A compassionate discussion about mental health

The staff would like to engage in a compassionate discussion about mental health.

This thread is being placed in the cider press, and the ulcer factory, so that people with sufficient apples (8 or more) can participate. Apples aren't a perfect method of selecting for people who understand the 'be nice' standard of this site, but it's a good starting point.

The staff are volunteers, and we'd prefer to not get bogged down in moderating threads. We'd rather be growing or making something lovely.

Therefore, we are intending to delete posts that have the slightest thing not-nice about them. Putting posts on probation, with a note to the writer, shouldn't be expected in this thread.

This topic might touch on social, political, and religious issues, and is prone to engender deep emotions, dark memories, even current fears. We invite a compassionate, kind, empathetic discussion. If the discussion strays outside of those parameters, expect generous apple cores. If the discussion is compassionate, nice, and helpful, expect generous apples.

If you are not already familiar with them please review the following before posting.

Publishing Standards
Leaving room for other people's ideas
Avoiding telling other people what they should do

Let's have a good, safe, gentle discussion about mental health, without being angry at people who are evil, lazy, greedy, sick, clueless, self-dealing, etc....

If you feel upset while reading or writing this thread, it might be prudent to write off-line in a word processor, or even on physical paper, and wait a day or two before submitting.

I, and many others I know, fall through the cracks of normal life. I can’t hold down a 9-5 job, due to physical and mental pain, I CAN work, just not the normal ways. I have to be able to choose my own times and days, and my own pace, tasks, and people to work with. Within those parameters I do VERY well, and I hurt for people who possibly have parameters they can cope within that they haven’t discovered.

These days I live with my mom, and that’s great, she covers for me on a lot of things, and I cover for her on things that are hard for her. Before then though, it was bad. There were months that I couldn’t get to a grocery store, for either physical or mental reasons. Too much pain or too many factors that I couldn’t cope with dealing with.

We have found the things I am really good at, and those are the priorities in my day, the things I really don’t do well are the priority in hers. The things that are just in between for each of us, we both do as we can.

If you are involved with someone who is falling through the cracks of normal life, how can things be changed to make it easier for them? For me, the days I don’t mind dealing with people, I do stuff out in the world, because on those days I bounce, and am friendly, and easy to deal with. Days I am not bouncing and feeling confident, I stay away from people, I work alone, and get a LOT of things done. I keep lists of what needs to be done, and on days I can, I buy supplies for projects that can be done later, when my physical or mental health is not up for much.

What can be done for those of us who don’t fit in?

About 20 years ago I worked part-time in a Psychiatric Hospital which serviced inpatients, outpatients, intensive day programs for adults and a separate one for geriatrics. What discouraged me was the sense of the "revolving door" which I further identified as at least partly due to a shortage of holistic thinking in many areas and an over-reliance on medication. The intensive day programs were leading the change towards a more holistic approach, but they were expensive and too many people look at short term rather than long term costs.

But what inspired me the most was how as soon as patients were stable and feeling better, they were looking for ways to volunteer to help others. They helped in the tuck shop and in the thrift shop. They volunteered at the local food bank and donated food when able, although I'm aware that was at least partly due to the reality that they knew they would likely be dependent on that service at some point.

Hopefully this thread will be a good place to mention options we've seen work. Humans have commonalities, but also uniqueness. I have seen how much more progress can be made when we look at how/which individuals benefit from which approaches, or which combinations of approaches. When "studies" are done, unlike permaculture where we try to look at the integration of parts, medicine tends to look at illness in isolation in many cases. Hopefully this thread will help us see that "pemaculture approach to mental health"?

My brother in law is 24 years old and has serious mental problems, probably schizophrenia. He lives in a remote village on Mindanao Philippines. He has had many episodes where he has stolen food, horses and other things. Outside of his own village, this could get him killed. He sometimes becomes quite agitated and runs off for hours or days at a time. While I was sleeping, my wife sent all of the messages below. The dots separate messages which came in over the course of several hours. She is safe in our town house in Cebu, on a different Island. Her information comes through barely coherent phone calls from her mother and other relatives. They have to climb the edge of the gorge for an hour to make those calls.
............
Nova ... We got a problem again. Sonny is lost its already 3 days since he's gone.
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We got a big problem.
...
Please answer the call my love.
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Sunny is died.
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Please answer me I need to go to Mindanao.
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As soon as possible.
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I'm getting worried but its not confirm yet.
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 Someone died because of the strong typhoon same place where he went.
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 We found him but he's out of his mind I send them 1, 300 for the food and metal for his hand.
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 We dicided to tie him for now because he always running and he is so strong.
...........
Dale again ... So the situation is somewhat under control for now. A blacksmith has a fixed a ring to his hand and he is tethered like a pig.

Obviously this is not a good solution. I'm going to get one of her relatives to strap him to a horse and get him to a doctor who can prescribe psychiatric medication. I won't be able to speak to any of these people personally , due to language and telephone issues.

There is no social safety net for people like Sonny. Families deal with this sort of thing, and Nova does not come from a good family. Father died 18 years ago and mother operates on a 10 year old level. They are the bottom family on the totem pole, from a village dominated by drunkards. So Sonny's life is largely in my hands.

I think the best thing to do is get him medicated, and then have him shipped to  Cebu, where his sisters can look after him. Any solution dealt with in the village is very temporary, because money sent for medication is likely to be used for other things.

There are very modern hospitals and other modern things in the Philippines that are available to people with money. For people living on the edge of society, there is just about nothing.

Sonny was a top student and was popular until something went wrong when he was about 19. This seems like the right time for schizophrenia to set in and certainly his behavior is consistent. He's mostly a danger to himself. He becomes euphoric and extremely energetic but not violent. He runs off, usually in the direction of the main highway where there are towns with electricity and other modern things. At one time he stole a motorcycle. This could have gotten him killed. Most people in the small village by the highway are familiar with him and they have delivered him home a few times.

