Discussion in 'The Watercooler' started by A dad, Oct 27, 2015.
Yeah that is my question can they control their actions?
I think this is a complicated question/answer -- really, "It depends." In theory, they "can." If however they are not in any sort of treatment, are unmedicated, or in the throes of a significantly unstable period in their illness, that control may be difficult for them to hold onto. It's very diffficult for an unstable mentally ill person to control anything - because their illness is telling them what to do, not their logical mind.
That's not to say they still aren't responsible for their actions, because they are in my opinion - but it doesn't mean they have much "control" over what they do. Therapy and medication can bring back that control - but getting a mentally ill person to comply with that can sometimes be a challenge.
Depends. Most times they can to certain degree. During for example severe psychosis they can't.
But even during their better times for many it is much more of a struggle than for average person. And often the need is higher than for average person. To treat mental illness well, you often have to have much more structured and self-disciplined lifestyle than most people have. And even then mental illness can not be controlled any more than for example cancer or epilepsy. medications often help some, for some a lot, lifestyle helps, but still; they do not cure and sometimes despite everything illness just has a new outbreak. And sometimes people lose the battle. And no, they are no more responsible for that than those who lose battle with cancer. Some of them could had done more to have the better odds, some did everything in their power, but nothing was to be done.
They can choose to actively participate in behavioral modifications and drug therapies or not. Just as people who are obese can choose to avoid fatty foods and exercise. It's not easy, and sometimes we fail, but there's always a choice.
I very much dislike the idea that mental illness is an excuse for poor behaviors. Don't get me wrong, I don't include developmental delays or learning disabilities in this little bugaboo of mine. But the thought of how much education through therapy and treatment that we gave our son that he chose to toss aside like so much garbage because he thought a diagnosis was an excuse makes me want to spit.
I agree, it's complicated.
I have Bipolar disorder and have gone into a manic state that lead to a psychotic state. I was only a harm to myself as I did try and grab a police officers gun in an attempt to shoot myself. Though I do remember driving during my psychosis and was listening to the song "Jesus take the wheel" and I actually let go of my steering wheel so as to show my faith...to prove my faith. Thank goodness I fell short or who knows what might have happend!
The whole episode was horrifying and quite real to me!
I was taken by police to a hospital and held against my will (I did try to break out at one point) until I began to think more clearly and come back to "reality". I take medication now every day and do consider myself a responsible person. However...the medicine I have taken for so long may stop working. Then, I may need to be hospitalized again until I am stable.
My husband and I have debated the point about the responsibility that the mentally ill who cause harm should be liable for...
I think it is safe to say that those who cause harm to others are in MOST cases held criminally liable and locked away behind prison bars these days. My husband even still believes in the death penalty in such cases. I lean moreso on lifetime sentence at a mental hospital.
It's just that I believe there is a difference between Ill will... those that intentionally set out to harm, premeditated evil and those who are afflicted by an "ill mind", ill thinking that incidentally leads to harming others. I can't imagine hearing voices tell you to do something to harm another. That is very scary. I think this is an ongoing debate as so many seriously mentally ill individuals are causing great harm in our society these days. But I do think there is a difference between "ill will" and and "ill mind". We MUST come up with a good solution!
Im still trying to learn and understand the various answers for your question for myself and my family as well as others. I agree with everyone here, the person needs to learn the skills to help control their actions, and keep practicing it. Depends on their diagnose too. I do also agree about the medications, they can work for so long and it may need to be changed. Also, they of course work better together. My son is still in the process of being diagnosed further, but as he tells me" sometimes I can control it, sometimes I know its wrong but cant stop (but at times tries) and sometimes I dont realize im so angry and/or dont remember it or why". Its hard to really understand unless we were in their heads.
Severity is one of the factors that determines whether there is any level of control when mental illness is involved. A person with rapid-cycling bi-polar might be able to hide those swings, but it takes a LOT of effort, and leaves less for ordinary living - which then brings other problems due to ordinary living not getting done. If swings are more intense and last longer, nobody has the strength to withstand those kinds of waves. The best hope for successful "control" is the willingness for medications and therapy that will reduce the impact of the illness and increase the tool-box so that they have more chance of being able to think things through and control their actions.
Witzend...I will be mulling over your comparison to weight loss and choices etc. to mental illness and certain choices all day.
This question posed is a classic and age old one. And one that my spouse and I discuss often.
I certainly think our Difficult Child who has Bipolar illness would do better if she went to therapy regularly . She, at least, takes her medications regularly.
Lots of great ideas and responses here, A Dad.
Bipolar is a spectrum. Some people are more severely disabled than others.
I hope that these responses help you along your journey to figure things out.
It should be noted that most of this discussion is about bi-polar. With some of the "other" disorders, there is no chance of control without medication - such as schizophrenia.
