Every October 10th since 1992, World Mental Health Day has been honored. This year, the focus is mental health in an unequal world. “Mental Health Care for All: Let’s Make it a Reality”, makes it clear that there are societal discrepancies when it comes to the acknowledgment and treatment of mental health challenges. According to The World Federation for Mental Health “75%- 95% of people living with mental disorders in low and middle-income countries are unable to access mental health services.”
The National Institute of Mental Health attests that nearly one in five U.S. adults live with a mental illness (51.5 million in 2019). Categorized by severity, you or anyone you know may experience mental health challenges. I eschew labels since I know that we are more than words that describe symptoms in the DSM-5 Diagnostic and Statistical Manual of Mental Disorders which is considered the bible of the psychological realm. I was introduced to it in college when the DSM-3 was published in 1980. As I pored through the massive tome, I learned about the various conditions and their symptomology. I have an old copy somewhere. These day, since the updated version is on line, I need only to type in the condition and the numbers pop up that insurance companies need to see in order to pay for treatment for the clients I see in my psychotherapy practice.
The most challenging aspect of mental health treatment is the stigma attached to it. I have long questioned why we cast aspersions on ourselves for experiencing depression, anxiety, loneliness, trauma, mania, or brain disorders when we wouldn’t judge a broken ankle or appendicitis. We see the former as weakness and the latter as happenstance. Michael Phelps, Lady Gaga and Simone Biles are outspoken advocates for bringing the topic out of the closet and into the light of day.
I’ve been in the field since 1979 when I worked on a crisis intervention hotline and in a youth shelter. Here I was, Psychology 101, learning more, boots on the ground than I did from any book. These were real people who were struggling with being human and some wanted to end their corporeal existence as a result. I thought my job back then was to talk them out of it. All these years later, I realize that my job is to be present with them as together we sort through the baggage that they unpack with me. It is an honor and privilege as a seasoned therapist to get invited into the inner sanctum. I learn from them every day. I remind them that their history is not their destiny. I laugh with them at the absurdity of life. I sometimes cry with them at the losses they have incurred. When they describe abuse they endured, I remind them that the fiercely protective mama bear stands with them to either symbolically or literally face the perpetrators at their comfort level. There are some in the profession who would remind me about counter-transference and taking too personally what they are expressing. I have gotten adept at recognizing it and also have the benefit of peer supervision at work.
Some of the child, adolescent and adult clients I have worked with in the past four decades, have been diagnosed with ADHD (Attention Deficit Hyperactivity Disorder). Although I have never been formally diagnosed or on medication for the condition, I fit some of the criteria.
I’ve always had an active and curious mind and ability to multi-task…until I forget what I started to do and have to go back to the beginning. I describe my brain as being like a computer with multiple tabs open at the same time. I have long been a Type A+ Overachieving Workaholic whose busy buzzy brain has a difficult time powering down at bedtime. My vivid and sometimes troubling dreams are evidence of that as I continue to process joys and challenges from the day.
“ADHD is not an attention disorder. It is a blindness to the future,” according to Russell A. Barkley, PhD This experienced clinician, researcher, and author has expounded on the concept of Intention Deficit Disorder which he graphically describes in a video on the topic.
Dr. Barkley goes on to say, “People with ADHD know what to do, but they can’t do what they know.” An illustration of the brain highlights the difference. The rear part of the brain houses knowledge, while the front part of the brain houses the practical application of said information. ADHD is, as he shares, “like a meat clever that separates the two.”
In an attempt to join the two hemispheres, I practice these techniques:
- Tell myself to stop and take a few deep breaths
- Put my hand on my forehead and close my eyes
- Say out loud what I need to remember
- Speak to myself as if I was a supportive coach, “You got this, kiddo!”
- Literally close computer tabs as I needed to do when writing this article
- I make lists and check off items after completing them
- Listen to music to calm my mind
- Exercise to move the energy that is moving me since I sometimes get the fidgets
- Go back to the room I was in when I had the thought to do something that has already slipped my mind
- Bring myself back to attention when I get distracted….ooooh look, a squirrel!
- When possible, do one thing at a time, since I can begin a task and then move on to something else before completing the first
- Break tasks down into manageable bites
- Reward myself for accomplishment
There is no standard normal. Normal is subjective. There are seven billion versions of normal on this planet. ―
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