Maybe it is really just about relationships

A western Kansas community averts tragedy through its close nit relationships.

Turn on your TV, look at a newspaper, or open an internet browser and it won’t take you long to find a story about violence.

Murder and suicide are common place in our news streams. And these stories have everyone asking why.

What could prevent such tragedies? Increased gun regulation? Less violence in video games? Or perhaps putting “God” back in our schools?

We focus so much on what could prevent heinous acts in the aftermath of tragedy. Rarely do we have, or take, the opportunity to examine the success stories: the people who contemplated suicide or other acts of violence, but chose another path, the people who decided to get help, the people who were guided to a better path.

On Tuesday I had the opportunity to hear a story of success at the Governor’s Mental Health Services Planning Council.

A 15-year-old named Jace from Deerfield, Kan., allegedly planned to kill himself at the school in front of his classmates.

This boy, along with his parents, the school principal, the school counselor, and mental health professionals from western Kansas joined the planning counsel meeting via conference call. 

As Jace and others recounted his story it didn’t take long to identify what enabled Jace’s story to have a happy ending instead of a tragic one.

Jace attends Deerfiled High School in a small, close nit community. His high school only has 75 students total. That means there are about 20 students in each graduating class. These kids know each other and they notice when things are off.

Deerfield school counselor Tammie Sabata serves as the student services director for the 272 students in the Deerfield School District.

Sabata said a concerned student told her about Jace’s suicidal thoughts. Sabata took these concerns seriously. She called Jace into the office. After an assessment with Sabata, Jace was sent to the emergency room and eventually admitted to the KVC Wheatland Psychiatric Hospital in Hays, Kan.

Jace spent two weeks at KVC, where he received treatment for major depressive disorder and generalized anxiety.

He said the students and staff at Deerfield High welcomed him back without the stigma that is often associated with mental illness.

“They really made me feel like a person and not just a label,” Jace said. “They have been able to make me feel accepted and supported.”

So what made Jace’s story different from so many others?

This incident happened in a community in Western Kansas where the rate of poverty is high and resources are low. It’s not the kind of community we typically look to for best practices. Yet, the successful ending of Jace’s story shows that in this incident Deerfield High School’s practices were better than the best.

So what made the difference?

Deerfield HIgh School principal Nathan Reed attributes much of this success to the relationships among his students and staff. Jace felt comfortable enough to confide in a friend, who felt safe telling the school counselor, who knew the people to go to for mental health care.

“Relationships and communication are paramount in this type of situation,” Reed said.

These people know each other. They care about each other. And in Jace’s case, that seemed to make all of the difference in the world.

So how does that translate into public policy? Can you make people get to know their neighbors? Can you legislate people to care? Because if you could I believe much of the world’s problems could be solved over a cup a tea.

If you could, kids might realize they aren’t as isolated as they may sometimes feel. If you could kids might feel safe enough to cry out of help. If you could the adults around them might notice those cries. Perhaps it is all about relationships.

As for Jace, he is now plugged into the area mental health system, grateful for the community who rallied around him.

“The plan is to take one thing at a time,” he said.

Mental health: An issue on which we can unite

In week’s since the shooting in Newton, Conn. I have heard a lot about the need for mental health awareness and access. Kansas Gov. Sam Brownback even changed his stance on providing public funds for mental health.

Brownback proposed a $10 million mental health initiative last month. In 2011 Brownback had proposed $10 million in cut’s to the states mental health programs.

The need for mental health services seems to be one both the right and left can get behind. As a state we have a unique opportunity to put our resources to use in a way that can help generations of Kansans who suffer from mental illness. I hope for everyone’s sake that genuine reform occurs. When it comes the mental health of Kansas everyone has a stake.

Last week Rev. Adam Hamilton represented Kansas in the inauguration festivities as he preached the Inaugural Prayer Service. Hamilton spoke about the importance of unity and vision in his message.

“A compelling vision unifies us,” Hamilton said to the President during the sermon. “We're in need of a new common national vision. Not one that is solely Democratic or solely republican. We need one or two goals or dreams that Americans on both sides of the aisle can come together and say, ‘Yes, that's what it means to be American.’ That's where we need to go."

