If there is anything I can agree with members of the Mad Pride movement about, it's that much work needs to be done when it comes to understanding and destigmatizing mental illnesses of all kinds.
That said, I keep wondering about those who refuse to seek treatments for their mental conditions, and what kind of impact that has on their loved ones, their friends, etc. How difficult must it be for those people to have to adjust their expectations and their lives to accommodate the illnesses of others? How hard must it be for Madigan Shive's friends to be willing to lose a few days every so often so they can babysit her in a hotel room somewhere? Do they consider it to be a fair trade for her music, in which case, what do those people who are not gifted in some way have to offer in exchange?
I keep thinking of the parallels between that and, say, my grandfather, who refused to control his diabetes even after he was diagnosed, even after his eye sight failed, even after he went on dialysis, all the way until his feet were amputated and he died. He hated that he couldn't eat whatever he wanted, and he often violated his dietary restrictions. His decision to do so put serious strain on the rest of the family, including my grandmother, a tiny woman who suddenly found herself having to practically carry this huge man. You could say that, yes, he has the right to do whatever he wants, as it is his own body, but it's not that simple, and I feel that similar things need to be taken into consideration for the loved ones of people who have mental illnesses.
@whynotshesaid: My sister won't take antidepressants because she doesn't want to be "medicated out of her mind," and her mood swings, anxiety, intolerance, and general crankiness drive us all CRAZY. It's miserable. You bring up a good point - letting an illness run free isn't fun for anyone involved.
@whynotshesaid: I agree with a lot of what you say here. I definitely think people should know what they're taking, side effects, alternative options, etc. However, when I see things like this, it makes me nervous. I once worked with a forensic psychologist, and we were speaking to a man with schizophrenia, who went off his meds and attacked and raped a woman. Once he was on his meds he was quite remorseful, but it is common, especially among people with schizoprenia, to feel as though they can control their illness when they are on their meds, and to be unable to do this in reality. To make things worse, each time someone goes off medication, it is typically less effective when they start it again.
I've noticed that a lot of people have brought up the stereotype of the tortured artist, and the idea that some people believe that they need pain and suffering in order to create. For the most part I agree- I think there is an over-romanticizing of the myth of the suffering artist, and it's a problem. That said, I am a writer, and I have been diagnosed with Bipolar II, and I cannot write while medicated. I also can't write while severely depressed- I'm only able to really work creatively when emotionally stable, or at the beginning of a manic period. I think it's important to remember that the side-effects of these drugs can be very very hard to live with. I imagine some of these artists who stay off medication do it not because they need the pain, but because the fog of the drugs is too much to take. When you are bipolar you don't just take one drug, you take several, and it can be extremely hard to find a combination of pills that makes you feel like yourself- not depressed, not high, and not in a drug haze.
@NellMood: I wanted to amend to this to say it's also important to remember the physical side effects. Many people who take mood stabilizers gain huge amounts of weight, and anti-psychotics can completely knock you out and make you constantly exhausted. I took Abilify (which is the worst drug name ever) and developed an unbearable restless muscle issue. It's pretty common knowledge that a lot of these drugs can affect your libido. So I think one more issue with taking these serious chemicals is taking on these side effects which can really negatively impact your life.
@NellMood: I hear a lot of people say "I can't take meds, becuase when I was on x medication I'm in a fog/gain weight/can't do my art/have no libido". If that's the case, then x medication is the wrong medication. If you're not experinceing a net gain in functioning then it not the right drug. I disagree that being bipolar means several drugs. My pdoc had me taking 3 at one point, and it turns out that Lithium is enough for me. It was a horrible process to figure it out, but it's worth it. I'm doing a lot fo good work now that I'm emotionally stabe and I find for me my medicaaion has a very low profile. I find a lot of pdocs are afriad of using lithium, the old standby.
@zaquon: I'm really glad you found something that works for you, and you're lucky that you're able to function by just taking one drug. However, that has not been the case for me, and most of my friends who are bipolar. I do know a few people who take lithium, but they take in conjunction with other meds. I'm honestly envious that you've found a successful treatment.
