms and feelings. Because this was my norm I didn’t understand how to act on things, I could only ever react. But I’d still managed to protect myself enough to keep it together on the outside by keeping my mind closed, heart closed, and often times eyes closed. Looking at old photos of myself I could see in my face and in my posture the weight of the world I had no idea I was carrying.

I clearly never had a benchmark for my wellness. I never knew where the line was drawn where I could say “something’s wrong with me, I need help”. As long as I felt what I perceived as functional, I didn’t know I needed help. And even if I did, I don’t know that I would have asked for it. It just was never really an option for me. Before I was on my own as an adult I knew that my wellness was my parent’s responsibility so I’d incorrectly assumed that if they weren’t actively taking any steps to help readjust the norm I was experiencing, no matter how much of it they bore witness to or not, then I must not need help. So I pressed on thinking this is the way things are supposed to be.

When I began to fully unravel around the age of 22, all I could really glean from it was that I was losing my mind, spinning out of control, and at this point the only one any longer responsible for my own well being. No more mind over matter, my mind is my matter. I had no idea what was happening to me but trying to get help all of a sudden seemed like the only answer.

Now, over a decade later and in recovery, I read or listen to others’ accounts of their mental health struggles and how or when they knew something was wrong. I find it incredibly fascinating to hear about people’s personal yardstick of wellness and sanity. When someone says something like “I had an entire week where I didn’t want to get out of bed. I felt really heavy, distracted and emotionally off-balance”, or “My thoughts would race, I was feeling apathetic and joyless toward life”, or “I stopped eating regularly and began substituting food with alcohol”, my reaction is generally to the effect of “Wait, that’s what made you realize something was wrong and you needed help? I lived that almost every day of my life. I had to lose my goddamn mind to have that revelation!”

I had to look up the examples I used of where the line is drawn to write this post because even still I sometimes have trouble delineating my reactions and behaviors as either triggers or genuine responses. That’s not to say I can never tell the difference, I’m better accustomed to that discipline by now as I’ve worked to build my personal protocol for working through whatever is challenging me. But it can still be a gray area for me to know where the line is drawn between acting and reacting, especially when in the moment.

“When I learned the other way people thought” was another good account that hit home, too. It used to be that I didn’t realize it wasn’t a shitty storm cloud inside everyone else’s head most of the time as it was in mine. It’s also difficult to see outside of your mental illness box when you’re that deep in it, so you can’t really use that as a tool for comparison. It’s tough to look around you and wonder why everyone else seems lighter and happier than you when you’re too tunnel-visioned by your own little personal, yet normal to you, hell to be able to see it.

It takes examples like this to really shake me, “The first moment was when I was 12 and I seriously considered killing myself rather than have to change in front of other boys in gym class. I thought it was normal to be constantly thinking about suicide when I was younger”, or “When I found myself sitting on a bridge with pocket beers after a 2 day binge. I had spent my entire paycheck on alcohol and went MIA all weekend. Lost my job, was kicked out of the house. I spent several years self medicating on any substance I could get a hold of. It wasn’t until being pronounced dead twice after ODing on heroin until I realized maybe this shit isn’t working”.

Despite getting a reaction out of me, it’s still easy for me to see how these types of behavior can easily become someone’s norm when they never really knew any different. So when someone recounts their experience with something like “I knew when colors weren’t as bright and music no longer made me want to dance”, I don’t by any means intend to minimize their feelings, but relative to the way I used to feel I have no idea what they’re talking about.

I’ll never forget when I was tested for ADHD in my mid-twenties, I told the psychiatrist my story and she called me “a survivor”. It blew me away. Me a survivor? No way, survivors are people who have lived through cancer, or rape, or wars, or car wrecks. I wasn’t a survivor, just a product of my environment looking to shed the layers that were unraveling and be on my way to feeling mostly in one piece. At that time I had no idea exactly what a survivor I was, I just thought I was carrying on. Turns out I’d spent my whole life surviving and had no concept because survival mode was always my norm. I’m happy to say things are exponentially different these days and much of that gray area has become more black and white.

Peace, love, and wellness.

Stay With Me

Stay With Me

Thank you to everyone who’s stuck with me over the last couple months, I know it’s been an obnoxiously long time since I’ve posted here or to my Instagram. My deal is that I got a new job at the end of June and it’s been absorbing every last one of my spoons every day and challenging me in ways I didn’t think possible. Truth be told, I don’t like it at all for a multitude of reasons, including the fact that I have changed exponentially since the last time I held this occupation. I’m coming up on month 3 now and I wake up every day and fight with this job. I’m not doing what I love and what I love has fallen by the wayside, but this is what I signed up for. That was the least of what I knew going into this.