I believe creating access to mental health services can be one of those unifying goals. And I think Kansas can be lead the way, as an example to other states.

I don’t agree with Gov. Brownback’s politics, but I sincerely hope he succeeds in this initiative.

This is not a problem that we can just throw money and expect to see an impact. Here are three areas that I think must be addressed to create a comprehensive mental health system that fosters a healthy society: 

 Psychiatrist shortage. The shortage of psychiatrists had not been part of the media’s post-Newton discussion on mental health. But this shortage is real and has already had an in pact on patients throughout the country. In 2008 only 4 percent of graduating medical students applied for residency programs in psychiatry. It can take up to three months for a first-time patient to get into a psychiatrists. Because of this delay most people who suffer from severe mental illnesses to not receive help until they are arrested or hospitalized. It’s no surprise that 38 percent of the adult correctional facility population in Kansas are mentally ill.

Licensed counselors in public school. As school districts’ budgets continue to shrink, school counselors are often the ones on the chopping blocks. Many elementary schools do not have full-time counselors and some don’t have counselors at all. The same is true for some middle schools and high schools. Concerned parents or students who might have turned to a professional they know and trust at their school no longer have that option. This make seeking help even more difficult. Because mental health is an issue that effects public safety and the state’s budget, it makes sense to invest in school counselors. Early interventions can keep these kids from becoming adults who end up in state correctional facilities or state mental health hospitals.

 Lack of an efficient referral systems. We need to work on a system that connects primary care providers to community mental health centers and psychiatric practices. Too often primary care providers overextend themselves by diagnosing mental illnesses and prescribing psychiatric medications. When primary care providers get the diagnosis wrong, instead of receiving much needed help the patient’s illness continues to worsen. We need to develop a system where psychiatric patients can easily be referred and treated by specialists.

These reforms may seem like only a dream, but I believe they can become reality. The Governor's Mental Health Services Planning Council meets tomorrow from 9 a.m. to 3 p.m. at the KNEA building. I will be live Tweeting the event. You can follow me on Twitter at @ArleysWords. 

Three things every space should have

Batman, our cat, loves to nap in the sun room.

Pets, personality and plants are a must in any space.

I never thought I would be a cat person. I mean everyone knows dog people are cooler, clearly.

But the truth is I fell in love the moment I laid eyes on our cat, Batman. Sure, I love our dog, but there is something special about this cat. And when I think about the pros on the cat side (their ability to clean themselves, their independence, their love of literature) I can’t deny that I am in fact a cat person.

As I type this I am watching Batman napping so peaceful in my reading chair. Watching his pudgy belly expand and contract as he breaths, I feel at peace.

Whether you are cat person, a dog person, or anything in between, pets have this ability to bring comfort in a way that can’t be explained. They provide their owners, warmth, love, and good energy.

I’m real believer in the energy of a space. Pets can bring an abundance of positive energy and I think everyone should have them in their space. 
The two other things I think every space needs are personality and plants.

I’ve never been a huge fan of the pink/salmon color of the walls in the sunroom off of our bedroom. It is where I have my office. I’ve wanted to paint the walls a light brown or cream for the longest time because I thought it would look good with the light blue curtains I made for the room.

I think the salmon looks tacky like the bright blue tile that needs to be replaced in our bathroom. But I just can’t bring my self to paint them. There is something about the color on the wall that I like. Sure it looks a little much with my pink reading chair, but I can’t deny that the colored walls give the room some personality. And the plants make the room feel alive, even if one of them is trying to take over the room.

It is important to create a space for yourself to create, meditate, and simply be. And make sure that space has personality and good energy.

Power of a pill

When you have a chronic illness you understand the importance of taking your medications as prescribed.

The trouble with some illnesses, such as bipolar disorder, is that the medications and dosages required to keep you well can change over time.

Finding the correct dosage can be tricky and when you do find that magic prescription you certainly don’t want to mess with it.

From my experience with bipolar disorder every psychiatrist has his or her own opinion about what medications work best and how you need to tapper off of, or alter, medications as needed.