@NellMood: I was taking it for about two years with and anti-depressant and thought that it was the combo that I need until I had a horrible episode. I was lucky my pdoc figured it out. My roommate also takes just lithium and that seems to be working out for her too. In truth, I still get depressed in the wintertime (even her isn SoCal) but my pdoc is too afraid to prescribe another anti-depressant, and I'd be too afraid to take it. So he prescibed excercise and it works like a charm. So I guess you're right, just one medication doesen't work for most of us. I just wish I could take a pill rather than having to run 20 miles a week.
@zaquon: Yeah, running helps me a lot, too. Obviously in a serious depressive episode a run isn't going to do much, but I find that consistently exercising helps me most of the time.
@NellMood: I've gotten clumsy on mine. It's so embarrasing, I used to be a gymnast and dabbled in dance when I was young. I had good balance. Now I drop things and knock them over. I break dishes all the time. It's very upsetting b/c I feel like the meds have stolen some part of me and replaced it with this buffoon.
@NellMood: Heh, we talkin scars? My first pdoc was older than Moses and he prescribed me something form the 50s, forget its name, starts with a T. It gave me DRY MOUTH. Fucking dark ages. Ta, I'll take the lexapro and hold the tooth decay.
@NellMood: I gained about 25 pounds in two months on Seroquel, and Abilify made me incredibly restless. It took me a few months to figure it out, though, so I spent a few months unable to sit still or focus.
I do find it easier to write when I'm slightly manic - it just comes so easily and I can write pages and pages of stories and essays. It's nearly impossible to write or do anything creative otherwise.
@Nariel: It took me about that long to figure out that Abilify was causing the problems- I thought it was just a new symptom of hypomania. I guess that restlessness is actually a pretty common side effect.
I found a lot of what I produced when I was manic just wasn't very good writing, unlike during stable times when I was less in love with everything I did. I think I'm just more likely to view my own work critically when I'm stable? No matter what, it's not easy to find a balance of what works for your body, your brain, and your creativity.
@NellMood: Beautifully said. I also have bipolar II, and have still not found a medication regime that works for me. As I told my psychiatrist a few days ago, I would very much like to exchange my paralyzing depressive episodes for emotional stability, but I am not willing to exchange them for constant agitation and anger, massive weight gain, hair loss, and sleep cycle disruptions. A less perceptive psychiatrist would mistake this for lack of compliance; luckily, my psychiatrist is anything but. We continue to experiment, and I continue to hope.
I have bipolar disorder, and were it not for antidepressants I wouldn't have the energy to type this. Or, I would possibly be so manic I couldn't focus on this article enough to read it, because my brain would be moving too fast.
Still, I've had some trouble with medication. Powerful chemicals should not be prescribed lightly. I've had mood stabilizers make me hostile and uncontrolled, or make me sleep all day and be in a zombie-like state when I was awake. Antidepressants have given me panic attacks. Currently I'm on Cymbalta and it's worked pretty well for me so far. Having experienced the side-effects of antidepressants and mood stabilizers has made me realize that yes, while they can be benificial and sometimes life-saving, they're not for everyone.
@Nariel: I just wrote essentially the same thing you did- I promise I didn't plagiarize your comment! I totally agree- those drugs can be very gnarly, and they're not a simple solution.
@Nariel: @NellMood: Thank you both for weighing in. I wrote below about my experience with my father who is bipolar. It's informative to read what both of you have to say about what potentially life-saving drugs do to your sense of self.
I have BPD. People with this condition are notoriously difficult to treat and generally do not respond well to medication. It’s often difficult to find a practitioner even willing to work with a patient who has BPD given that we generally are a.) not very good about sticking with a therapy program and b.) virtually non-responsive to pharmaceutical intervention.
BPD is classified as an Axis II disorder in the DSM-IV TR, and is included in the "personality disorder" cluster. Even with effective treatment or pharmaceutical intervention, I will likely have BPD and experience its associated symptoms to some degree or another for the rest of my life. I certainly wouldn’t call BPD a gift. However, I also wouldn’t say that I "suffer" from BPD. It’s merely a part of who I am. I have not sought treatment and don’t wish for chemical intervention, nor do I want the stamp of BPD on my medical records, given the associated stigma – even within the medical profession.
There were times when I likely ought to have been medicated (self-injury has been a common coping method for the periods of severe dissociation that I have experienced over the years), but I think that bridge was burned when some concerned friends of mine brought up evidence of my self-injury to my HS guidance counselor who immediately phoned my parents and made no attempt to meet with me personally to discuss the situation. This severely undermined my trust in the system and I truly wish it had been handled more delicately.