He eats what he can find and sleeps outside. It never gets cold there.
.......
I really hope to find a long term solution,  I expect that he will live in a small house on my farm eventually. But for now, he is tethered to a tree and being cared for by his mother, who is barely able to look after herself.

We have discussed his situation at length today and decided that we will get him whatever medication is recommended. If that doesn't work we will try another one and another one. Sonny is quite likeable when he's functioning normally, but he scares people when he has an episode. We are afraid that he will meet the wrong people while he is in this condition.

Dale Hodgins wrote: I really hope to find a long term solution,  I expect that he will live in a small house on my farm eventually.

I really hope you can make that happen for him, I suspect that would be the best solution. It's hard for people who don't know what can be done to do what is best for someone like Sonny.
I cried when I read that post, I feel for everyone involved, there aren't any easy answers. I think you have the best one though :D You have my gratitude for being willing to help him. As someone who has been in bad situations, I appreciate what you are doing, and thank you for him, until he is able to thank you himself.

My wife worries about him constantly, but she's always had trouble getting others on board to do anything. The most any of the family has earned is the equivalent of 80 US dollars per month , so they have always been hampered by lack of funds. There's never been any real chance of family outside of her immediate family doing anyting.

So it will be pretty much me and her, although the younger sister wants to go to school full-time, but she also wants to earn a bit of money. So perhaps I will pay her to be her brother's keeper when we are away. Not a real long-term situation, but at least while she's in school in the same city. He doesn't just go off all of a sudden. It's a gradual thing where you realize he's getting worse. If she were just to administer his medication and make sure he takes it every day, that would go a long way toward getting him stabilized.

We tried him in school starting in June, but it didn't work out at all. Nobody could make sense of the work he did, and he was constantly trying to get his sisters or other people to do his homework. That might change if he gets on the right medication and has some motivation. There are times when he goes on a working binge and he's very productive. Other times, he just lays there.

He can be quite irritating, but it's not something you can really blame him for. Giggling and constantly repeating things and then just annoying things like pissing all over the toilet seat. You'd think a guy 5 ft tall could hit the toilet. He gets so lazy that he will avoid bathing for days at a time.

He didn't like living in the city before , but it's because school was going so poorly. I think if he is having some success, he might like it. At 24, he has never had a girlfriend and has lost touch with all friends from when he was more normal. He really just has his mother and sisters.

He is really good with animals. Never abusive and always wanting to feed and water them. He has a cow in the village. When he becomes euphoric , he likes to release tethered animals. This really pisses off people who have to go chasing after their cows and pigs. But when he's in his right head, he really enjoys looking after animals , so I hope to create that type of job for him on a farm.

I'm a teacher. Over decades of classroom teaching I have seen all sorts, but some particular cases stick in my head. I had a student a few years ago who had undiagnosed and untreated ADHD. They were also very smart, and keen to do well, but had the "naughty" label because of their behaviour, and always under-performed in exams.

I fought to get them assessed, and they ended up on medication. The transformation was utterly remarkable. They went from being completely unable to control themselves, and being a major disruptive influence to others, to loving the classwork, excelling in the subject, building positive relationships, and being excited to study. In their particular case a neuro-chemical imbalance, fixed by some medication, liberated them from something they was unable to manage themselves. They went on to get top grades in my subject, and much better grades across the school.

There is a pervasive narrative that medications for mental health issues are somehow a sign of giving in, or of weakness, or in some undefinable way a negative. I agree that in some cases medications are not necessary or desirable, but in the cases where they are they can work miracles.

Dale Hodgins wrote:He becomes euphoric and extremely energetic but not violent.

This looks  more like the manic phase of bipolar to me (saying as a bipolar person).  Euphoria and extreme energy are hallmarks of that phase.  Mania can come as part of a cycle or it can be triggered by stress or over-stimulation.  People often run off during a manic phase and not infrequently steal things or get in fights, and consequently end up in jail.

My sister and I have bipolar disorder as did our maternal grandmother.  Fortunately we have never been jailed though my sister has been hospitalized many times.  Even with modern treatments this is a tough disorder to deal with.  I've been stable for a long time thanks to medication and a low-stress life, but my sister is still struggling to maintain stability.

Tyler beat me to it. This is a layman's point of view, but my job involves me with psychiatric patients. Sonny sounds like he may be struggling with bipolar issues, as Tyler said.  Many people do very well with the proper meds. I hope you find a conscientious doctor. Getting the right meds properly dosed makes an enormous difference.

My own struggles are so tame compared to some people's here, it's almost embarrassing to voice them. I'm a pretty extreme introvert, but I'm pretty likeable in general, for reasons i don't understand,  and I get along with people. I find social situations exhausting but I've learned to deal with them. My biggest struggle is coping with the loss of my brother.  We were very close and I miss him so much it's hard to describe.  Tired and sad pretty much sum up my existence now.  Even when I'm doing something I enjoy, there seems to be a dark cloud in the background, just waiting to overwhelm me when something reminds me of my brother.  It can hit out of the blue and it's worst when it catches me off guard so I can't brace myself. Add to that that I feel like a complete whiner because I can't just get my shit together, suck it up, and get on with things, and you have the recipe for mental chaos. And now I feel like a whiner again.  Ugh.

My daughter is bipolar. She struggles to deal with everyday stuff, now with the death of her son, I just don't know if she will make it. She has an amazing therapist, that she listens to. I'm hoping that will help. I am extremely grateful that she didn't try to harm herself when the sheriffs were here. Her being locked up wouldn't have helped anything. We don't leave her alone ever, right now. But everyone's around right now. I'm afraid for when they all leave. We are working on getting her back on medication. She has been off of it because of the pregnancy and subsequent nursing. Although they never really came up with anything that worked well. She doesn't have much mania, mostly depression with short rapid cycling manic episodes. Hopefully we will find a good psychiatrist for her, her therapist is helping us.

I'm going to pursue the bipolar angle. That does make more sense, because it's a gradual build-up and there were a few triggers. He had an episode after a long car trip where we went to a waterfall and other things and he had another one shortly after our wedding, when there were lots of social interactions that he is not accustomed to. He is used to being ignored or ostracized and that is his normal. So being included in lots of social events in a short time period, may have been a trigger.

