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Monthly Archives: August 2014

School Days

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IMG_0266  Last May, I drove over 1,000 miles to Sewanee, Tennessee to pick up my youngest following her first year of college. That was May 6 and I was full of excited anticipation. Yesterday, August 26, I said goodbye to her, after covering the same 1,000+ miles and returning her to her home-away-from-home. I was tired, physically worn out after helping to haul her boxes and bags up three flights of un-air-conditioned stairs, and I was ready to get the heck out of Dodge. She was equally ready for my departure and, unlike last year’s tears and extended hugs, we pecked each other on the cheek and said, “Bye! Love ya!” She’d been home for 18 weeks; that’s 4 1/2 months, assuming there are 4 weeks per month. That’s over a quarter of a year. And… that’s just too long. I’m not being mean. She’d be the first to agree. What’s a college student to do for all that time? You send them off to school to learn to be independent, meet new friends, work (and play) hard. Then, after 8 months or so, they are expected to come home and turn into our sons and daughters again. That is easier said than done. In college, as a matter of survival, our kids learn to manage on their own. They do their laundry; they change their sheets every now and then. They decide what and when they’ll eat. Suddenly, they are free to go to class or not, to study or not, to go out on a Wednesday night or spend time in the library. Choices, so many choices. To drink or not to drink? To smoke or not to smoke? To try new things…or not? They become friends with others who chose the same school, who are engaging in similar experiences, and they begin to cut ties with many of their high school friends. They call us, sometimes teary, saying they’re homesick or they’ve had a bad day, and we tell them to hang in there, it will be ok, things will get better. “Stay the course, keep your eye on the prize.” “Grow up,” is what we’re really saying. Then we ask them to come home and be our kids again. Really? What are we thinking? They do come home. They go back into their childhood bedrooms and shower in their old bathrooms. They try to engage with us and with their siblings, but they kind of look like zombies. Something is just not quite right. After a few days they smile and share stories of life at school. They find  jobs that don’t pay much but keep them busy and on a schedule. Everyone walks around on eggshells and then, when no one is looking, everything feels normal again. Laughs and smiles come easily and friends come to visit. Family drops in and stories are exchanged. Vacations are enjoyed and the lazy summer days pass too quickly. Then, it’s time to pack and load the car. Time to drive a thousand miles and unpack in a new dorm, with a new roommate, and a new schedule, new responsibilities. And, time to say goodbye. Time to drive home to a quiet house, and get used to a new normal all over again.


The Stigma of Mental Illness

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seize_the_day_carpe_diem Robin Williams died Monday. It seems that everyone is talking about how his death touched him or her, and lots are saying how his death might finally help eradicate the “stigma of mental illness.” For me, it was surreal to get the news of his death, as my daughters and I had gathered ’round to re-watch “Dead Poets Society” just the night before he died. We fell in love all over again, with his voice, good looks, and the beautifully-delivered lines which were still fresh in our memories when we heard the tragic news that he’d killed himself. I felt profoundly sad for his wife and kids. How horrible they must feel, I thought. This reminded me that I used to think that suicide was nothing more than a selfish act, meant to inflict great pain upon those surviving the victim. Now, I’m extremely embarrassed and ashamed that I would harbor such thoughts. That mind-set is part of the “stigma of mental illness” to which the talking heads refer; it’s ignorant, sanctimonious, and intolerant.  It’s taken some of us an awfully long time to realize that depression, and many other disorders, are forms of mental illness.

My daughter has devoted the last eight years to the pursuit of a career in Psychology. She is now in the midst of a Ph.D. program in Clinical Psychology. She’s at home at the moment, so I thought I’d pick her brain about this issue. While she’s not an expert (yet), she certainly has more experience than the average bear, so, here we go.

Claire, since Robin Williams’ death, people are talking about the “stigma of  mental illness.” What does that mean to you?

CK: I believe there is a lot of stigma associated with mental illnesses in general; people are reluctant to let others know they’re suffering because they’re afraid of what people will think of them. They hear people with mental illness called derogatory names, like “crazy” and “lunatic.” The media often portrays people with mental illness as dangerous.  Education is lacking; people are afraid they’ll lose their jobs if they admit they have a mental illness, because their boss may think it makes them unsuitable to do their job. I think another reason it’s stigmatized is because we often feel that the patient is at fault and somehow responsible for their suffering. Even people with mental illness sometimes feel that they’re weak because they realize that they can’t help themselves.

