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Saturday, May 26, 2007
(3:31 PM) | Stephen:
Tired Of The Fight

Living with someone who has a psychological disorder is not merely difficult or challenging. Diseases of the mind are fundamentally different than those of the body, even though they are still physiological in nature, still affecting a part of the body. But whatever the science of it all may be, we human beings have decided that our minds are not the same as our bodies. Whether we are body, mind, soul, or body, soul, mind and spirit, or body and mind, everyone has at least a functional compartmentalization with which they order themselves.

Psychological disorders wreak havoc with all of this. The normal way of looking at things is upended, subverted, turned around. The existential barriers that most people have are sometimes broken down, sometimes made stronger, sometimes moved around. That's really the worst part of living with a person who suffers from a mental illness: the unpredictability of it all. There is a perverse sense of comfort that comes from knowing what to expect, even if what we expect is something bad all the time. We can at least set up defenses, procedures, ways of coping with the chaos, with the pain and all the trouble that is caused. When a mentally ill individual starts upon medicines and talk therapy, things do not get better. They actually tend to get worse. Marriages actually suffer more once the road to recovery is begun, because all of the ways in which the husband and wife have learned to deal with the mental illness no longer apply - indeed, one of the first things that people learn is how decidedly unhealthy these ways of coping can be.

Then, of course, there are the inevitable setbacks, the regressions, the new ways that the disease expresses itself and tries to reassert control. So you leave in the morning with everything fine, and return home to see that all is out of control, the house is ransacked, all the painfully bought progress of the last few years seemingly lost in the space of a few hours. The good news, of course, is that the progress is not lost, not completely.

The bad news is that the setbacks never end. No medicine can cure a psychological disorder. The best that we can hope for is maintenance, a near-normal approximation, a faux-healing purchased with stomach cramps, sweats, weight gain, loss of taste, and physiological addiction to drugs that no one fully understands. And after a while you develop a tolerance, so your dose is upped, and upped, and upped until it's too dangerous to take any more of that drug. Each time the dose goes up, the side effects come back, or get worse, or new ones come around. And when the maximum dose is reached, some new drug must be tried, with new side effects. Maybe it will work. Maybe it won't. Maybe two drugs need to be taken at the same time, with each one waging its personal war on your body, each one perhaps finding an ally in the other so that the upset of your body's systems is worse than either one could possibly do alone.

These diseases are often progressive, so even if your body isn't developing a tolerance, it may be that the changing face of the disease requires a different method of attack. And each method of pharmaceutical warfare has its own list of collateral damage. This is not science. It's fumbling in the dark, hobbled, with plugs in our ears. No one really knows what causes Depression, or Bipolar Disorder, or Dissociative Disorder, Schizophrenia or any of the other ways that our minds can betray us and declare war upon our souls. No one really knows what makes the medicines work. Doctors wrap their uncertainty in words like "clinical diagnosis," which means that the doctor doesn't know what's going on, but the best guess is such-and-such, and so let's try X medicine and see if it works.

All this is about me from my perspective. The difficulty of living with a mentally ill person that I mentioned is the difficulty that I face. I can't imagine what it's like for my wife or my kids, because I don't know what it's like to be healthy, let alone healthy yet so close to one with a chronic illness. I'm tired, tired of fighting this foe that wears ever-changing masks, that learns a new strategy every day. Oh, I'll keep fighting, don't worry about that. I'm just sick of it.

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