He hasn't lived with his sisters since they all headed off to work at 6 years old. So living in the house with me and two of his sisters was probably overstimulating. The girls always have something on the TV or YouTube and they invite friends over for Zumba dancing regularly. This seems to be the number one cultural practice in some areas, more evident than Catholicism. You can show up at the mall before it opens and do Zumba.

We tried to include Sonny in everything, and it may have been too much. I took him to the bustling market with me and took him to the fried chicken place and the to other places where I thought he might be able to meet girls. His absolute shyness put the brakes on that idea.

We were in an area where it's not uncommon to go hours or days without seeing another foreigner. Sonny always had people questioning him about me. Do you work for him, is he married, do you think he would wantto hire me? Lots of questions that he may have had trouble keeping up with, but none of it was in English and I never thought of it being overwhelming.

Every day, in the city of Cebu, Sonny would have been subjected to many more social interactions than are normal for him. Whenever he was with me, I'm sure that was magnified, because he was always expected to speak. I enlisted him as translator many times and I know that was difficult because his grasp of English is quite minimal. He seemed to understand what I say but does not often respond verbally. I could tell him we need eggs, and give him the money and he would come back with eggs. I could ask if he was hungry and ask what he would like to have, and he might give a one word answer like chicken or eggs.

In the village, the most likely trigger is his mother who seldom stops talking. When we were there, she woke us up at 3 a.m. to see if we wanted coffee. Half an hour later she roused Sonny out of bed and sent him to the well for water. That could have waited till morning. Because of her behaviour he seldom has a full night sleep or A Moment's Peace.

A couple weeks ago, Nova mentioned that she would like to build our house immediately adjacent to one that we build for her mother. I told her absolutely not. She will get her own house in the farthest corner of the farm , because I can't listen to that all day. Nova was 11 the last time she lived full time with her mother. She was taken out of school and away from her job for about 18 months, when her mother decided that grade 5 was more than enough education. Then, when she was 11, she revolted and told her mother that she wanted to get another job and go back to school so she wouldn't end up like her. Apparently it was a very tense time between them.

Sonny is the only offspring that has lived with her as an adult, except for the brief time when we had them all living in a townhouse in Cebu.

I will build two little houses on our farm, so that we can accommodate Sonny and his mother, separately. I think there needs to be some separation at some point. They may end up in the same house most of the time, but at least he would have somewhere to retreat to.

I don't plan to completely ostracize Nova's mother, but I'm not going to let her dominate 1% of my time, so that means we need some distance. I will get her dentures and other medical help. All of her teeth are stubs. She likes animals and she wants to be doing something constantly , so I will make sure she has enough animals and enough things planted that she has something to do with her time. When she's doing something, she sometimes stops talking.

Dale Hodgins wrote:

He gets so lazy that he will avoid bathing for days at a time.

Dale, please, please, please try very, very, very, hard to replace in your brain the word I bolded with the word "sick". Reading over both your posts, I'm wondering if your mother-in-law doesn't also have some diagnosable mental illness which constant talking and moving and not sleeping well are a mixture of symptoms and her attempts to cope with the illness on her own without help.
I am *not* going to ask you to edit your post, because I really believe that the first step in helping people who are struggling with brain chemistry or wiring that is hindering their lives, is by helping all the people who might read through these posts to stand back and look at themselves and their loved ones through a different lens.

A simple concrete, non-threatening example. My #2 son has dyslexia, but the public school system denied it because he could use his strengths to balance the problems and look "average". In Grade 4, he figured out on his own, that he could reliably tell the difference between "B" and "D", but not "b" and "d" (or "b" and "p" for that matter). For whatever reason, he had more trouble in the middle of words, so "problem" became "proBlem" or "public" became "puBlic". Was this because he was lazy? Not a chance. Was this was because he has great skill at finding solutions outside the box? Quite possibly. I finally took the plunge and home-schooled him for several years and spent a lot of money (worth every cent) on programs that helped to grow and develop new patterns in his brain that would help him compensate for the areas that were weak or giving trouble. This does not change the fact that he's a card carrying dyslexic. It just gave him *many* more tools, and more socially less obvious tools, to handle the problem. Brains are not fixed in concrete. I've seem them change and adapt for seniors who've had strokes, so there's no reason they can't change and adapt for people who have chemical/hormonal challenges - at least that is my sincere belief, based on things people have told me and things I've seen.

Dale: I think you are on the right track wanting to give Nova's mom stuff to do. If you think about that she has been busy all her life, in a culture that values women for what they do, it's not surprising she does what she does. Everyone needs to feel wanted and needed, and she is used to that.

As someone who goes into social overwhelm, I'd say you may be correct in Sonny being overwhelmed, especially if he's shy and hasn't had a lot of social interaction. For me, it depends on the way my energy is running, when I'm bouncy and fine, I have zero problems with people, when I'm not feeling confident, it's cumulative, I can handle x amount of interaction, then it starts going bad, and if I'm pushed after that, it gets bad. I bit a lot in high school, due to overwhelm and being pushed WAY too much. Animals are easier to deal with, they don't mess with your head, it's predictable what they want.  
I LOVE The visual of Sonny having a small house, down by the animals, and let him find his own level he wants to cope at. One of the things I have learned is to not let people force me to levels I don't like. I am perfectly capable of managing a business, I hate it, won't do it anymore, don't care what you are offering to pay me. He doesn't sound confident enough to draw lines like that, especially against his mom, who would be overwhelming. Suggestion: when you are there, ASK him "do you want to go to the market with me?" and let him know that "No" is a valid answer, that will be respected. I have had people ask me, then get pissed if I said no, makes it hard on a bad day.

Jay Angler wrote: I really believe that the first step in helping people who are struggling with brain chemistry or wiring that is hindering their lives, is by helping all the people who might read through these posts to stand back and look at themselves and their loved ones through a different lens.

