Mental Disorder

What do you know about mental disorder? If you ask me that question few years ago, I wouldn’t have a slightest idea. I knew that a man whom I saw on the street in my neighborhood in Jakarta had a mental disorder (or what we always say "crazy") because he always spoke to himself and never wore proper clothes. I knew that an illness like schizophrenia (which I first came to know when I watched Beautiful Mind) was categorized as a mental disorder but I had no idea why it ever occurred to people. The world of psychiatry was completely out of my sight — almost nonexistence, until my own sister suffers from it for the first time in 2005.

My family and I have been trying to hide from other people that she has a problem. Even from our extended family. They knew — of course — that something wrong going on with her, but we always denied it. And now I’ve had enough of it. I can no longer bear the secret. I want her to get better. I need to get as many information as possible from others and to do that, I need to tell them the truth. I know that our friends would like to help us out with this. And I’m sure some of them encounter this kind of problems — either through their friends, family, etc., and hopefully they’d be able to point us out what to do and where to go. To put her in denial is not going to solve any problems, but it’ll make us even more trapped.

I know that my parents want my sister to get better and they have done everything they can to do that. They have taken her to doctors, from GPs, to psychologists, to psychiatrists. But what makes me really worried is that the doctors never diagnosed her illness. The only thing they did was giving a new set of medicines that we didn’t even understand what they were capable of doing to her. Since the doctors never even mentioned about the possible therapy, my parents thought taking a medicine will cure her illness. Years gone by and my sister’s condition never get any better. There were one or more times in a year that she’s completely ill and couldn’t do any simple tasks. And there were times when she’s just as normal as any other human beings.

The fact that I’m always away from home means that I can’t do much things for her. And that aches my heart deeply. All I could do was to cheer her up; thinking that she was just suffering from depression. I always thought she was somehow not fully satisfied with her life. She was depressed because she didn’t get what she wanted. As a result, my parents began to pamper her with whatever things she liked, but in reality that didn’t solve the slightest problem. She was also rejected for few times by a university she always wanted to enroll to — and that’s perhaps one of the reasons why she was so depressed (although she always denied it). I blame myself for not doing enough research back then. I blame myself for always denying the fact that she has mental problems. I blame myself for always thinking she is too weak to handle her own problems which makes her vulnerable to depression.

When I finally came home last year and stayed with my family more than 3 months for the first time since high school, I didn’t do much things for her either. She was practically in good health and I thought if we always cheered her up and kept her busy then the illness wouldn’t come again. But few months before my departure to the Netherlands, she suffered from the same illness again. I was too busy with my work and preparation for university, so I didn’t do much research that time. But I took care of her everyday and witnessed for the first time how she lived her life during this difficult time. She didn’t remember to eat, take shower, and go to toilet — let alone pray. Her mood often changed, sometimes she cried, laughed, felt angry, or even happy for no clear reasons. She was very obedient to me (but not to my parents or brother for example) so I was the only one at home who could persuade her to eat, drink, go to bath and toilet. I had to wait next to her when she ate — sometimes more than an hour; otherwise she wouldn’t eat anything. Sometimes I felt like she had delusions and hallucinations; which made me question myself: was she suffering from schizophrenia?

My sister has depended on drugs for 3 years. The doctor told us that she needs to consume those expensive medicines FOR HER ENTIRE LIFE, even when she is in a normal condition. Knowing that for those 3 years my sister never got any better, I always questioned these medicines and argued with my dad because of it. My dad completely abides to whatever the doctor said to him and I am a person who is very much against medicines and never wants to believe 100% of what any doctors tell me. I know that there’s got to be a way to solve this without medicines! And that particular doctor was stupid enough to not diagnose my sister’s illness and provide her with therapy. He and all other doctors we visited thought she’s just suffering from normal depression. Screw them, I said!

So I thought, I had enough of waiting for her to get better and waiting for my family to take a dramatic step. I had to do something else. Wikipedia was definitely a heaven when it comes to getting the right information. After studying the signs and symptoms for each mental illnesses and reading different resources, I drew a conclusion that my sister is suffering from bipolar disorder. Since I’m not a doctor, I couldn’t be 100% sure about my own conclusion until a doctor can confirm it to me, due to the similarities of symptoms between different mental illnesses. But I can relate my sister’s condition when she’s ill to that of the signs and symptoms of bipolar disorder.

According to NIMH, bipolar disorder is a brain disorder that causes unusual shifts in a person’s mood, energy, and ability to function. A person who suffers from bipolar disorder has episodes of mania, depression, or hypomania. These episodes may last for one week or even months and may occur one, two, or more times in a year with periods of normal moods in between. The signs and symptoms of manic episodes include increased energy, activity, and restlessness, extreme irritability, decreased need of sleep, and many more. A person in this phase can also experience psychosis, e.g. hallucinations, delusions, etc. A mild to moderate level of mania is called hypomania. Often time a person in this phase denies that something is going wrong with him/her, and this makes it harder for us to persuade the sufferer to take medications or go to doctors. Depressive phase in bipolar disorder is characterized by persistent feelings of sadness, anxiety, guilt, anger, isolation, and hopelessness. Looking back at the previous episodes that my sister has been through, I can say that she’s been having severe mania most of the times. Sometimes if the mania is so severe, she experiences psychosis. The shifts in her mood always occurs even in the normal condition. When she wakes up, for example, she is so quiet to the point that she’s so irritated if somebody ever asks her questions. But during the day, she may feel contented. Sometimes the change of moods takes only few minutes. She’d say that she wanted to go shopping, then few minutes later she’d change her mind and her mood went down (or vice versa). It made us feel a bit irritated because sometimes we’re already in the car and had to go back home again to pick her up / drop her.

