Lies in Silence Part 1 of 3: Interview with SJ Hart

Tragic and inspirational are the two words that come to mind after reading SJ Hart’s book, Lies In Silence. SJ Hart has a unique experience when it comes to these issues because she is someone with bipolar disorder, a parent, and a clinician, all of which will be explored in upcoming interviews. Hart tells the compelling story explaining the heartbreaking impacts bipolar and co-occurring disorders had on her family. The more I learned about this family and their battles, the more inspired I was to share her story with others.

SWH: On page 101 you explained, “There are millions of families like mine. I think about the many clients over the years that undoubtedly had similar severe mental illness. The millions who lie in silence and remain voiceless, suffering from addictions to gambling, drugs, alcohol, shopping, food, and sex”. In your opinion can you name those things in your family that lie in silence?

SJ HartSJ: Well I have to start with our genetics and the amount of illness that has been transmitted from generation to generation. It does appear that the severity and the lowering age of onset increases, making treatment difficult and complicated. Like the Hemingway family as an example, the random crises lie in silence with the potential symptom of deep hopelessness and suicide, and/or violence and hurting other people.

Not only does all of that lie in silence, it is also invisible and random. One other important point is that people lie in silence; Family members, friends, professionals, and the medical community. Our family did not discuss the obvious issues and our culture back then, and even now also remain silent about illness that is no one’s fault, bringing loneliness and the feeling of being broken.

SWH:  Your father’s story was very moving as well as tragic, yet you chose to use it for education in regards to the details of his struggle with bipolar disorder (manic-depressive disorder). How did you make that difficult decision while writing the book?

SJ: It took me decades of quality professional therapy, and doing some work on my own to grasp how an illness can take over your life and become who you are, in spite of all factors including intelligence, personality, compassion, etc. I knew more about my sick and violent father, than about gentle and thoughtful man he was. So, I investigated by interviewing family members. It really wasn’t until I got sick, which is detailed in the book, that I really understood how dramatic and profound mental illness can be, and his was severe. I wanted to demonstrate the biological and internal change and the situational external change. They occur simultaneously. I personally believe this continues to be misunderstood. The only way I know to shift change is by speaking so others can learn. It wasn’t a matter of if I should teach it was when I would teach.

SWH: How did the stigma attributed to mental illness impact the rest of your family prior to your father’s passing?

SJ: We became disconnected from our extended family and our community. His family did not believe there was anything wrong with him, which decreased the amount of people who could help in our desperate situation. It was the beginning of our devastating new normal, and my mother really loved him before he got sick. Later on I understood more about the impact it must have had on her.

SWH: Many of the experiences regarding mental health in your family point to the argument of nature vs. nurture, particularly genetics. Today there has been a lot of talk about biopsychsocial influences of mental illnesses. What are some of the biological, sociological, and psychological effectors of your mental illness?

SJ: Well that is fairly complicated. I was 43 when I had an acute onset of bipolar disorder, after being prescribed a medication for migraine prevention. I had recently had a mild stroke triggered by a migraine, so my neurologist wanted to lower the risk of subsequent migraines. Within days I started to have mood changes and in 6 months I crashed into a black, suicidal depression. I also wrote about that so it is clear how my onset occurred. My children had some vague mood symptoms that could be attributed to hormones of childhood development, but were also catapulted into acute episodes by pharmaceuticals. Would any of us gotten sick without chemical agents? I tell my audiences that they are not questions that can be answered. Do we have genes? We know now that we do.

The short answer in my opinion is that it is not which one. It is all. My husband and I watch the news and are completely dismayed by the continued use of the statement “looking for the motive”.  In cases where it is clearly mental illness involved, disease is not a motive, and one has to ask if any other diseases would be handled that way in regards to public insults. For instance recently an actress suddenly committed some vandalism, posted disturbing comments on social media, and was clearly not well. Yet many of the news outlets defined it as a publicity stunt. When she was finally involved in something where they could hold her, it was determined she had an acute onset of mental illness. Our culture should examine why they defined her actions as a publicity stunt. So again, for me it is all of the above. For some it is which came first. But honestly it doesn’t matter once it is here. It’s here.

SWH: What have you learned from your experience that can be helpful to someone who is also dealing with a family history of Bipolar and Co Occurring Disorders?

SJ: I am actually participating in a book soon to be released that addresses that as one of its questions.

  1. Read, Read, and Read – magazines, books, reputable websites, join an online support group with a credible history. Go to seminars, research professionals such as therapists and psychiatrists. We have fired many as they only understand the text book. Your insurance or private dollars pay their salaries so don’t settle.
  2. Participate in finding the right med cocktail. It is the difference between functioning v nonfunctioning, suffering v not suffering,
  3. Find the people in your life who get it, and when you feel up to it seek out people you do not yet know who get it. They will support that you are not broken.
  4. Don’t be silent. Find ways to stabilize and become an advocate. Nothing will change if we don’t challenge and speak. Our culture is way off the mark, and will continue to be unless we speak when we are able.