My point is I didn’t seek help when I needed it most and every day I’m reminded by the scars that are still visible on my forearms, permanent reminders of temporary feelings from years past. I can’t advocate the path I chose, but I’m pro-choice in all things, and it’s not up to me to decide what course of action is best for anyone but myself. It’s been a long, hard road and I’m not yet out of the woods, but I’ve spent years learning about myself and the idiosyncrasies that come with having a mental illness, and it’s been enough to inspire me to pursue a graduate degree in Psychology so I can dedicate the rest of my life to helping other people like me.
Anything to lessen the stigma of mental illness I think is a good thing. I work in a psychiatric hospital & many of the patients used illegal drugs on the street to self-medicate b/c there is less of a stigma with being a drug addict than with having a mental illness. There is something so wrong with that.
cate3710 promoted this comment
Edited by screaming_on_the_inside at 08/26/09 4:10 PM
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He's founded a nonprofit organization "based on accepting, encouraging people to admit to their disease — to seek treatment and become even greater members of society."
This part does intrigue me. Acceptance is one of the hardest things - accepting that there is this thing wrong with the way the brain works is one of the main steps needed to seek and continue with proper treatment of any mental issue. But those that say all or even most mental illnesses can be treated without drugs sometimes have the adverse affect on the people that suffer from the mental illnesses. I'm just going to throw out the example of my schizophrenic grandfather. He was ashamed of his condition and deeply wished it didn't exist. To the point where after he was on medication for a while and being a productive member of society and a reasonably good family man, he'd think the condition had just "gone away". Then he'd go off the medication that helped keep his paranoia and other behavioral issues in check, and all of a sudden, he'd beat my mom and grandmother, do other things I prefer not to post, stalk random strangers under the guise that they were either secret lovers of his or attempting to hide from them in a belief that they were with the KGB and out to get him. And I'm not exaggerating one bit.
On the other hand, there is the issue of people being medicated who don't need it and think they do. And it's a delicate line to walk.
My mother had a desire to over-medicate during a good part of my life because of the issues with her father under-medicating and the trauma she went through when he was in that state. When I went into a situational depression in high school, she wanted me on Paxil. I didn't want to take it. I'd read Brave New World not long before the situation that caused the depression (an unexpected move in the middle of high school) and didn't want any stinkin' "happy pills". And I worked myself out of it through my own ways, because it was not chemical. My mom, on the other hand, has gotten docs to prescribe all manner of pills to try and deal with her issues, but they never worked, and often times had a negative effect on her. Finally, she accepted that she needed therapy more than pills to deal with those early life issues she went through and unhappiness in her marriage, and things have gotten better, in a less medicated way for her.
Overall, I think Joey Pants' idea of forming an organization that helps create a support network and a safe place to seek therapy is a fantastic idea. It's those that take it to the extreme, a la the Scientologists, that scare me a bit more.
I wanna know who these psychiatrists are that just push pills on people, 'cuz when I see my p-doc, she asks me a number of questions to make sure the meds are working, that I don't have any wonky side effects (including suicidal ideation) and what I'm doing in therapy (I see a psychologist and am doing a cognitive-behavioral therapy focus to deal with the depression and improve my life). Someone needs to tell her she's doing it wrong.
@snark_shark: I used to work for seven ob/gyns. You do not want to know how many scrips for Paxil, Prozac, Wellbutrin, Xanax, etc., I handed to patients on a given day.
These were OB/GYNS. They should have been giving psych referrals, not hooking their patients up with medication.
@whynotshesaid: This, and the other replies further cements my opinion that only p-docs should Rx psych meds. When I was diagnosed, my GP gave me Paxil, which is one of the oldest SSRIs (to be fair, she also strongly encouraged me to see a psychologist and psychiatrist) but also very infamous for the side effects of fatigue and weight gain. Considering that I had the atypical symptom of sleeping a lot and could gain weight on a diet, it wasn't the best fit for me. When I finally saw a p-doc, she put me on Effexor so I wouldn't be as tired and not gain any more weight. A psychiatrist is going to have a lot more expertise with psych meds than a GP, so it makes more sense for them to Rx them.