After reading different sources about psychiatry on the net and watching different documentaries and lectures on Youtube, I grew more skeptical about most of the thing in the world of psychiatry. First of all, there are no medical, biological, or scientific tests to verify that someone is diagnosed with a particular psychiatric disorder. The diagnosis is usually done by examining the patient through simple questionnaire and checklists to determine if he/she has common symptoms of bipolar disorder, for example. This is the reason why many people are often incorrectly diagnosed by psychiatrists. People who are experiencing psychosis in bipolar disorder may be diagnosed with schizophrenia. People who are in depressive episodes may be diagnosed with depression (just like my sister). So, there are no medical or pathological tests for mental disorders. The signs, symptoms, and diagnostic criteria of mental disorders are actually defined in a book called Diagnostic and Statistical Manual of Mental Disorders – which most psychiatrists refer to. These descriptions, symptoms and criteria are developed by a consensus/vote during committee meetings (this is just so similar to politicians who vote for an approval of public policy, can you imagine that?!?!). So these illnesses are practically established through somebody else’s opinion about a particular behavior. None of them is scientific medical data that can be validated or supported by any psychiatric related reports. Scientists may argue that a certain mental illness is caused by chemical imbalances, but who can prove that?? No one.

Second of all, taking medications are not the only way to solve the problems. Since doctors do not even know what causes a certain illness, how can they give us some random anti-depressant medications??? Many people who suffer from mental disorders are given anti-depressants by their psychiatrists. If one medicine does not work out, they give these patients another one and so forth it. This thing disgusts me! These drugs try to deal with the chemistry of the brain; so if you’re incorrectly diagnosed or given a wrong medicine, can you imagine what damage can these drugs bring to your brain?? I’m furious! These anti-depressants have side effects, CANNOT in anyway cure any mental illness, and have no guarantee that someone will not have an acute episode again. They can make someone feel better, for example, but the underlying problems are still there. They can also make someone feel worst and even suicidal. Everything depends on the person itself. Cure is an unrealistic goal for these medications. There is no scientific proof that anti-depressants can correct chemical imbalances. So what do these drug exactly trying to do???

Some resources that I read say that mental illness is caused by "brain disorders." I still don’t understand this hypothesis (remember that nothing in psychiatry have proofs!). How can a person’s character or behavior affects the dysfunction of brain? If someone was previously a happy and bubbly child, and suddenly she got depressed and suffers from severe depression… how does it relate to the brain? Is her brain suddenly damaged? Or what? Someone please explain this to me! Argggh. One thing I also learnt from doing this psychiatric-related research is that psychiatry does not acknowledge that they can cure the mental illness. So, mental illness is not curable — which means that there’s no full recovery for people who suffer from mental illness (see this video). I don’t know if it’s true or not; I have read some true stories of people who used to have bipolar disorders and are now free of any weird episodes (manic, hypomanic, or depression). Perhaps the bipolar episode does not appear for a long period of time, but then one day it’ll appear again? Who knows? But one thing that is for sure is that we can prevent and reduce relapses.

I guess, the most effective way to prevent relapses is to undergo "Psychosocial Treatments", including psychotherapy. I have told my parents to bring my sister to psychiatrists in Jeddah for therapy, but for some reasons, they still prefer the old traditional way of medication treatments. So I thought I’m going to do this alone. Since my whole family is going to Jakarta during the summer break, I’m gonna hunt for the best psychiatrist in Jakarta whom I can communicate with and get as much as information as possible from with regards to the this illness and its treatments. I need a doctor who can understand my sister and whom she’s comfortable talking with. Doctors in Jeddah are unfortunately not patience enough and somehow talk in a high-tone voice to their patients. And that didn’t make my sister any better. The next mission is to persuade her to go to the doctor. This is the hardest part; she always denies that she’s ill. She always thinks she’s okay and healthy. Forcing her to do something will eventually  make her even more stressed out and we don’t want that to happen. So I need a good trick for that .

This is by far one of the hardest posts that I write. I couldn’t stop crying; writing this really hurts my heart, knowing that I’m just a helpless and useless human being. Please pray for my sister’s health. If you have some information about trusted psychiatrists that I can contact in Jakarta, drop me a line. Your help and pray is very much appreciated. Thank you.

* Interesting Youtube videos to watch:

• Bipolar Depression: 8 Reasons to RUN from Anti-Depressants
• Truth About Mental Illness and Disease
• Cures for Mental Illness
• Recovery for Mental Illness Redefined
• The Truth about Mental Health Disorders – Psychology
• Youtube Channel: It’s A Brain Thing by David Henley, MD