So why did I do it? I was comfortable in my last job but financially as an independent contractor I felt I could be doing better. An opportunity was put in front of me to go back to an industry I’d worked in in my early 20’s. One where I knew I’d have to bust my ass at first but once I’d laid the foundation, the potential for income was there. It’s an industry I know I don’t like, my heart is not in it but I thought I could compartmentalize for the sake of the future stability. It was also an industry at which I used to be really successful. It didn’t take long for me to realize how the new me was not fit for this role, how it was now sucking my soul, absorbing all my personal resources, and triggering mental health symptoms. I now have a prescription for Xanax. I haven’t medicated for anxiety in 4 years.

So here I am rounding out week one of reentry from Burning Man, with the revelation that I have found a silver lining to this occupational experience. This job I don’t like was the much needed catalyst to get me out of my comfort zone and boot me into a place where I could realize the path to pursuing my true passion. There has been a huge lesson to be had out of this as well- stop chasing money and chase my dreams. My heart fully lies within helping people with mental health, I’ve known that for a long time.

For the last 5+ years I’ve been told countless times I should be a social worker, because I’m so passionate about helping people. That’s why I started this project because I wanted to advocate for mental health without having to spend the time on a degree to do so. Realistically I can’t expect this project to pay the bills when I’m doing it for free, and I don’t have the scale or business model in place to make this a career yet. I also don’t have a degree. Therefore quitting my job and going back to school for a BSW is my answer, and once I came to that conclusion earlier this week, a huge weight felt like it lifted off my shoulders and my heart.

That said, I wouldn’t feel right about not sharing my mental health struggles given that I’m here to use my experiences to help others. At first I was really excited for the change of pace and challenge of this job but as I began settling in the anxiety started kicking in. I think it was due to the realization of exactly how alone I was with this position. I took on a territory that I was to build from the ground up within 6 months, with minimal support by a management staff that’s also brand new, from a company that is going through a lot of growing pains and doesn’t have a very substantial or thorough training foundation. Expectations are high, support is low, pressure is on and it began affecting me quickly. The further I went a long the more I realized how this company wasn’t overly capable of setting me up for success, and that I’m not alone in my sentiment. 

I started as per usual, thinking I could manage on my own, naturally with my favorite anti-anxiety/mood regulator lithium orotate. That quickly became no longer enough to manage and I was forced to seek professional help. I began taking .125mgs of Xanax every morning just to take the edge of so I could get my head on straight and begin work. Then another .125mgs in the afternoon, and often another .125 to get to sleep. I had to be careful not to take too much because Xanax is really strong for me and makes me very sleepy. However prior to that the anxiety levels were so high that it began clouding my head and my ADHD kicked into ultra high gear. We know how one mental health issue can feed into others, this was a classic case.

I explained both fronts of my symptoms to the doctor and he suggested medicating the ADHD as well but I was incredibly hesitant. I’ve been off Adderall for about 18 months now as it was incredibly caustic to my body and also never really helped my focus. He suggested Strattera because I mentioned I might be open to a non-stimulant medication but after researching it, I still wasn’t convinced it was the answer.

Xanax was helping the anxiety which did help to ease the ADHD to some degree. I also researched natural ADHD supplements and found Neuro-Peak which has also been pretty helpful as well and I decided I didn’t need to medicate for ADHD which I was really happy about. Still I found myself waking up everyday feeling like a live wire as a result of how ungrounded this position has made me feel. I definitely lost entire days here and there to anxiety because I simply couldn’t function. I also lost plenty of hours to ADHD for the same reason.

I’ve now reached a point where I’m going to ride out the next 3 months of what’s left of my guaranteed base pay and give it my best effort. I want to be able to leave saying I really tried but that the job wasn’t for me. Meanwhile I’ll be working on getting myself back into school and I’m genuinely excited at the prospect of having my degree, and having a future in helping people that will pay the bills. Even if I’m still scraping by, at least I’m doing it heartfully. I’d rather be broke and happy than rich and miserable. I’m also looking forward to a time again when I don’t have to medicate to function.

I now feel a sense of gratitude for this hardship and experience I’ve been through. For the lessons I’ve learned, the new path I’m on, and the weight that has been lifted. I’m also grateful to be a part of this community, to have people who love and support me, and to have you guys who are hopefully still getting something out of my posts. Like you, I’m doing the best I can with the resources I have, and I hope like me, you’re genuinely looking forward to what’s to come in life.

On another note, it’s National Suicide Prevention Week, September 10th-16th. I want to take a minute to recognize the American Foundation for Suicide Prevention and the work they do to help #stopsuicide.

Peace, love, and wellness.