SWH: A lot of people go by the motto: I am not my mental illness. How did you learn to internalize your mental illness upon realizing the severity of it?

SJ: Oh boy. This is a lifetime process. I’ve always known my family members are not their mental illnesses, as well as me. No different than cancer, lupus, Parkinson’s, diabetes, asthma, epilepsy, etc. The big difference is that with any chronic illness is that they are chronic. It is a matter of developing ways to minimize the episodes with longer periods of remission. It is a battle that gives you only certain warnings, and as I say often it is not forgiving. I have had so much grief and trauma directly from mental illnesses. It has been with all of the people I love, and then eventually with me.

Each wave is just that. Some you can jump some knock you over, some you can see coming, and some come out of nowhere and you can’t catch your breath. Internalizing was immediate because I had children to care for, and that by far has been the saddest. However, when I crashed, I had a group of women that called me every hour on a rotation. A group of women who also lived it and I met in a support group for children. And they all said the same thing, “I love you. You need to be well for your children. They will not be able to stabilize while you are sick. Put the oxygen mask on yourself first.” They were right. Two of my three children are in treatment.

I’ve been a clinician for over thirty years. I’ve known mental illnesses my entire life. The severity changes sometimes day to day. The waves in chronic illness are about preparation, knowledge, support, resources, and connections. The biggest difference with chronic mental illnesses than physical is that our culture is uneducated, judgmental and lacks compassion.  So…for those who remain silent now is a good time to find your voice. There are lessons in everyone’s story.

Acceptance and Commitment Therapy: A Different Approach to Anxiety Disorders

Most coping techniques that teach people how to handle their abnormal anxieties focus on skills that reduce, replace, and avoid discomfort. These techniques are many that I have tried for my own anxiety including deep breathing, relaxing music, muscle relaxation, and more.

Cognitive behavioral therapy teaches people to control and change their upsetting feelings and thoughts. On the other hand, Acceptance and Commitment therapy teaches people not to change their thoughts or feelings but to change the way they react to them. The three steps of Acceptance and Commitment Therapy are; accept, choose, and take action.

According to Psychology Today,

Acceptance and Commitment Therapy (ACT) is a type of psychotherapy that helps you accept the difficulties that come with life. ACT has been around for a long time, but seems to be gaining media attention lately. Categorically speaking, ACT is a form of mindfulness-based therapy, theorizing that greater well-being can be attained by overcoming negative thoughts and feelings. Essentially, ACT looks at your character traits and behaviors to assist you in reducing avoidant coping styles. ACT also addresses your commitment to making changes, and what to do about it when you can’t stick to your goals. Read More

  1. Acceptance: Acceptance of anxious feelings means learning how to observe and sense them without judgment. Instead, you are able to use compassion and gentleness when confronted with anxiety, fear, worry, panic, and other sensations that may cause discomfort.
  2. Choose: This step is where you decide how you want your life to go. You can ask yourself do I want to remain a prisoner to this anxiety or do I want to live a fulfilling meaningful life?
  3. Take Action: This is by far the hardest step. This involves accepting that in order for things to change you much change your behavior. Taking action means facing your fears and anxieties and making them a small part of your life instead of something that consumes you.

To learn more about Acceptance and Commitment Therapy check out the book:  The Mindfulness & Acceptance Workbook for Anxiety by John P. Forsyth and Georg H. Eifert.

A Dream Turned Into A Reality: Interview With Julie Brown

We all heard the phrase “Recover is Real”, I honestly didn’t believe it until I learned about Julie Brown and her story. I connected with Julie through Tumblr, and I was immediately fascinated by her determination and strength to recover from her anxiety and depression. Julie experienced the crippling externalities that came along with living with a mental illness. Being a college student with dreams and goals, Julie decided that after her 21st birthday she no longer wanted to live as a prisoner to her mental illness, and here’s the what Julie had to say about her recovery journey:

SWH: What role did those closest to you have in your recovery?

Julie Brown
Julie Brown

Julie: My friends played the biggest role in my recovery. Had it not been for my best friend Michaela coming over at midnight when I was in the middle of a mental breakdown, I’m not sure I would be here today. I am lucky that my parents also supported my choice to start my path down recovery, although my friends still gave me the greatest push. My friends and parents supported my decision to start group therapy, and I always called my mom and told my friends how it went after each session. Now, they are all proud of how far I’ve come!

SWH: What was one thing that kept you on the road to recovery?

Julie: I think it was my determination to get better. My grades started to suffer, I wasn’t as fun to be around, I didn’t want to get out of bed. I was miserable and made others not want to be around me. I had this image in my head of this woman that I wanted to become; she was strong, did not care what anyone else thought of her, followed what she loved, and was so happy that everyone wanted by her because of her energy. I knew I had to get better in order to become her.

SWH: What was the most important thing you learned about yourself through this recovery?