YES!!!
The lens of "normal" functioning is not the right one for some of us, and that's what I have been trying to explain. Within my own parameters, I can do all KINDS of neat stuff, I can't cope in a "normal" 9-5 type job situation, it just shreds me. Trying to explain that, though is hard, as most people have no context for anything other than what is familiar because they can do it easily. A suburban life, with a 9-5 job would break me into small bits, most people would tolerate it, if not thrive.
The question I'd like to have people asking about their loved ones is "What parameters can I help them make happen, so they can thrive too?" And one of the first ways to answer that, is to ask them, and to listen to what they say, and try to understand it, not always easy, because it's hard to communicate what you can see, sometimes. And the answers are the tip of the iceberg. "I can't work with Jean." might mean "I need to not be micromanaged by anyone, Jean just being the current one doing so."  I do well with "here's a list, tell me if you need anything" but I had a girl who worked for me that if I gave her a list she got 2 items on it done, didn't matter what was on the list, after two items, she overloaded. Totally opposite of me. She thrived on being told pretty much every step.  We are all different, and that's even more extreme when we are farther off the bell curve of "normal" for whatever reason.

I view showering as an indicator, nothing more. When I had my breakdown years ago, I barely got out of bed for 5 years. Generally, I could only manage one thing a day, typically I chose to feed my kids (teenagers). Every couple weeks, we would get take out, so I could shower.

My experiences with hospitalization, partial hospitalization and IOP (intensive outpatient program) are that hospitalization and partial hospitalization (day programs) were mostly babysitting, and provided little real in depth therapy. They were always worried about triggering others. IOP was a life-saver, with a nice mix of check-ins, coping technique teaching, and small group therapy.

I moved out here, so as to live in an environment that I don't need to be sedated to survive, now I don't know if it will be enough. And my daughter and I are very different people, with different diagnoses. All of my kids have borderline tendencies, because they were raised by a borderline mother, but they are not borderline. My daughter needs to be around people to stay out of her head. I'm not a people person, other than children, and now he's gone.

I know that I'm all over the place, but that's as good as it gets right now.

Stacy, I hope you and your daughter seek all of the help that you need. You may not always be the best one to help her , because you are so close to the situation, with the loss of your grandson. I hope that you both are able to access and accept help.

This hangs on the wall at my place of employment. I find it to be simple, and profound, and it never fails to put a lump in my throat.

This resonates with me as well.

I took Sunny out of his comfort zone on numerous occasions. He didn't have to be talked into it. He was quite enamoured with the motorcycle the minute we bought it, since they have never had anything that expensive. It's worth 5 times as much as the mother's house.

So pretty much whenever I suggested a trip to the market, or to get chicken or ice cream, he was good to go. When we rented a car I was informed that this was the first car ride for both Sonny and his mother. But once we got to wherever we were going, he had a lot of interactions with other people, simply because he was with me.

I had also mentioned to him that when he finishes school, we would work on getting a driver's license, and then when me and Nova get a new bike, he would get the old one. So again, he was very keen to go places on the motorcycle.

His mother really pushed the idea that it's good to have your own white man. Both her and Sonny, and the sisters, shared details about housing, dental work and other things that I have provided. They did this on Facebook too, with mixed results. Some people were happy to learn that Sonny and one of his sisters were back in school full time, but one of the relatives made sure to point out that they were still the bottom family in the village, who would be there again, when I return to Canada without marrying his sister. We did get married, and that particular one hasn't bothered us anymore. This is something Nova dealt with the day we visited her village for the first time. It was mostly the women, wanting to remind her of her place, at the bottom.

I don't know how much his lowly social status has affected his mental health, but it can't help, to always be told that your mother is crazy and therefore you will be crazy and never amount to anything. I have seen this on my wife's Facebook from relatives who are jealous about money. One of them suggested that I should be killed, because I've chosen to not invest in the village, or give money to all of them.

Dale - thank you. I know that I'm not always going to be able to help her, and am fortunate to have help. Both of us, currently are feeling extreme guilt for any moment that we are not despondent. We are trying to balance the pain, and trying to stay busy.

We will be planting a linden tree with his placenta and ashes so I doubt that my daughter would ever want to leave our property, but we often feel like this place should be scorched earth.

The only comfort we have is that we had him, for a while. There are many people in this world that never get that, never get to have that kind of love. He was our sunshine, and a blessing in our lives.

"The staff would like to engage in a compassionate discussion about mental health."  I had to admit I was take aback a bit when I read this first line, Joseph....as in "...is there any other kind of discussion except a compassionate one to pursue when discussing this topic?"  But I would be playing ignorant to the fact of how often discussions and recommendations are steeped in shaming and belittling the sufferer.  Coming from a family that mostly approached mental health from a shamed/shaming perspective, to propose a discussion thread rooted in compassion is as foreign as it is welcomed.  It is an area that I feel permaculture as a phenomenon may provide great opportunity.

Even though I'm not Native American by lineage or culture, I start with this outlook on community and cosmos:
"One of the most important Native American value is respect.  It is believed that all of life is sacred: the mountains, lakes, plants, animals, and people.  Each has something to teach and all things have a purpose.  No person is above another, everyone is equal.  To show respect, Native cultures teach that respect should be giving and shown for all beliefs and religions.  Show respect for other people by never interrupting a conversation or intruding into a one’s personal space. Never speak negatively about others and listen respectfully to what others are saying even if you do not agree.  Be truthful in conversations with others and with the self.  Native American values and cultures believe that everything and everyone is connected.  What we do to others and to the planet we do to ourselves.  Practicing love, honor, gratitude and respect daily will unify us with the planet, its creatures and the Great Spirit...." -- https://kheopsinternational.com/blog/native-american-values-and-their-impact-on-native-culture/

With the reminder that permaculture, minimally, is "...an agricultural system or method that seeks to integrate human activity with natural surroundings so as to create highly efficient self-sustaining ecosystems" (merriam-webster.com), and that natural surroundings *tend* to be biodiverse, it's not surprising that diversity of human thought, behavior, and activity is generally valued in a permaculture vision.