Aren’t the prejudices different depending on the illness?

CK: Yes, but I think all mental health disorders are stigmatized, some more than others, especially those that involve psychosis, like schizophrenia, because people with that diagnosis often make us feel uncomfortable. It can be more severe and chronic.

So why do you think most people can’t think of mental illness like a disease such as cancer or diabetes?

CK: Lay people often don’t understand what mental illness is and have the misconception that it’s the patient’s fault and that they’re struggling because they’re not trying hard enough. And, without medical tests to determine what the problem is, diagnosis is difficult and even experienced professionals can disagree about the diagnosis. They’re often not the clear-cut picture that’s laid out in the DSM; there are usually a number of symptoms and over-laps between diagnoses. And, medications aren’t necessarily a quick fix. It may take awhile to find the appropriate drugs, therapy, or combination of the two to appropriately treat the patient. And, a lot of these diagnoses are chronic, life-long, and therefore, must be constantly monitored, and treated for flare-ups.

People seem hopeful that Williams’ death will help to eradicate the stigma surrounding mental health. Do you agree?

CK: I don’t think that it will eradicate the stigma, but I hope that it helps decrease stigma, and it may. He was so well-loved by so many, people suffering from depression may think that if Robin Williams was so depressed, then they can say that they are, too. People may find acceptance in that.

My friends and I have commented that it seems that certain illnesses are diagnosed more frequently today than they were when we were young. Like, ADHD, depression, etc. Do you think that means we’re getting better at seeking help and recognizing those who need help? The implication seems to be that there is over-diagnosing and over-prescribing of drugs.

CK: We are better at diagnosing certain disorders because they’re better defined and more recognizable. People are a little more willing to seek help, and there are a few more treatments available. ADHD is a special case, though. Parents and teachers often want a quick fix for disruptive classroom behavior and learning difficulties, but I’ve researched how it is under-diagnosed in girls, especially minority females, because of differences in symptom expression. Girls tend to be inattentive and suffer quietly whereas boys often act out, and are disruptive in the classroom.

What particular experience have you had in observing how mental illness stigma has affected people?

CK: When I worked at an eating disorder clinic, I saw girls who were in treatment for a week or so, and their families would ask if they were feeling better and ready to leave treatment. They wanted them to get well so badly, but they didn’t understand that it takes a long time, it’s a process. I also saw girls who were very reluctant to tell anyone about their disorder. Clients felt really guilty when they heard about the suffering of others, like hunger in Africa, etc. Even they didn’t realize they had an illness and couldn’t help it.

What advice would you have for parents who suspect their son or daughter is suffering from depression or any other mental health problem?

CK: The most important thing is to seek help early and realize that you, as the parent, may not be able to help them. Don’t be afraid of taking your child to a mental health professional, just because you may not have heard of anyone else doing so. Keep the lines of communication open; make sure you let your child know you love them, you’re not judging them and that it is not their fault that they aren’t feeling well. Be patient with them; they may not want to engage in the activities that they’d normally be interested in. They may be irritable and cause conflict in the home. Try to understand and meet with their psychotherapist or psychiatrist if the child is under 18 in order to get advice on how to best help them.

Do you think that you and others working in the mental health sector can reduce stigma?

CK: Yes. I hope to raise mental health awareness in my community by speaking to schools, parents, kids, and physicians about types of and signs of mental illnesses,  and how to seek help. One of my goals is to help reduce mental health stigma, which could possibly  reduce the number of suicides due to people’s fear of seeking help, and to help treat children suffering from various psychological disorders.

And, hopefully, we lay people will help you in that endeavor by trying to be more empathetic and understanding of others; we truly don’t know what they‘re going through, even if they appear to have it all. 



Thirty Years and Counting…

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IMG_1864    Thirty years ago, on August 11, 1984, my husband and I exchanged vows and began this journey called marriage. Thirty years seems so monumental; 25 seems like a drop in the bucket, comparatively. I still marvel that it happened at all, considering it began when I spotted my brother driving our shared vehicle away from a fraternity house, where I’d chosen to attend a small soiree, and I took off running, chasing him down the street in the middle of campus, screaming my head off and calling him ugly names. When he finally slowed down and I caught up with him, I noticed a handsome young fellow, (my future groom), sitting in the passenger seat, so I toned it down a bit and asked if I could accompany them to wherever they were headed. They relented and I slid into the back seat. The rest is history. We spent that semester courting, as my father would say, until Bill graduated and headed to San Antonio for dental school. I had another year of college ahead of me, but managed to get accepted to law school at St. Mary’s University, also in San Antonio, when I graduated. A year or so after that, he changed his mind and decided to leave dental school for medical school in Dallas. Amazingly, upon graduation from law school, I was able to find a job in Dallas. A proposal was issued, we married, and lived in Dallas for three years before returning to San Antonio for his surgery residency. (I now realize what a large amount of time we spent courting up and down I-35 between Georgetown, San Antonio, and Dallas. If we could survive that, we could survive most anything life could throw at us!)