I have been seeing a resident psychiatrist. Every visit I would see the resident and the he would tell me his thoughts on my medication and then an attending physician would come in and tell me what he or she thought. Most visits I would have the same resident, but the attending, who had the final say on my treatment plan, always changed. And so did my treatment plan. This became worrisome when I decided that I wanted to get off of my medications to try and conceive.

Some docs prefer a more conservative approach while others shrug off the idea of getting off my meds for pregnancy as no biggie. Typically the doctors I saw who were more easy going about getting off my meds were new male residents.

I knew I needed to find an experienced psychiatrists who was female. I thought I female doctor would take my concerns about pregnancy more serious than a male doctor. I realize just how sexists that sounds. And I acknowledge it is in fact sexists.

I’m okay with my sexism because I know that a female doctor works best for me. Trying to have a baby is a complex, emotional issue. Particularly if you have health problems that stand in the way. I admire people who can just get pregnant on a whim without thought to how it will play out. I am not one of those women. Even if I didn’t have bipolar disorder I would not be one of those women. It’s just not my personality.

For over seven years I relied solely on lithium to manage my moods. It worked great, but a several months ago my anxiety and depression seemed to need more than lithium. I got on 50 mg of Zoloft, which seemed to do the trick for a while.

After a few months on the 50 mg, my depression started to creep back and seemed to be even worse than before. I felt on edge at work and drained when I came home, crying at the drop of a hat.

The resident I saw during this bout increased my dose of Zoloft to 100 mg. This complemented the 900 mg of lithium I took daily.

The extra Zoloft made me feel happy, really happy. Soon I felt elated and decided that I should get off the antidepressant. After all, it would be one less thing to worry about when I decided to get off all of my medications to conceive.

I tapered off of the Zoloft in about week. A day after my last dosage, I felt amazing. My therapist classified me as hypomanic but warned me that coming off of the Zoloft could have side effects.

Two days later my mental state completely collapsed. Nothing could motivate me and I couldn’t stop crying. It seemed as though I had dove head first into a deep depression.

After only three days of this depressive state I found myself in a dry heave style of crying. I had put out calls to my doctor, but they weren’t returned. I decided to go back on the Zolft at 50 mg (and get another doctor).

Within a day I felt like myself again, not depressed or elated, just myself.

I never realized what dramatic impacts such subtle shifts in my medications can cause. Now that I am back to myself I’m hesitant to change my medications again. I know I will have to before I can conceive, but I will never again take for granted the power of these pills.

Waiting for life's harvest

The day after my wedding, before my husband and I headed to our honeymoon destination, we planted a garden in small plot of dirt at the side of our house.

Tomatoes, peppers, cucumbers, we planted a variety of delectable veggies. And we did together on our first day of marriage.

In my mind it was symbolic and sacred. Logan probably thought of it as the practical thing to do. He finally had time off from work and if we waited until after we got back to from the honeymoon to plant the garden it might be too late in the season.

To me, these seeds symbolized much more than the produce that we would eat that summer. They represented the journey that we had just begun with our marriage.

When you plant a garden you have to water it, pick out the weeds, help your seeds become the plants they are intended to be. The same is true marriage. It is work. You have make time for each other, nurture your relationship, and help your partner live up to his or her potential. Marriage is work, but the fruits of a good marriage make all the work worth while.

In my own marriage, we are still somewhat in the honeymoon phase. Thankfully, our relationship has done much better than the crops did last year. As a gardener, there just isn’t much you can do during one of the worst droughts in Kansas history. We survived the drought but unfortunately our tomatoes didn’t.

For the past year my marriage has somewhat been in cruise control as we’ve enjoyed quality time together at home and random road trips. Things like unemployment, sickness, and an entire KU football season with only one win didn’t seem to shake us.

But lately I worry that we may have entered a drought. And I worry that this drought is self-imposed by me and my stupid depression, and stupid medication changes, and even stupider ideas about getting pregnant. (Full disclaimer I do not think trying to get pregnant is stupid. I just feel like the effort that is required for me to get pregnant is stupid. It should be much easier. I just know it.)

Apparently I went off my anti-depressant a little too quickly. But I didn’t think it was the wrong thing to do because I was feeling hypomanic, which is bad, really bad. You can read my last blog for details on that.