Not challenging the 'organic' origins of some aspects of some mental health conditions, it just seems to me that a good portion of mental health problems stem from "square-peg-in-round hole" experiences and environments.  There is both a developmental aspect of the ramifications of the sense of "not belonging/understood" as well as later feeling, as an adult, of continued estrangement from family, community, and/or the culture at large.  And of course there can be intersection between what we are gifted in our genes and how these interact with our experiences.

I think the good news is that 'compassion' at least **seems** to be gaining steam as a/the crucial component to the alleviation of mental suffering, possibly even to measured recovery.  Gabor Mate is an author and practitioner prescribing this approach for addiction recovery,....after decades of addict shaming programs and directives that appear to have yielded mixed results.  A recent radio show that I heard clearly exemplified the desire to move away from shaming those seeking pregnancy termination to showing compassion regarding their difficult decision.  Another story occurred not long ago where a young man brandishing a gun at a school was met with compassion from an unarmed teacher/coach and de-fused the situation.  To feel shamed is to feel cast out....to not belong and no longer feel valued, often as a consequence of cultural norms, but not infrequently pervading family codes themselves.  I would argue that in some extreme cases, this could be the origins of a mental health condition all its own, but even if not, to engage in shaming behavior as a means to deal with mental health conditions would seem almost to guarantee failure.

So this is where permaculture, with a potentially greater openness to diversity of thought, feeling, and experience, may allow those with viewpoints/visions.....states of being that otherwise may be a source of intense dissonance with 'non-Permie' outlooks....to more readily and early in life connect with those who may nurture their development and/or their mental and spiritual health.  By way of disclaimer, much of this view was formed in early life personal experiences that might be considered the opposite of diverse, of respecting, and exhibiting compassion and it is a view that clearly is addressing a complex issue with broad paint strokes.

I know a young woman right here in Victoria who isn't getting the mental help that she needs, because her mother is dead set against it. She's not willing to concede that there could possibly be something wrong with her daughter. This woman has pretty much ruined her medical career by latching onto every faddish thing she has seen on the internet. It's more important to her that patients avoid medication, than they get better.

She's become almost anti everything and when someone exhibits bizarre behaviour, it gets blamed on foods or treated as a personal failing, requiring counselling, to correct the behaviour. She refuses to see any behavior, no matter how bizarre as symptomatic of a mental illness. Shaming, denial and blaming her ex-husband, who is pushing for a psychiatric assessment.

I know a young woman right here in Victoria who isn't getting the mental help that she needs, because her mother is dead set against it. She's not willing to concede that there could possibly be something wrong with her daughter. This woman has pretty much ruined her medical career by latching onto every faddish thing she has seen on the internet. It's more important to her that patients avoid medication, than they get better.

She's become almost anti everything and when someone exhibits bizarre behaviour, it gets blamed on foods or treated as a personal failing, requiring counselling, to correct the behaviour. She refuses to see any behavior, no matter how bizarre as symptomatic of a mental illness. Shaming, denial and blaming her ex-husband, who is pushing for a psychiatric assessment.

Sadly, I know too many people with stories like this.  

People don't want to seek help, because they think help=pills.  This is no longer the case, at least where I live.  Medication is usually a last resort, as most medications can cause physical, permanent harm.  Other methods are tried first, and the doctor has to prove there is a need, and continuing need (every 3 to 6 months depending on the medication) for the meds.  When the meds are needed, they are provided.  But the preference is for other ways through the dark times.

What's more, people fear that once you get a label of needing help, you keep that label forever. You are now officially a failure (or a failure of a parent for producing a faulty product).  It's a very harmful belief and one, I'm sad to say, is very strong in society. One of the causes of this fear is the lack of information.  Talking about mental health is taboo.  Admitting to not being able to cope means you aren't trying hard enough.  At least, that's how it is viewed and I think that's probably the biggest hurdle to understanding that needing help doesn't mean that you are a failure.  It means that you are a member of society and we are all in it together, so of course, it's okay to need help sometimes.  needing help at one stage in your life doesn't mean the rest of your life need be dictated by that moment.  Like breaking a leg - we need crutches to walk while things heal, but that doesn't mean the rest of our life will be defined by that crutch.

The way to understand this is to talk about it.  But we don't.  So people live their lives afraid to ask for help and seek out more 'acceptable' causes for these symptoms.  


A big problem is that the mental health system here isn't as transparent as it can be.  It's gone a long way towards healing rather than drugging problems - BUT people still see the old Victorian approach to mental health and fear seeking help.

Mental issues are one of the few things that are still openly mocked in society, whether it be a comedian or someone who is just angry with a politician. They will say that he's crazy . He's gone off his rocker or anything else to display that they don't share similar views.

Sitcoms often contain characters who have mental issues. They've gone from those who are just a raving mad, to characters that have extremely obsessive tendencies.
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When I was a kid, I watch the cartoon where Bugs Bunny somehow ended up at the Bedlam Lunatic Asylum. The inmates were punchlines. We didn't see anyone emerge  greatly improved. They often sent people in other cartoons, out with a van and nets to capture people exhibiting unusual behaviour.
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A few years ago, one of my homeless workers was standing on top of a table at McDonald's, playing his harmonica. The staff had called the police and when they got there, two of them wanted to take Freddy down violently. Luckily, one of the cops knew him and she sat down with me and Freddy to talk about what had happened and that he now must leave. He was a little too drunk to be dropped off at the homeless shelter, but he agreed to get into her car peacefully, on the condition that she would take him to the shelter in a few hours when he sobered up. That's what happened , and that freed up police resources, instead of keeping him locked up all night and half of the next day.

Freddy was in the middle of a manic episode that seems to be exacerbated by alcohol. Punishment or the threat of punishment when he's in that state, would not be appropriate. ...On a positive note, Freddy is an awesome harmonica player even when he's had a little too much to drink. Many of the onlookers were happy to listen to him, but the staff wanted him gone. Before the police showed up, I had talked to some of the staff and said that he just wants his moment and he will tire soon enough and leave without incident. But the manager was insistent that it needed to be a police thing, in order to punish his behaviour. Several of the junior staff were happy to listen to the performance.