The medical community has a nasty history of treatment of people with psychiatric disabilities. I think that largely informs a lot of activists who don't like psychiatry in general and meds in particular. Psychiatry is not my specialty, but many of my patients have had psychiatrc issues and have been hospitalized for them. There are actually a lot of safeguards in the system to keep people from being medicated or even hospitalized against their will - court orders, limited holding times etc.
What is disturbing to me is that I'm reading here about people who are being pressured to take antidepressants. Depression is one thing - unhappy another. You can get over unhappy - if you are unhappy you can actually imagine a time when you will not be unhappy. Depression is not that way. When you are depressed it's like you've been kissed by a Dementor - all the happy and hope gets sucked out of you. You wish you had the energy to kill yourself. A psychiatrist friend says that many times depression is a terminal disease. And sadly people do die of depression - wither through active suicide or passive suicide (not eating, not taking meds etc.)
I'm not saying that people should 'suck it up' if they are 'just' unhappy. Many times a short course of antidepressants may be appropriate after a loss or trauma and can immeasurably improve quality of life (being unhappy does, in fact, suck really bad). But the tenor of the direct to consumer advertising of antidpressants as little more than a 'happy pill' does itself trivialize depression.
I'm not even going into the whole schizophrenia/bipolar argument except to say that if that woman in the story has people in her life who will sit with her in a hotel room when she's manic and psychotic, she is one lucky, lucky woman.
@boobookitteh: For your first point, while it is true that there are many procedural safeguards it is important to note that they are often merely a rubber stamp. I recommend Michael Perlin's article "On Sanism" - I tried to find a link but couldn't or pretty much anything else he's written about the legal system's failure to properly respect civil rights with respect to mental illness.
That being said, I do believe there are situations where involuntary hospitalization/medication are appropriate. I'm just not optimistic that civil rights safeguards are properly enforced.
@Ms. Crankypants: I think it's probably very dependent on the institution and the psychiatrists. The psychiatists and psych nurses I've worked with are very careful about respecting people's rights (in fact, we medical people would get aggravated with them and be like - just MAKE them take their meds!)- but that was at a large, reputable, well funded, academic hospital in a northeastern city- not a poorly funded and staffed state hospital in East Potato Patch Idaho. The procedures are not a total safeguard - but an improvement on treatment of people with mental illness a generation ago when you could just lock folks up and medicate and shock them with no appeal at all.
We are just all so effed up about this subject. I think it's overall great that we can talk about it. I really respect people who come forward with their own strugles. Look how far we've come with addiction since Betty Ford came out. Not perfect - but more evolved.
@boobookitteh: She's lucky that she's got that resource, but as someone who's been around communities of wackos, I doubt they're really helping her. Anyone who would put up with a bip off her meds is someone who's going through something similar, or at least thinks this is normal. It must be like living in a warzone, and they WANT that level of drama. How sick do you have to be when normal life is too boring without a weekly crisis? That whole energy this woman and her friends giveoff is very creepy and cultish to me.
When my marriage broke up I was a mess. And the only thing I seemed to be able to do was to drink booze and lots of it. I even took a handful of pills and decided to die. A friend sat me down, talked with me- not at me and suggested I seek some help. I met with a therapist and eventually ended checking myself in for a month in rehab.
That month and the Dr's and a year of meds saved my life. I am now off meds and only see a Psychiatrist every 3 months to check in. Not everyone's situation is the same but meds do help some get on a better path.
...he doesn't offer a solution for people who are so violent or suicidal that they can't make decisions about their own treatment.
It seems like no one offers a solution for these kinds of situations. I have a nephew who is in his early 20s and absolutely crippled by paranoid schizophrenia. There is no way he can take care of himself or make decisions for himself. He has been in and out of youth authority and prison (where no one monitors his mental state or if he's taking his meds) since he was twelve years old. His mother is similarly ill and his father has written him off, when he should be hiring a lawyer to declare him incompetent so that he can get the treatment he needs. The rest of my family can't do anything because of the laws regarding adults with mental illness. The best authorities can (or perhaps will) do is arrest him on 5150 and hold him for 72 hours in a hospital. Now my nephew is presumably living on the streets, and I'm constantly worried that he'll hurt someone. I see little use in someone like him embracing his madness. I can't imagine how horrible it must be for him to have a mind that warps reality so much.