In the past week my mood has went from the utmost high (I was totally ready to start my own publication, which in my defense I still think I have a good business plan) to the lowest of lows. These last three days the only time I am able to stop crying is when I am around other people or when I am running. I know three days doesn’t sound very long, but keep in mind Jesus was in the tomb for the three days. Some theologians believe he spent those days in Hell. I believe if you ask Jesus if those were a long three days he would say yes. He would probably say, hell yes.

So the last three days have been rough. Not just on me, but on Logan as well. I mean no one likes to come home to a crying wife. Particularly if she is crying for absolutely no reason. And I imagine he feels about as powerless as I do in this.

I have thought about going back on my anti-depressant. I have phone calls out to the doctor. The truth is I don’t know what to do. Because this stupid SSRI is the least of my worries. I cannot fathom how I will be able to be off lithium, even it it’s just for the first trimester and the time it takes for us to conceive. And there is as much chance of me being off lithium long enough to breast feed as there is the Chiefs winning the 2014 Super Bowl. And yes, I know that breast milk is best.

The truth is, I don’t know if I can do this. I fell ashamed, so ashamed.

I don’t know if I can conceive a child because I am dependent on a mood stabilizer to treat my bipolar type 1 disorder.

There I said it. And in some way I feel little less ashamed. 


I remember when I was tutoring third-graders at elementary school in Philly. One of my students would always say he felt so ashamed when he got a flash card wrong.

“I’m so ashamed,” he would say in his adorable third grade voice as he buried his hands in his arms.

“It’s okay,” I would reassure him. “Try again.”

When he got the problem right the smile on his face was priceless.

“I’m not ashamed anymore,” he declared.

Even thinking about that little boy’s face makes me want smile all these years later.

And as write this blog, confessing my fears, I feel like shouting from the rooftops.

“I’m not ashamed anymore!”

My husband and I are tilling this garden we call our life. And we really don’t know what the fruits of our labor will be. But we do know is that we love each other, we love God, and we are not going to live feeling ashamed about things beyond our control.

Mania's seductive high

Sometimes on the weekends my husband and I like to veg out by watching random documentaries and trashy reality shows. And by sometimes, I mean nearly every weekend.

Last weekend we watched a marathon of Drugs Inc. on the National Geographic Channel. Episode after episode we watched people trying to chase the high they remember from their first time. Some of the episodes featured drugs I had never even heard of.

I have never been adventurous when it comes to experimenting with drugs but I have experienced the rush and intensity of mind altering highs.

Mania and hypomania are a natural, and often unavoidable high, those of us with bipolar experience.

I, ever the conscientious person, always alert my therapist and doctor when I start to feel the buzz of hypomania. After being hospitalized in 2005 after a full blown manic episode I am determined to avoid mania at all cost.

But things have changed in my life. With the comfort and trust of a husband and the absence of a full-time job, I felt that a little hypomanic joy couldn’t hurt anybody.

When I noticed my mood start to escalate, I didn’t have the urge to call my doctor and ask if my lithium should be increased. Instead I embraced the urge the laugh, shop, dance, have sex (with my husband), drink wine and be happy. Really happy. 

I started to wonder if maybe my giddiness might be a symptom of hypomania. My thoughts were also becoming more rapid.

I worried my last post about the pair of red corduroy pants embroidered with dogs that I recently bought my husband might be a sign that I hypomanic. Maybe, just maybe.

I thought my increased sex drive might be a sign. Perhaps, but my husband certainly wasn’t going to complain about that.

I blamed Christmas on my increased shopping and relished in the creativity my rapid thoughts produced.

When I started annotating 50 Shades of Grey for theological themes and cultural trends, I knew I had a problem.

Still, I didn’t want to lose the joy and insight my hypomanic buzz provided.

When you are manic or hypomanic, it’s as though you are looking at the night’s sky and the more manic you become the more constellations you are able to see, the more the dots connect, the more intense your happiness becomes. When you are manic the world is yours. And who wants to give that up?

My therapists picked up on my hypomania at our recent session. The longer I spoke, the more obvious it became.

She recommended that I talk to my doctor about increasing my lithium levels and told me I should cancel my plans to hit up the flea markets after our session.