Great example of another cultural difference.

I think we are blessed with some pretty awesome police officers.  I like the ones that hand out $50 bills to good drivers at Christmas rather than tickets to bad drivers.  

But a lot of my peers are antagonistic to police because they see only the bad news from other countries.  

Trace Oswald wrote: I feel like a complete whiner because I can't just get my shit together, suck it up, and get on with things, and you have the recipe for mental chaos. And now I feel like a whiner again.  Ugh.

Trace, I've heard it said that everyone feels their own suffering in isolation- i.e. it's like comparing pain. Does a kidney stone hurt more than labor? How about getting your toe crushed by a horse? How about a sliver of metal in your eye? When you're hurting WHO CARES, it's %¨(!&$¨PAINFUL!! Our own suffering is what we know, and it's not fair to yourself to try to compare it to what other people have managed to get over. Those folks can be inspirations to us, but we also don't know what kind of help they have had to get through it, and even if all conditions were the same, people are not the same, nobody comes with the same baggage.
I guess what I'm trying to say is please be kind to yourself, not least of all because you're still hurting and vulnerable. Grief is a heavy load to bear and also sneaky like a nasty pony, will come up and bite you in the back when you least expect it. Take care of yourself and take one day at a time. The day will come that you will get your shit together and get the show back on the road, even if it feels like you're at the bottom of the well right now.
Big hugs. I've been down at the bottom of that well and it's not fun.

John Weiland wrote: ...
Not challenging the 'organic' origins of some aspects of some mental health conditions, it just seems to me that a good portion of mental health problems stem from "square-peg-in-round hole" experiences and environments.  There is both a developmental aspect of the ramifications of the sense of "not belonging/understood" as well as later feeling, as an adult, of continued estrangement from family, community, and/or the culture at large.  And of course there can be intersection between what we are gifted in our genes and how these interact with our experiences....

I wanted to join the compassionate discussion. Didn't know where to start. But then I read this. This is one of the things I thought about.
We live in this world, this system, around us. That world is based on 'the average person'. Of course that average person doesn't exist. But some people differ more from the average than others. They (we) 'just do not fit'. Like the square peg in the round hole. And that causes problems, mental issues, which can lead to physical pain too.

In my opinion being different from the average, very different, often goes together with being interested in permaculture. So talking about mental health needs to be in Permies!
I saw some other threads on related subjects here on Permies (f.e. on introverts, on Asperger / autism). Like biodiversity is promoted through the principles of permaculture, neurodiversity is too, in 'social permaculture'. All kind of different individuals are part of 'the people', mentioned in the permaculture ethic 'People Care'.

So I work for a criminal defense lawyer. Tons of the clients that come in here have mental health problems. Often times it's because they've slipped through societies cracks, attempted to self medicate (with drugs) and societies solution is to throw them away again. It's a broken system for sure. I don't know how to improve it though. Part of the problem is getting people to seek out help. Then there is the problem of being able to afford it.

My husband has also gone through mental health problems. The medications aren't good. The side effects of them being far more serious than appreciated. I can't even tell you how many times he went to the ER due to medications interacting (prescribed ones at that) or other things. So, he's developed a holistic approach that works very well for him. I'm not saying no one should take psychiatric meds but I do think if you can manage your mental health without them, you should give it a go.

Elle, it's so hard to see people not get the help they need (especially when they expect/need/depend on some sort of response from medications or therapies).

Dale, I really think it's excellent you are looking at ways for your in-laws to be involved in your future. It is a really hard situation and you clearly care about your new family.

We have a situation in our family that is similar, we have an older distant relative (I've met her twice in the 13 years I've been here) who is holing herself up in her house, accumulating dogs, and throwing rocks at anyone who tries to come and talk to her. She is frail, but even so has these episodes in which she gets offended and does something wild (a neighbor parked his tractor trailer on the street in front of her house. She didn't like it so she slashed the tarp covering his load, his tires, scratched up his paint job, and apparently smashed in the windows). She was arrested but released because of her age. The town is tiny (5k people) and has no services to offer. The neighbor didn't pursue charges, people keep calling my mother in law (who was her sister in law) to "do something" as the only living relative. We (the kids) have talked about what can be done, and we've driven the 6 hours out there to talk to her, only to get hit with stones for our trouble. She yells and says we're out to get her money, then locks herself in the house. For me, getting hit with stones once is enough.
She obviously needs help. But our only option is to have her declared mentally incompetent and institutionalized, which I don't believe is the right thing to do. First, it would entirely destroy the life she knows, and she'd probably be sedated and/or restrained since she's kind of violent. The other question is that we'd be responsible for paying for that care. For a person who has never been a part of our family, while my mother in law doesn't have a health plan, for example. It's a huge financial burden for someone we barely even know. For the time being we're leaving the situation, it so happens that we know her lawyer (the one person in the town she will talk to) and he has said he'll let us know when he thinks she is no longer competent. It's an uncomfortable situation (I cannot imagine being her neighbor, for example) but I really don't think there is an easy solution.

Tereza Okava wrote:

She obviously needs help. But our only option is to have her declared mentally incompetent and institutionalized, which I don't believe is the right thing to do. First, it would entirely destroy the life she knows, and she'd probably be sedated and/or restrained since she's kind of violent.

I can totally see the police point of view. I believe the last time I heard the statistic quoted, there were 4, only 4, dedicated publicly funded beds for potentially dangerous seniors for all of the Nursing Homes in the Province of Ontario. There are articles about seniors killing other seniors in nursing homes and what can be done about the "problem", but there are also *very* strict rules in Canada about drugging seniors "just to calm them down".  (I suspect the rules are *much* laxer in many places.) If Auntie's gone a little paranoid, the last thing anyone would want would be to surround her with strangers or helpless seniors! Of course, slightly paranoid people are going to be *very* suspicious of any drug offered as well. I don't know if we've got any herbal people who could suggest a tea that might take the edge off, or if she'd even consider drinking such a thing, if she won't even talk to you.