Though same goes with more severe bipolar type 1 too. And for some medications do not help that much either. And therapy doesn't do squat without medications.
My old friend who committed suicide last winter was one of those who got only limited help from medications and with whom mania led to psychosis quite frequently even when she was diligent with medications, therapy and lifestyle factors. During her better periods she of course had more control, but for the long time she used to be involuntarily committed for few weeks or months at least once a year due mania and psychosis breaking through despite medications.
I know someone with bipolar 1 who is a physician and a very successful one. She sees a psychiatrist regularly, exercises regularly, eats in a healthy manner and goes to therapy when she needs to. And she takes her medications regularly. So, she seems to be doing all she can to keep her illness well controlled. No doubt this has helped her succeed in life. However, she has also been married five times. And periodically, if in a bad mood, she will scream at her staff and they sometimes quit because of it causing difficulties in the office.
So, things are NOT ideal, but she seems to have made a decision to do her best to do what she personally can do to keep herself well.
The comparison to dieting sort of makes sense to me. I have done WW many times. Why? Because it works for me. I need the accountability, etc. recently, I'm doing MyFitnessPal. This also works well. When I don't use it, I don't lose weight. It is a conscious choice whether I use it or not. Geez, I wish I didn't have to. Geez, I wish I was one of those gals that just magically know when to stop eating. But I'm freakin NOT. So, I can use the MFP, a tool that works or I can cry in my milk and be overweight. The choice is mine.
Now, with the difficult child that we adopted. Dios mio. There are times, I'm fairly sure she doesn't have a clue. I don't know if it is a refusal to accept personal responsibility, a futilitic attitude, learned helplessness, depression, brain damage, etc. She has said the only reason she takes her medications is she won't sleep without them. She has made better decisions with a therapist in the past, but finds them taxing and sometimes aggravating and doesn't like having to remember appointments.
She makes many peculiar mistakes, but very often repeats them. No cause and affect reasoning.
Very generally speaking, I think she can do better to a certain extent. So, I think she has some control over her actions...but I think it requires an enormous amount of her will, energy, concentration etc. I don't think it is something I fully "get." It seems to be like her brain is stuck in muck and something what would be common sense and simple to a smart ten year old, would take tremendous effort and every last ounce of her energy and strength to make a good decision for my Difficult Child. Soooo...it would be like lifting a three pound weight for us and a 50 pound weight for them ???? So, they can do it , but much more difficult.
Still processing this age old question.
So they "can" do it. But we don't just have one or two choices to make in a day. There are many. And if every choice is a "3-pound weight", we can do that repeatedly. But how often can you lift a "50-pound weight", unless you're a competitive weight lifter?
It isn't just mental health issues. Developmental Coordination Disorder is another good example - the person can, for example, "write" or "print". But it takes 10 times the effort, and has to be the only focus. Listen and take notes? 100 times as hard - so they don't. And teachers just call them "lazy"... because they "can" write. But they can't write thoughtlessly and automatically the way most people can. So they actually can't take notes. It's been the best graphic representation of mental illness that I've found - easier to visualize for me.
The writing example is good.
It does give me pause (and joy and relief) that our daughter makes the choice to consistently take her medication. She seems to do it automatically. She made a choice to do it because she recognizes that she needs sleep. She doesn't like it when she doesn't sleep.
Perhaps she doesn't recognize it when she makes horrible decisions. Doesn't learn from mistakes. Makes the same mistakes repeatedly. Usually makes better choices with a therapist. doesn't seem to make good choices in these arenas.
I do "get" it / understand the idea of repeatedly lifting the heavy weight several times all day long.
There might very well be only so much she can do logically in the course of a day and then it's as if she fatigues. Energy, for me is a key word. It's as if there is nothing left in terms of mental health sometimes...often times.
It is a hard question. Sometimes it makes me sad to think a person might not have control.
But, in the case of the doctor I mentioned above, she clearly has done everything she knows how to do to be well and although not ideal, it has paid off.
Still working on this...maybe I always will.
Exactly. I've seen it too. Sometimes it's even "me" that runs out of mental capacity to act responsibly.
Thing is, though name of the illness is the same, for example bipolar or breast cancer, the illness itself is not similar to all. For some it is more severe than for others. And some have more supporting factors or strengths against the illness than others.
When person has more than one challenge, they do not just add up, they multiple. For example Nomad's daughter may have (and if I remember correctly does have) that kind of challenges, for example in some areas of cognitive function, that this doctor with bipolar has not. That type of things make a huge difference.
My kid has not been diagnosed (at the moment at least) with bipolar but has other mental illness. However with him it seems very evident that it is all the challenges added together, and having to continue the battle for extended time, that destroys the person. However hard you try, try to do everything right, there is a point for everyone when it is just too much.
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