You should not be shopping right now, she warned.

I made an appointment to follow up with my therapist in about a week and requested that my doctor (or his nurse) call to discuss changing my lithium dosage.

There, I thought, I did the responsible thing. There is no reason why I should not go to the flea markets. I had $40 cash burning a hole in my pocket.

My mind began to flood with all of the vintage home goods I could find. I had to go to the flea markets. I had to.

Then I paused.

No, I reminded myself. I don’t have to. I am still in control.

And that is the difference (or rather one of the differences) between mania and hypomania. When you are hypomanic you still have a certain amount of control. When you are manic you have no control. When you are manic you are captive to manic impulses and urges.

In the battle of bipolar disorder when you are hypomanic you still have the opportunity to retreat.

And that’s what I decided to do. I retreated. I didn’t go shopping. I talked to the nurse. I came home, cleared my thoughts and wrote this blog.

Battling the beast of mania, trying to chase that high, can be sad and descriptive as the lives I saw on Drugs Inc. It’s a battle I don’t want to fight. So today, I chose to retreat.

There but for the grace of God, and lithium, go I.

Just for sh!#s and giggles

When you live with anxiety, or watch 5 minutes of cable television, the world can be a scary place. For that reason, I make it a point to laugh as much as possible. Even if the laughter occurs at awkward moments or causes me embarrassment.

I like to laugh.

And sometimes the opportunity for laugher sparks when you least expect it.

Last week I, like so many Americans, took back all of the clothing items that my husband and I received for Christmas that didn’t fit. (In order to protect my husbands privacy, and to ensure that he will continue to let me write about him, I will refer to my husband as Jamal from here on out in my blog.)

So, my mom had gotten Jamal a KU T-shirt that was too small. Jamal is a tall guy. I exchanged the shirt and found one in a size that would work. After a few minutes perusing the sales racks in the women’s section, I headed for the check out.

Before I got to the register a male mannequin dressed in corduroy red pants with dogs embroidered on them stopped me in my tracks. Yes, you read correctly, grown man corduroy pants with dogs embroidered on them. Here is a picture to prove that I am not lying.

This is a real clothing item in the men's section at Kohl's.

Above is the face of a man who loves his wife and is still confused about why he is letting her a take a picture of him in corduroy doggy pants.

I took a close up of the manikin to make sure everyone could see the dogs on the pants.

“Is this a real thing?” I said as I took a closer look at the pants. Pretty sure I said it out loud.

I immediately knew I had to get a pair for Jamal. I laughed as I searched for his size. I stopped laughing a little when I saw the price tag- $40. Holly cow thats a lot of money for a pair of pants, especially at Kohl’s.

I had a 20 percent off coupon so I made the executive decision that the laughter I would receive from seeing Jamal in these pants would be worth the $32 I would have to put on my Kohl’s card.

My plan was for Jamal to wear the pants to the Christmas celebration we had a my grandmothers the next day. I wanted to see how long it would take my extended family to comment on his pants. I bought them as a social experiment, fully intending to take them back after Jamal wore them to the party. (You can judge me if you want, but keep in mind I was doing this in the name of science.)

When Jamal got home and saw the pants he was totally in. We both exploded into laughter. It’s times like this that I realize, I have the perfect husband.

Jamal kept laughing until he saw how much the pants costs.

Apparently, he didn’t like the idea of me using Kohl’s as a clothing rental service.

I did get a few pics of the hubster in the pants before I took them back. (He doesn’t want me to use his real name, but he was totally fine with the photo? Crazy, I know.)

So, the point of this blog, is that laughter is good. Enjoy it when you can. Dancing is also good. So is prayer and poetry. When I search for the goodness in life, it is not hard to see the beauty, even a midst all of the challenges in life.

My resolution this New Year’s is to do more of the things that exhibit the joy in my life. I want to laugh more, dance more, pray more, and write more. I want to experience joy more.

Dr. Phil would dismiss this resolution because it does not include a measurable goal. But when have a ever agreed with that guy?

Find what brings you joy, and this year do more of it. Unless the thing that brings you joy is meth, but I’ll save my “just say no to illicit drugs” blog for another time.

Happy New Year!