@lisaraine: "Similarly, David Oaks, leader of Mad Pride group MindFreedom International, says his organization isn't against drugs, but only against forced drugging of people who would rather manage their illness in other ways."
When I was severely anorexic, I dodged treatment. I skipped therapy and lied about whether I'd eaten. I was, literally, dying. My treatment providers helped me by pushing and pressuring me into hospitalisation, where I stayed for 3.5 months. It saved my life. Literally - I was given six months to live before I went in.
Now I run a small business (dog boarding) and am healthy and happy, but without forced/pressured treatment, I'd be dead. And unlike when I was sick, I want to be alive!
08/26/09
That said, I keep wondering about those who refuse to seek treatments for their mental conditions, and what kind of impact that has on their loved ones, their friends, etc. How difficult must it be for those people to have to adjust their expectations and their lives to accommodate the illnesses of others? How hard must it be for Madigan Shive's friends to be willing to lose a few days every so often so they can babysit her in a hotel room somewhere? Do they consider it to be a fair trade for her music, in which case, what do those people who are not gifted in some way have to offer in exchange?
I keep thinking of the parallels between that and, say, my grandfather, who refused to control his diabetes even after he was diagnosed, even after his eye sight failed, even after he went on dialysis, all the way until his feet were amputated and he died. He hated that he couldn't eat whatever he wanted, and he often violated his dietary restrictions. His decision to do so put serious strain on the rest of the family, including my grandmother, a tiny woman who suddenly found herself having to practically carry this huge man. You could say that, yes, he has the right to do whatever he wants, as it is his own body, but it's not that simple, and I feel that similar things need to be taken into consideration for the loved ones of people who have mental illnesses.
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I do find it easier to write when I'm slightly manic - it just comes so easily and I can write pages and pages of stories and essays. It's nearly impossible to write or do anything creative otherwise.
08/26/09
I found a lot of what I produced when I was manic just wasn't very good writing, unlike during stable times when I was less in love with everything I did. I think I'm just more likely to view my own work critically when I'm stable? No matter what, it's not easy to find a balance of what works for your body, your brain, and your creativity.
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Good luck finding something that works for you- you are so fortunate to have (what sounds like) a great doctor.
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Still, I've had some trouble with medication. Powerful chemicals should not be prescribed lightly. I've had mood stabilizers make me hostile and uncontrolled, or make me sleep all day and be in a zombie-like state when I was awake. Antidepressants have given me panic attacks. Currently I'm on Cymbalta and it's worked pretty well for me so far. Having experienced the side-effects of antidepressants and mood stabilizers has made me realize that yes, while they can be benificial and sometimes life-saving, they're not for everyone.
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BPD is classified as an Axis II disorder in the DSM-IV TR, and is included in the "personality disorder" cluster. Even with effective treatment or pharmaceutical intervention, I will likely have BPD and experience its associated symptoms to some degree or another for the rest of my life. I certainly wouldn’t call BPD a gift. However, I also wouldn’t say that I "suffer" from BPD. It’s merely a part of who I am. I have not sought treatment and don’t wish for chemical intervention, nor do I want the stamp of BPD on my medical records, given the associated stigma – even within the medical profession.
There were times when I likely ought to have been medicated (self-injury has been a common coping method for the periods of severe dissociation that I have experienced over the years), but I think that bridge was burned when some concerned friends of mine brought up evidence of my self-injury to my HS guidance counselor who immediately phoned my parents and made no attempt to meet with me personally to discuss the situation. This severely undermined my trust in the system and I truly wish it had been handled more delicately.
My point is I didn’t seek help when I needed it most and every day I’m reminded by the scars that are still visible on my forearms, permanent reminders of temporary feelings from years past. I can’t advocate the path I chose, but I’m pro-choice in all things, and it’s not up to me to decide what course of action is best for anyone but myself. It’s been a long, hard road and I’m not yet out of the woods, but I’ve spent years learning about myself and the idiosyncrasies that come with having a mental illness, and it’s been enough to inspire me to pursue a graduate degree in Psychology so I can dedicate the rest of my life to helping other people like me.