The risk to mentally ill persons in prison is also very real and totally scary to me. Too often, the "lock-up" is the worst possible location for the person. Our mentally ill have no place in the prison system, in my opinion. They need counselling, health care, possibly some medication, usually education, and frequently a sense that they are in a safe, supportive environment, and prisons meet few to none of those needs. People may suggest it "would be for her own good", but many people are raped or assaulted in prisons, so I would rather come up with better models of holistic care for our mentally ill, than following that advice.

The cost of "warehousing" people in either hospitals or prisons is an incredible drain on the economy. Unfortunately, too many people fear those who are different. Thus, they worry that group homes in their neighborhoods will "decrease their property value" -  NIMBY at work. A permaculture approach of small group homes surrounded by food producing gardens would seem like a much healthier situation and would give the people the opportunity to work with nature in a supportive and healing way. There is good evidence out there of positive outcomes secondary to working with animals in particular. And yet, a recent government closed the one remaining "farm prison" on the prairies.  They claimed it was "too expensive to run". They didn't look at the cost of the revolving door. There are actually statistics relating to homeless people who get themselves arrested on some not-too-serious charge around November, knowing that they'll be let out around spring!

Sonny is speaking now and they will try to get him to wear clothing soon. I didn't know until yesterday that he has been naked all this time. Nova said that this is something he does when he goes on a tear and he lashes out at anyone who wants him to get dressed. It never gets cold there. Various relatives have atempted to get him dressed, but he is quite strong and they keep their distance. Many of the men in the village are very lightly built. Sonny is 5 ft 1inch tall, but quite powerful. He took up boxing in his teens and has a 7 and 1 record, all by knockout. His loss was a disqualification.

He has been tethered to the house so that he can go to his bed but also to the porch. His mother washes him. He wasn't eating much but now he has begun eating and this usually means he's getting back to normal. There's still a risk of him running off and stealing.

He's been taking medication for about a week. My sister-in-law is going there on Saturday to deliver more medication. She has convinced a doctor to prescribe the same thing as last time, but a higher dose, without seeing the patient. This is common. Many things that would be prescription in North America are over-the-counter things in the Philippines. Street vendors sell Viagra. The television advises people to self-medicate for all sorts of real and imagined ailments.

His youngest sister is travelling there for Christmas, and she will bring him back to Cebu.

Nova tells me that one of his triggers is hunger. We sent plenty of money for food, but his mother is extremely wasteful of food when they have lots. She cooks and cooks and cooks and then when there's too much, she gives it to the pig. This family has the most expensive pork on the planet, and they are in the bottom 1%, in a poor country.
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We are going to try to get their mother to come as well. They need to get rid of the last of their livestock so there is little need to return.
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The children have always been embarrassed and endured ridicule because of their mother. She often delivers animals from small villages, to the highway for a fee. She will carry a little pig in a burlap bag over her shoulder, so that she is covered with pig shit by the time she reaches her destination. Many people are helpful to her, allowing her to clean up at their well, and giving her water, but there are also many who avoid her.

Nova said that even when she was quite young, she would look at her lot in life and wonder why she had to be the child of the strangest person she had met. She was taken out of school for over a year and included in the  livestock delivery business that pays  far below the poverty line. The three sisters would meet people in town and they're always very surprised to discover that Vilma had daughters who were normal and pretty. She seems like someone who might live on her own, in a cave.

When I went to the village last year, they had a relatively new looking outhouse. I found out last week that this was constructed with money I sent, and it was the first proper toilet that they have ever had. All during their childhood, the whole family just pooped in the bushes or in the river. The relatives were not pleased with this, but nobody ever took the time to build an outhouse for someone who was never going to do it on her own.

Nova, and her younger sister Isabelle feel a constant need to prove themselves to the villagers. When they were only earning $2 a day, half of it went to the village. She has been a bit angry at her older sister Ricci, for her attitude toward it. She's pretty much done with it all and doesn't think she owes those people anything. She decided a few years ago to save herself, and concentrate on her education. Nova is slowly coming around to this line of thinking. Isabel, the youngest, is still a slave to the expectations of people who don't give a damn about her.

Things have not gone well for Sonny in the last few weeks. He was talking and behaving himself, but then started spitting his food and lashing out. He is still tethered. His youngest sister will be on the ferry tomorrow morning and she will take him to the doctor. Nova assures me that when Isabelle gets there, sonny will calm down and he will listen to her. It has happened before. His mother becomes more and more agitated, and they feed off one another. Her mother also exaggerates every situation in order to extract funds from her daughters. When I first met Nova, she was sending more than half of her $100 per month, to her mother and her sisters were doing the same. I've seen this with many families, where they pour resources into those least likely to succeed. Upwardly mobile families don't do that.

Isabel will take him to the doctor and then they will probably spend a week or so in the village until his condition stabilizes. They won't let him on the ferry to Cebu if he is acting wildly. There are other relatives in the city where this doctor is, but Sonny is not welcome there, because of past nudity and open defecation that they are not comfortable with. He had no toilet growing up and doesn't seem to realize just how unusual this is. All of his sisters were aware by the time they were about 6 years old, that their home situation was anything but normal.

After the doctor gives him the okay to travel, he will move into the townhouse with Nova and Isabel. Both of them are able to deal with him pretty well even when he is not medicated, but we are still very much wanting to find a medical solution.

Last week, my mother who was raised in Canada and graduated from school, suggested that Sonny should be taken somewhere to have demons cast out. This was on a family messenger page. I explained a little bit about the place and family history of going to witch doctors and sorcerers and told her that of course that's the first thing they tried. But, because this is not the Middle Ages, that is not a route we will consider. My brothers and sister thought I was too harsh with her. So, we both have mother issues.
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Just today, I learned that 2 1/2 years ago the villagers got word that someone could help him in a neighbouring barangay. They bought a 20 kilo pig and took it to someone who was some sort of priest. There was praying and chanting and then the pig was laid in front of Sonny and killed. The plan was to put the evil spirits into the pig and then they cooked up the pig , which would kill the evil spirits and make it safe for consumption. Then they had a big pig roast. A good time was had by all, including Sonny, who had a good feed of roasted pork. Nova was unaware of the exact plan when she sent them 1/3 of her monthly income. Embarrassment is a big thing in Philippine Society. She didn't tell me about it before, because she was embarrassed. She was raised with all of this stuff, but in her early teens stopped believing in any of it.