On our wedding night, we exited St. Michael’s Church in Cuero, hopped into my parents’  yellow Lincoln, and headed for our reception. After being properly feted and showered with rice, we drove 90 miles north to the Driskill Hotel in Austin. We checked in around 1:30 a.m., after rinsing all the shaving cream off the car somewhere along the way. Early the next morning, the alarm sounded and we dashed to the Austin airport for our first trip together: a Southwest Airlines flight to San Francisco. The plane that would deliver us to our honeymoon hopped up and down across the country, stopping in Dallas, El Paso, Las Vegas, San Diego, and finally, twelve hours later, the City by the Bay.  Exhausted from the wedding festivities, and the endless trip across country, we were barely recuperating when it was time to head back at the end of the week. We returned to my parents’ home, and, entering my childhood bedroom, happily discovered the twin beds pushed together. The next day, we loaded up our car with wedding presents and made our way to Dallas, where our life together would begin .

I remember happily setting up our home in a small apartment in Oak Lawn, placing our silverware in a drawer, and our new, shiny dishes and glasses in a cabinet. I sometimes felt like we were playing at being grown-ups. Before long, we settled into a routine. I left for my downtown office early each morning, and he headed the opposite direction to med school. He studied non-stop and spent weekends surveying mice in a lab. I flew out of Love Field nearly every Monday morning to Houston, Lubbock, or the Rio Grande Valley for hearings that I was barely qualified to participate in. Those were the days when I prayed all the way to the courthouse that an older, wiser attorney would make a reasoned argument that I could cling on to. When we had free weekends, we’d call old college friends to come over and have dinner, usually something prepared on a mini charcoal grill on our condo’s balcony. In a blink, three years had gone by, Bill graduated medical school, and it was time to move to San Antonio for his general surgery residency. Neither of us had much time to search for housing, so we were lucky to find our first house in just a few hours. My husband started his surgery residency and was on call at the hospital every other night. I took up needle-pointing to fill the long, lonely hours. In addition to feeling sorry for myself, I felt sick. My mom suggested that I see an obstetrician. He was young, funny and attentive. “When do you and your husband think you’ll be starting your family?” I replied, “Oh, I don’t know. In a couple of years, maybe?” He said, “Well, this baby’s coming about a year early.”  Our first baby, Claire, was headed our way in just a few months.

Nearly everything that’s happened since has been just such a surprise, or, at least, an unplanned, usually happy, occurrence. Two more baby girls were born over the next six years. After one final trip back to Dallas for more medical training, we settled in San Antonio for good, where my husband is still practicing with the  group he joined in 1993.  We’ve been in a house located in the same neighborhood in which we found our first home for over 19 years. I worked off and on in the legal field for 14 years at three different firms, trying to juggle ambition, career, marriage, and maternal duties.  In the meantime, our girls grew up, attending various local schools as we tried to find the best fit for each. We’ve endured numerous illnesses and injuries, including our eldest daughter’s slip on the playground in fourth grade, resulting in a skull fracture, and my husband’s concussion, inflicted by a chainsaw striking a young tree that popped him in the forehead, making him feel like he was on a ship in the high seas for weeks. As for me, there’s been menopause, which isn’t, technically, an illness, but sure provides a lot of symptoms to endure. We’ve supported each other through the illnesses and deaths of three of our four parents, and have held each other up during the funerals of a few close friends.  We’ve fought and made up more times than we could count. We’re part of two families, but over thirty years, we’ve become a unique family all our own.

No young, starry-eyed couple can know when they promise to marry, “…for better, for worse, for richer, for poorer, in sickness and in health,” that they probably will be tested in each eventuality. I’m so grateful that we’ve made it to this milestone, relatively unscathed, still enjoying our life together, still uncertain what the future holds, yet comfortable in the knowledge that we’ll face it together. Here’s to many more anniversaries, Honey!

“Life is what happens to you while you’re busy making other plans.”

John Lennon