08/26/09
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This part does intrigue me. Acceptance is one of the hardest things - accepting that there is this thing wrong with the way the brain works is one of the main steps needed to seek and continue with proper treatment of any mental issue. But those that say all or even most mental illnesses can be treated without drugs sometimes have the adverse affect on the people that suffer from the mental illnesses. I'm just going to throw out the example of my schizophrenic grandfather. He was ashamed of his condition and deeply wished it didn't exist. To the point where after he was on medication for a while and being a productive member of society and a reasonably good family man, he'd think the condition had just "gone away". Then he'd go off the medication that helped keep his paranoia and other behavioral issues in check, and all of a sudden, he'd beat my mom and grandmother, do other things I prefer not to post, stalk random strangers under the guise that they were either secret lovers of his or attempting to hide from them in a belief that they were with the KGB and out to get him. And I'm not exaggerating one bit.
On the other hand, there is the issue of people being medicated who don't need it and think they do. And it's a delicate line to walk.
My mother had a desire to over-medicate during a good part of my life because of the issues with her father under-medicating and the trauma she went through when he was in that state. When I went into a situational depression in high school, she wanted me on Paxil. I didn't want to take it. I'd read Brave New World not long before the situation that caused the depression (an unexpected move in the middle of high school) and didn't want any stinkin' "happy pills". And I worked myself out of it through my own ways, because it was not chemical. My mom, on the other hand, has gotten docs to prescribe all manner of pills to try and deal with her issues, but they never worked, and often times had a negative effect on her. Finally, she accepted that she needed therapy more than pills to deal with those early life issues she went through and unhappiness in her marriage, and things have gotten better, in a less medicated way for her.
Overall, I think Joey Pants' idea of forming an organization that helps create a support network and a safe place to seek therapy is a fantastic idea. It's those that take it to the extreme, a la the Scientologists, that scare me a bit more.
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These were OB/GYNS. They should have been giving psych referrals, not hooking their patients up with medication.
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What is disturbing to me is that I'm reading here about people who are being pressured to take antidepressants. Depression is one thing - unhappy another. You can get over unhappy - if you are unhappy you can actually imagine a time when you will not be unhappy. Depression is not that way. When you are depressed it's like you've been kissed by a Dementor - all the happy and hope gets sucked out of you. You wish you had the energy to kill yourself. A psychiatrist friend says that many times depression is a terminal disease. And sadly people do die of depression - wither through active suicide or passive suicide (not eating, not taking meds etc.)
I'm not saying that people should 'suck it up' if they are 'just' unhappy. Many times a short course of antidepressants may be appropriate after a loss or trauma and can immeasurably improve quality of life (being unhappy does, in fact, suck really bad). But the tenor of the direct to consumer advertising of antidpressants as little more than a 'happy pill' does itself trivialize depression.
I'm not even going into the whole schizophrenia/bipolar argument except to say that if that woman in the story has people in her life who will sit with her in a hotel room when she's manic and psychotic, she is one lucky, lucky woman.
08/26/09
That being said, I do believe there are situations where involuntary hospitalization/medication are appropriate. I'm just not optimistic that civil rights safeguards are properly enforced.
08/26/09
We are just all so effed up about this subject. I think it's overall great that we can talk about it. I really respect people who come forward with their own strugles. Look how far we've come with addiction since Betty Ford came out. Not perfect - but more evolved.
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That month and the Dr's and a year of meds saved my life. I am now off meds and only see a Psychiatrist every 3 months to check in. Not everyone's situation is the same but meds do help some get on a better path.
Shout out to my shrink...he is the best!!!!!
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It seems like no one offers a solution for these kinds of situations. I have a nephew who is in his early 20s and absolutely crippled by paranoid schizophrenia. There is no way he can take care of himself or make decisions for himself. He has been in and out of youth authority and prison (where no one monitors his mental state or if he's taking his meds) since he was twelve years old. His mother is similarly ill and his father has written him off, when he should be hiring a lawyer to declare him incompetent so that he can get the treatment he needs. The rest of my family can't do anything because of the laws regarding adults with mental illness. The best authorities can (or perhaps will) do is arrest him on 5150 and hold him for 72 hours in a hospital. Now my nephew is presumably living on the streets, and I'm constantly worried that he'll hurt someone. I see little use in someone like him embracing his madness. I can't imagine how horrible it must be for him to have a mind that warps reality so much.
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Now I run a small business (dog boarding) and am healthy and happy, but without forced/pressured treatment, I'd be dead. And unlike when I was sick, I want to be alive!