Thursday, October 11, 2007

Week in review

Terminal insomnia again -- but since I haven't posted in a while, I'll try to convey something about what's been happening.

Simchat Torah. It was fine. I didn't do a ton of mingling, but I did get out of the apartment and spend time with friends.

Fight! I got into a very heated discussion with another student during my Health Care Policy class. We were doing an exercise mimicking Oregon's process of determining which mental illnesses were most severe and therefore Medicaid-reimbursible. We were supposed to list the top five from a list that included schizophrenia, bipolar and unipolar depression, Tourette's Syndrome, panic and anxiety disorders, etc. The criteria, which were not in order of importance, were:

1. Risk of death without treatment
2. Impact of lack of treatment on individual economic security
3. Impact of lack of treatment on quality of life.

This student is a bossy German woman, Frau Know-it-all, who's interning at The Other Bad Place. She's got the snotty European disdain for America, which ticks me off, and she's just too forthright about her opinions. So am I, of course, but I agree with most of my opinions.

So she was in my discussion group, and we were fighting about whether to rank schizophrenia or bipolar first. Frau Know-it-all kept saying, "I'm at The Other Bad Place, and we see a lot of bipolars, they have a high suicide risk and they're more often successful (i.e., actually die); they should be first." Whereas I (and most of the other students in the group) thought that schizophrenia was more economically and emotionally disabling and made for a much poorer quality of life.

Another student in our group pointed out that with treatment, most people with bipolar can live very productive lives and manage on their own. "There are probably a bunch of people at this school with bipolar disorder, and you'd never know." Frau Know-it-all dismissed that notion. She kept pushing and interrupting and insisting she was right. I pointed out that many people with schizophrenia also attempt suicide, and she just kept saying, "Not as many as bipolars." She fixated on suicide and ignored quality of life, and also kept insisting that 1, 2, and 3 were in order of importance, even after the professor said they weren't.

I finally got fed up with her interruptions and snapped, "Let me speak!" She said, snidely, "I think you get enough time to talk in this class." At which point I shut down. It was out of control.

When the professor asked the groups to list our top 5 illnesses in order, Frau Know-it-all said nastily, "Oh, I think Ayelet should speak for the group." I didn't.

I guess three things were really operating here. First, I didn't like the way Frau Know-it-all thought she knew everything about bipolar, and the way she talked about people with the illness. Second, I'm still annoyed and hurt by what happened at The Other Bad Place, and I definitely don't consider them experts on anything. Third, sometimes I fear that I speak up too much in class, and this was painful to hear. Even though the professor and most of my fellow students don't seem to have a problem, having her poke me square in the center of this uncertainty was uncomfortable.

Jerry and I talked about it later. He told me not to worry about how she perceived me, which was nice to hear, and that the point of grad school is to bring debate and questions and outside knowledge into the classroom.

He also told me I'm pretty, which I wasn't really expecting. After we dismissed Frau Know-it-all, he told me that he thinks my depression and hypomania are under control but not my anxiety, which was an interesting perspective. I told him that part of it has to do with my continuously frustrating dating experiences, where I'm being rejected right and left. He said, "I'm going to tell you what I tell my daughter: Guys are intimidated by two kinds of women. Smart women and pretty women."

Pretty? Moi? "I guess I don't feel so pretty since I've gained all this weight," I hedged.

"Scrawny women look better with clothes on, but men of the world," he opined, "know that women like you look better with your clothes off." That was some unexpected reinforcement. I don't know how many frum men are of the world, but it was really great to hear that he thought I was pretty. I often feel so old, chunky, and dowdy next to all the dewy, slim 20somethings at school. So his opinion was a boost to my ego.

A light for the blind. In the lab I was situated near the computers that are designated for visually impaired students, as is one of my classmates, Jessie; she comes to classes with her adorable black lab guide dog. I was talking to a friend, and Jessie said to me, "Oh -- you're in one of my classes, I know your voice. Could you help me with something?"

I was delighted to help her -- and felt vindicated for every time I spoke up in class. If I weren't so in love with the sound of my own voice, she wouldn't have recognized it. Smoke that, Frau Know-it-all.

Jessie's very nice. I felt kind of bad for not introducing myself to her sooner -- having visual problems doesn't just make it harder for you to get around, it hinders you from interacting with people. She talked about getting on the elevator and asking them to push 3, only to hear, "Jessie, we're all in class with you!"

"How are you supposed to know that?" I asked her. "Are you supposed to recognize them by smell?"

Panel discussion. Did not go as well as I'd hoped. Three presenters: a certified peer, a family psychoeducation expert, and a faculty member. There weren't many students, even though I had my professors send the flyer out to all of their classes. One of the people I developed the idea with said she'd post flyers, but her coverage wasn't that extensive. There were more attendees from another social work school, who had heard about it from the faculty member. It was disappointing; publicity/PR is just not my m├ętier.

The certified peer presented a lot of important information but he tended to ramble, and he went way over time; I found myself wishing I'd helped him outline his ideas for conciseness, although when I would have managed to do that, I have no idea. He and I are supposed to work on some big advocacy projects; I'm going to have to really try to focus him, because otherwise he won't make the right kind of impact.

Fortunately, the faculty member, Professor Supportive, was glad I'd organized the event and proud of me. That felt good. The peer had asked her to write him a letter praising his performance, and she wants me to sign it, too, since I organized the discussion. That was really nice.

Also, I met another student, Claudia, at the end of the discussion, after most of attendees had left. She was talking to the family psychoed. expert about her experiences with bipolar and borderline personality disorder. It was amazing to meet another student/consumer! I told her that I have bipolar, even though the professor, who didn't know, was standing there. (The family psychoed. expert knows me well.) It felt so liberating to disclose, even on such a limited basis, and the professor was absolutely terrific, incredibly supportive. Claudia and I are going to have coffee next week and chat about her policy midterm and our overdoses/comas.

So the school has at least three students (Joan, Claudia, and me) who are diagnosed with severe mental disorders and taking psychoactive medications. I wonder how many of us there really are.
Copyright (c) "Ayelet Survivor"


  1. See what happens when you don't post in a while? You give us all a huge amount of material to digest at once.

    Well - last things first - I find the idea of two people dishing about their overdoses/comas pretty funny. Sorry.

    Then - you said the panel discussion had a "bunch of people" from another school. This would imply, to me, that it was reasonably well attended. That makes it a success. If one of the speakers rambled, so what? It happens. You did good.

    Then - Frau Know-it-all is not good for you. She's nasty and she delights, obviously, in cutting people down. I'd do my best to avoid her.

    On a side point, why wouldn't the 'death' factor weigh more heavily, in your discussion, than economic and quality of life issues? I realize this is a philosophical question, but isn't it better to be poor than dead? Mind you, I'm not taking Frau Farbissineh's side.

    Lastly, even though I know you're just fishing for compliments, trust me when I say you are lovely and attractive, not dowdy in the slightest.

  2. I'm glad things sound to be going well overall.

    I know the sick feeling that results when someone reinforces your worst opinions of yourself. It's like getting punched in the stomach. I'm glad you have Jerry for support. And it sounds like you and Claudia can be buddies now too. :)

  3. From a fellow psychologist: I don't know about suicide rates of people with bipolar vs. people with schizophrenia. However, I will say that in my clinical experience, people with schizophrenia seemed to be, overall, "worse off" than those diagnosed with bipolar. The latter group seems to have a higher level of functioning.