Columns

On Mental Illness: It Takes Time

By Jack Bragen
Wednesday January 12, 2011 - 11:48:00 AM

When someone has cancer, their life becomes busier in order to handle the chemotherapy, radiation therapy, checkups, and so on that go with that disease. Today, many people who have that disease get most of their treatment on an outpatient basis. 

In the case of having mental illness, the responsibilities may be even more sizeable than those of cancer, and may take up large amounts of the mental health consumer’s time and energy. This can allow little, other than mental health related events, to occur in that person’s day to day schedule. 

It is little wonder that persons with mental illness identify themselves as a “mentally ill person,” when most of the events that occur in their lives are connected to being mentally ill. Furthermore, it makes employment or school even more complicated, when one must schedule one’s work or school around psychiatry or psychotherapy appointments, around meetings with those in charge of their housing, or around the hours that the pharmacy keeps. 

“Clozaril” is a drug for treating Schizophrenia that many psychiatrists like to prescribe when no other medication works. It involves mandatory blood tests every two weeks in order to screen for a deadly side effect, called “agranulocytosis.” This is an extreme lowering of the white blood cell count. 

These blood tests will put a cramp into anyone’s schedule. If it were just a matter of getting the blood taken, you’re talking about fifteen minutes. However, you must consider that there is the wait time at the lab, which might be a half hour or might be a couple of hours. There is the commute to the lab, which might involve a van ride at someone else’s convenience, or might involve two hours on a bus. (This is currently how long it takes for an average bus ride in Contra Costa County.) 

If you take a drug called, Zyprexa, or another one called Risperdal, get ready to schedule in meetings with the health educator for the diabetes you will soon have. Medication induced diabetes will entail a radical change in how you live. There will be more time spent preparing healthy meals. You will spend more time at the pharmacy getting your insulin. You will need to check your blood glucose several times every day, to make sure that it is not at a dangerous level. You will need to see the foot doctor and the ophthamologist. And this is on top of the responsibilities of keeping yourself mentally stabilized. 

Not including medication related visits, which do involve large amounts of time, there are the meetings with a psychotherapist which most mentally ill people are encouraged to attend every week. These therapy sessions will take place during business hours, and so will your meetings with your prescribing psychiatrist. This makes it much harder to have a nine to five job. You may not want to tell your employer that you are mentally ill. And that makes it harder to explain why you need the two hours off every week to see your therapist and psychiatrist. 

If you are collecting Social Security as your safety net, on occasion you will have to go into their office to be reevaluated both financially and in terms of still being disabled. If you have housing benefits, you will need to go into their office at least once a year for recertification, and will need to stay home all day at least once a year to have your unit inspected. 

If you have a mental illness, you will also probably have “down time” at unpredictable periods. This is simply a time in which you just don’t feel well, and in which you need to take it easy and take care of yourself. This need is one of the hardest for people in the mainstream to appreciate. It is a need that often makes the mentally ill person feel guilty or think of themselves as lazy. Yet it is a genuine need that most mentally ill people should respect. 

In short, if you have a major mental illness, you may have little time left over to do or to be much else.