Thursday, 6 February 2014

Combating Mental Illness from the Outside

Mental illness is a terrible thing.  It wrecks families.  It destroys people.  And yet, there are ways to combat it.  Not only to treat it when it happens, but I hope, to prevent it before it does.

My children have inherited a genetic predispostion to mental illness.  My ex husband's brother and his uncle were both diagnosed schizophrenics.  My ex and his sister suffer from a host of both diagnosed and undiagnosed mental maladies including (diagnosed) generalized anxiety disorder and panic disorder and likely (undiagnosed) narcissistic personality disorder, paranoid personality disorder and obsessive compulsive disorder.  

I'm not a doctor.  I can only tell you what I've observed.  

My ex's anxiety was apparently apparent enough for his doctor to diagnose, although possibly because my ex was in his office so regularly with ridiculous claims (he had concerns that he had cancer (about every 6 months he had his skin checked), MS, SARS, and he was certain he was going to have a heart attack - especially if he had to shovel snow or do any heavy lifting.  At a low point, he tried therapy, and he came back with the most incredulous stories about what the therapist had told him.  Basically that it was OK for him to self medicate with a bottle of wine on a regular basis.  And at his lowest, he asked me to talk to the doctor's office myself - which I did, explaining the symptoms I had observed (some of which are below).  Following which he denied that he'd ever asked me to call or that he'd had any of those symptoms.

It was only after he went to the hospital twice with a heart attack scare (the second time after drinking an entire bottle of ice wine, driving himself with my infant son in the car), that they finally diagnosed the Generalized Anxiety Disorder.  Thank goodness the doctor convinced him (I'm still not certain it's true) that the medication MUST be taken or severe withdrawal symptoms would be experienced.  So at the very least, he takes it regularly.  In addition, the medication could NOT be taken with alcohol.  So my ex swore off alcohol.  Psychotherapy was not continued though - I suspect because the therapist told him something he didn't want to hear.

Despite the medication he continues to suffer with severe germaphobia.  At one point during our marriage, I found him spraying Windex on the dogs as they came into the house to make sure they were "clean".  He had closed the door and was hiding in the stairway so I wouldn't see what he was doing.  When I pointed out to him that the Windex was likely poisonous he stopped, and shortly after that I left.  My dog died at a young age of a complete organ failure - about a year after I left.  To this day, I'm not certain that this didn't have something to do with it.  During the SARS scare, he focused on the Asian population and anyone with a cough.  He decontaminated every time he'd been out in public.

My ex has a lot of difficulty with public washrooms (which must be fun with kids), goes to the drive-in because he can't be that close to other people.  I don't think my children understand that's why he doesn't take them places.  He tells them that he's going to take them to the amusement park or the fair - but there's always something that comes up last minute so they can't go.  Never the ex's fault.  But likely always related to his anxiety.

And that wasn't all I saw.  I also suspect:

Narcissistic personality disorder:  according to psychcentral.com (and many other books I've read) this disorder "is characterized by a long-standing pattern of grandiosity (either in fantasy or actual behaviour), an overwhelming need for admiration, and usually a complete lack of empathy toward others."  I can't think of a statement that better describes both my ex and his sister.  I've seen both of them make up things just because they think it will make them seem more important.  My ex has actually made up a job title and told my children that he's a "Corporate Trainer".  In actuality, he is a crane driver with a high school education and struggles with both reading and writing.  But, quite frankly, my son would actually think driving huge equipment like a crane was really cool - if my ex would tell him what he does.

People suffering from paraoid personality disorder (from psychcentral.com) "are generally characterized by having a long-standing pattern of pervasive distrust and suspiciousness of others...Individuals with this disorder assume that other people will exploit, harm, or deceive them, even if no evidence exists to support this expectation."   I have little doubt that both my ex and his sister suffer from issues related to this disorder.  I can remember my sister-in-law refusing to meet with us in her office at work because she was sure it was bugged.  She had a magnetic folder for her passcard at work in her purse - because she was certain they were using it to track her.  My ex was suspicious of just about everyone and everything.  We weren't allowed to accept gifts from the neighbours because they could contain explosives.  And we were never able to have dinner at their house because they might poison us.  The same was true at pot lucks for his family.  He wouldn't eat anything except what we'd brought with us or he'd seen taken out of a sealed store package.  Not to mention the constant suggestions that I was having an affair - despite no evidence.  He kept me very close - having lunch with me almost every day and needing to call me when I was out.  I didn't recognize this as abusive until after I was out of the marriage.
Obsessive compulsive disorder, according to psychcentral, is also driven by his anxiety and  "characterized by recurrent and disturbing thoughts (called obsessions) and/or repetitive, ritualized behaviors that the person feels driven to perform (called compulsions)."  I can't speak to his sister, but my ex needed to compulsively drive by the same places from his childhood on a regular basis (including a friend's house).  We had to drive back to the house more than once so he could make sure that the door was locked (even though he'd already checked it three times as he left).  He couldn't leave his toothbrush in the bathroom when we had company because they might do something to it.