Julie: It had to be my own strength. I’m not even sure how I got out of bed some days, but I did it. And now when I have one of those really hard weeks where it feels like I’m coming apart at the seams, I remember that this feeling won’t last forever. Life is damn hard sometimes, but it’s your own choice to either settle for that, or to do something about it. And also that you never have to go through it alone! Having a strong support system is so incredibly important. I cherish my best friends so much more now and make sure everyone I love knows that I love them and appreciate them.

SWH: How did you get the strength to push yourself toward recovery when it got tough?

Julie: Again, a lot of the push came from my friends, and having my group in group therapy helped A LOT as well. I literally had two hours once a week of nothing but encouragement to better myself. Music helped me a lot as well. When I was really going through a particularly rough patch, I’d just put in my headphones and let everything else fade away. I wrote in my journal a lot and vented on tumblr. I did not let things set in for too long and learned to let it all go.

SWH: How did the medication, therapy, etc. help you in your recovery? What were the pros and cons?

Julie:Even though I only stayed on antidepressants and antianxiety medication for 5 months, I think that really helped me transition further into recovery. Had I not started on antidepressants to begin with, I might have attempted suicide. They made my suicidal thoughts go away, and they helped me get to a place where I felt I could go back to helping myself. The only downside to the medication was getting sleepy and I would throw up often when I drank. I also had some bad side effects to two of the different kinds I tried.

Prozac made me VERY dizzy when they upped my dose, and Wellbutrin made my appetite disappear. All of the antidepressants I went on also made my sex drive disappear. Group therapy was probably the best decision I made in my recovery. I had an initial appointment with a counselor, and we talked about what my issues were and what path I wanted to take. I chose group because I wanted to be able to help others along too, and I wanted that relationship with others as well. Had it not been for my group, I would not have gone to see the psychiatrist I saw that started me on medication. There were no cons to group really, other than not being able to talk to the other group members outside of those 2 hours once a week.

SWH: What advice would you give someone who was going through the same obstacles you faced?

Julie: Firstly, eliminate all negativity in your life. If there is someone who is bringing you down and not adding positivity to your life, get rid of them. They will only make your journey harder. Secondly, reach out to those people that you do trust in your life. Confide in them and let them know what you’re going through. Let them help you! If they care about you, they will want you to get better as well. Get help. Go see a counselor, psychiatrist, therapist—whatever is available to you. If you’re in college, you have a ton of resources available, use them! And if you’re not, research different centers that you could go to for help. You can even start with your general doctor; they can refer you to someone to help you.

You really need to let others in. In order to get help, you need to accept help and you need to accept that you want to change. These are real illnesses and disorders, and sometimes medication is needed in order to help you get better. Like I said, I needed medication for those first 5 months before being able to do it on my own. Starting medication does not mean you’re weak! If anything it makes you stronger because you are doing whatever possible to get better. And above all, remember that life goes on and that you can do it. Write yourself a reminder on your mirror that you’ll see every day. You are worth it one hundred percent.

SWH: What does recovery mean to you?

Julie: Recovery means getting my life back. It means everything. I took my recovery seriously and I became that woman I first talked about. I love myself and I am truly happy within myself and with my life. I still have my rough days and weeks, but I always come out of them stronger now. Recovery saved me.

Deciding Whether or Not To Take Medication for Mental illness

To Use Medication or NotDeciding whether or not to take medication for our mental illness has got to be the most difficult decision one has to make. Personally, I decided not to take medication for my anxiety. Instead I wanted to take the natural route by exercising, eating healthy, taking vitamins, and therapy. Whether you decide to take the medication route or the natural route having good insight and weighing your options can be really benefit you in your decision-making.

Medication is the primary treatment for many mental illnesses. Despite the negative portrayals given by the media, there can be many benefits to medicating your mental illness. Medication can really help people function in their day-to-day lives by reducing some of the paralyzing symptoms of mental illness. It is important to note that the reduction of symptoms does not indicate a cure. Many have really positive results from taking medications when taken the right way.

On the other hand, taking the medication route can also have its downsides. One of the main turnoffs to taking medication for me was the fear of certain side effects. Some common side effects for anxiety meds include drowsiness, dizziness, blurred vision, heart racing, rashes and more. They can also eliminate one symptom but with these side effects other symptoms may persist. Another thing to consider when deciding on medication is that it will involve a tough trial and error process. This process can include going through several different meds until you find the right combination with the right dosage. The most serious consequence that taking meds can come with is the risk of addiction.

All in all, by recognizing your mental illness, weighing your treatment options, and talking to your doctor, you are bound to find the path that is right for you. Many people, who go into treatments blindly, do not end up finding the right solution. As long as you do your research and go into the situation with an open mind, your mental health will thank you.

Listen to Episode 3 of my podcast Anxious Ramblings:

This episode will begin with some updates from my personal life. I will discuss my thoughts on medication as a treatment for anxiety. Anxious Ramblings will conclude with me reading some responses to the question: What role does the medication play in your mental health? Is it more beneficial or detrimental?

Listen to Episode 4 of Anxious Ramblings


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