My oldest brother is autistic. When he was 11 they decided the demons needed to be cast out of him. They scared him so bad that he peed the bed for a while. Rural Ontario, early 70s.

I'm glad that Nova and her sisters understand that this can only be dealt with as a medical condition. You can see why I have to send a family member and not send money. Money has been tried before.

Isabel arrived at the village yesterday. Her total travel time would be somewhere between 12 and 14 hours.

They released him from the tether. Sonny got dressed and went to the city, with his sister. They went to a doctor, where something was prescribed. When we last heard, they were eating at a restaurant.

I would prefer that they proceed directly to Cebu. But they are going back to the village, for Christmas. Nova has sent a bunch of little gifts for various aunts. Good size bottles of perfume for $1.25. You just know that's going to be nice smelling stuff.☺
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I don't know how much Sonny remembers about his episodes, after they are over, or if he has any control over what's going on during the event. I do know that several months alone with his mother in the village, culminated in what we saw over the last month. After one day with his sister, he got dressed and went to town. It didn't look good for a while. At one point he was vomiting and the midday heat alone requires that attention is paid to staying hydrated.

I'm pretty sure that they are all going back to the city together. Last time, he shared a room with his mother. This house has one more bedroom, so I'm hoping they can put him somewhere on his own, or with Isabel.

I would like to see their mother medicated in some way, just to stop the chatter. If it helps her in some way, all the better. Anyone sharing a room with her, never gets more than two hours of sleep at once. She might decide to rearrange her clothes, or sweep or make coffee at 3 a.m. . I don't imagine that this sort of schedule could do anything but harm to a person who is already on the edge, mentally. She claimed that she wanted to go back to Mindanao because of the heat, in the city.

There's a good chance that she didn't like my insistence that she shut up sometimes. The children have always listened to her, to some degree, because she is the mother. I made it quite clear, that she had no say in anything, and I am still very firm on that. She was pressuring Nova to have a baby right away, and insisting that I shouldn't be allowed to go anywhere on my own, for fear that I would take off with the first floozy who showed interest. Most importantly, she treats Sonny, her oldest child, like a baby. I don't think she wants him to grow up and move past her. She doesn't want to be alone, in the village or anywhere else. All three daughters are well beyond the point where they would ever choose to live with her. Sunny is her only offspring, who has absolutely nothing going on in his life, and can therefore spend all of his time with his mother. He's 25 years old and it needs to stop. I noticed that the first day I met him. It's just not a normal situation.

They will arrive in Cebu, in early January. I think it will be all three of them, but you never can tell. Nova will be in charge of medication enforcement. If whatever he has been given, stops working, she will take him to another doctor.
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I have made all help with education and housing and everything else for Nova's siblings, conditional on them not consuming any alcohol whatsoever. I suspect that Sonny has broken this rule. Alcoholism is rampant among the males, in his village, and the drunkards don't like to see anyone sober. He has probably caved in to that pressure. The oldest sister has tried alcohol but now claims to not drink any at all. I certainly don't send enough money to support any sort of habit. Nova and her younger sister have never tried alcohol, and they know it's something I would not tolerate. If someone has enough money to consume alcohol, they obviously are wealthy enough that they require no help from me. Their father spent time in prison  and died from alcohol and there are about 10 uncles who are headed in that direction. Alcohol has been a big concern for Nova. She said that her uncles constantly tried to get Sonny drinking, even when he was quite young... They come from an absolutely beautiful place, in a deep gorge by a clean river that runs out of the mountains. It's a really shity place to be, most of the time, because of alcohol.

The money that was to last until early January, is gone. Her mother called through a relative yesterday. We said no. Their tickets are already purchased and they wanted to change them to today, which would also be another expense. Food is very cheap there. If they are truly out of money it's because it was spent on other things. She can gather coconuts or something from the river.

Nova has been quite angry with her older sister, who gave up on her mother a couple years ago and said she would no longer send money. She decided to put all of her resources into getting her teacher's degree. So, for a while, it was just Nova and Isabel sending every spare peso her way. I told Nova that if I were in their situation, I would have done the same thing as her older sister. At some point, I think people in poverty need to decide to save themselves and that may mean leaving the weakest link behind. She feels the need to punish this sister now, over a pragmatic decision that was made out of necessity. In talking to her about it, I compared it to someone struggling desperately to fill a leaky bucket. I was glad yesterday, when Nova was the first one to say that we should not give them anything more, until they arrive in Cebu.

I've decided to pay a little extra to bring them back sooner. I don't know why Isabelle bought the tickets as she was leaving the terminal upon her arrival, but that's what she did. I'm bringing them back early because we don't know what will happen with Sonny.

The plan had been for Isabel to go there and monitor her brother, while being sure to administer his medicine daily. She arrived at just about the same time as her older sister. After one day, that sister , the one who is the most fed up and embarrassed by her family, headed back to the comfort of her employer's house in the city. Then, after another day, Isabel took off to visit her boyfriend's family. I don't know what was done with the medication, but the only thing that could have worked, would have been to give it to one of her aunts, so they could make sure it was taken. Within 2 days of her departure, Sonny was naked again and he had run off to visit other villages where he is not welcome. This time they rounded him up after only one day, and Isabel again administered medication. She has been with him since that time, and she's anxious to leave the hell hole of her birth.

Once he arrives in Cebu, Nova will administer medication daily. I've instructed her to make it a condition of being fed. If he won't take his pill, he is not to eat. We will see how that goes. I have no trouble being firm on something like that, but Nova has always wanted to feed the multitudes. :-)