All this to say - it really worries me that the children not only have a genetic predisposition to all of those illnesses, they continue to be exposed to the behaviour.  And I suspect, given that all three siblings in my husband's family suffer from it, that some of those behaviours are learned.  Both from their father, who likely also suffers from more than a few mental illnesses himself, and also from their mother - who was probably forced (as I was) to develop coping mechanisms including enabling behaviours in order to continue to live with him.  

I saw some of the enabling behaviours as her other son started manifesting symptoms of shizophrenia.  She gave him a debit card so she could be sure that he was still alive by checking the trail online.  After a wandering trip out west, and an infinite number of nights in some sketchy motels, as the money was wearing thin, she got him an apartment and convinced him to stay there.  But she never talked to a doctor.  When he started manifesting some dangerous symptoms, my ex and I worked with the police mental health team - but she wouldn't talk to them.  And when my ex went in to talk to the court system to have him committed, she wouldn't go into the room.  She enables her other two children's behaviour too. And yet, I don't blame her for it.  I'm sure it's a coping mechanism she developed after living with a man who was mentally ill.  I'm not so certain, if I'd stayed in my marriage, that I wouldn't have ended up doing the exact same thing.

And my ex's behaviour continues to deteriorate.  I had a job on the fringes of the mental health field and I've had extensive therapy since leaving the relationship.  Several of the professionals I've spoken to have suggested that the likelihood of a total mental break given the symptoms I've observed is a real possibility.

I know what you're thinking.  How can I continue to let my children live in such a situation?  I ask you this - what choice do I have?  His doctor's not willing to touch the issue.  We went through YEARS.  His NPD makes him charming - and initially anyway, most people (including teachers at the children's school) are sympathetic.  I'm cast as the bad guy because I've put so many limits on his behaviour, and because I've put it out there that I think he's sick.  And frankly, our relationship is so caustic, they're not sure who to believe and err on the side of caution because they're afraid to offend either of us.  

Why not report him to the children's aid?  The children are not abused.  Not physically.  I worked in the family law system for a while when I was in university.  I saw them give children back to crack addicts and abusers.  My children have no marks on them.  They are clean and wear clean clothing.  Their father sends them with lunch every day - they're well fed.  The only thing that the children's caregivers can attest to is strange behaviour on his behalf.  Even a therapist who talked to the children wasn't able to find anything specific.  

And I just don't have the money or the emotional wherewithal to go back to court.  Not when the system is skewed against me.  Not when there's not any way to force him into a psychiatric evaluation.  Not when there's a chance he might pass if he was - because he might be just smart enough to lie his way through to appear normal.  Despite all of my observations - I have absolutely no proof that he's unstable even with the GAD diagnosis.

And as I said in my previous blog, Do My Children Need Therapy? A Divorced Mother's Worries, despite everything, my children are thriving.  Even with his learning disability, my son is performing in school.  My daughter is a delight.  They don't have severe behaviour issues.  They sleep well.  They eat well.  He doesn't intentionally expose them to danger.  And until that complete mental break happens (hopefully not while the children are with him), which will hopefully result in a full diagnosis and assistance, there is really nothing I can do.  

So what do I do?  I work at it from the outside.  This morning, my son told me we couldn't possibly eat the cookies that the neighbour gave us because they might be poisoned.  I was completely taken aback.  It was hard not to sob out loud.  But I didn't.  I sucked in my breath and I challenged him.  Calmly.

That's an interesting statement, Puck.  Why would you think that?    

Because you're not supposed to take food from strangers.  Dad said.  It might be poisoned.

It's from our neighbour.  She's not a stranger.  She's a nice lady.  

(We don't know her very well, but have little chats outside our house - she's a grandmother, 84 years old, and the farthest thing from an axe murderer).

Oh.  But we don't know her very well.  And why is she giving us cookies like that?  

Mommy and Flower shovelled her driveway yesterday.  She gave us the cookies to thank us.  

Oh.

I agree we shouldn't take food from people we don't know.  But we've had cookies from the neighbours before.  At Christmas.  Remember?

Oh.  Yeah.

And they weren't poisoned, were they?

No.  I guess not.

And Flower and I had some of the cookies yesterday.  We don't look sick do we?

No.

OK.  You're right Puck.  You should ask before eating anything given to you by someone else that you're not sure about.  But you don't know anyone who was poisoned by eating treats do you? 

No.

And we've eaten treats from the neighbours before and we're still OK right?

Yes.

So it's OK if I put a cookie in your lunch?  They've got chocolate chips in them.

Yes.  

And that was it.  A small interaction.  A learning moment.  For both of us.  I validated his feelings, and gave him the tools to challenge them.  I tried to make him critically assess the thought and come to his own conclusion.  Because he needs to learn how to do that.  And he needs to understand that suspecting everyone is not normal behaviour.  Because a genetic predisposition does not mean he is destined to have a mental illness.  That's the natural part.  I'm working on the nurturing part.  And hoping that it's enough.


Image Credit:  [psychiatry.org]

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