Monday, October 14, 2013

Margaret Trudeau on Mental Health

There's a crack in everything.  That's how the light gets in.  - Leonard Cohen  

From CBC Books
I had the fortune of seeing Margaret Trudeau speak on mental health a few days ago.  She told her life story in exactly an hour with great intensity and humour.  She peppered her speech on mental illness with snippets of the stuff I remembered as a child - the hippie skirts then later dancing at Studio 54.  I'm of the age to have wanted to emulated her audacity.  She was the Prime Minister's wife, yet she didn't let that box her into being a stereotype - at all.

She wrote a book a couple years ago, Changing My Mind, which made her plight with mental illness public.  

She talked about the many things that might have triggered her bi-polar condition.  She always had a greater range of emotions, but it was kept in check by her mom who made her life regular: eating, sleeping, and playing all regularly.  But things happened to her that made things worse: a concussion as a child, no regularity at university, pot smoking, loneliness as the PM's wife, post-partum depression, and then profound grief when her son died.  She was "mad with grief."  

She took us through the history of mental health strategies to stabilize hormones:  She talked about how serotonin lets us feel ready to take things on, and it's replaced when we eat well and sleep well.  How low levels left her feeling dead, and Prozac helped her get back to level ground from depression, but it triggered mania.  Elevated dopamine levels, which gives us inspiration and creativity, led her from one compulsion to the next : spending money, sex, drinking...  Lithium helped, but it lead to weight gain and hand tremors.  Next came Epival which gave her serious liver failure.  Finally a low dose of Seroquel has been helping.  But she also advocated electroshock therapy - an interbrain stimulation to a specific place can completely end some problems with immediate results.

But, more importantly, she candidly talked about what it's all like.  The depression made it so she could barely get out of bed to care for her children.  And then there's this sweet spot in the manic phase that made her energetic and capable and confident.  If she could only stay there forever.  But it would soon be eclipsed by full-blown mania in which she had so many great ideas, but she couldn't do any of them, because the next one coming kept interrupting.  She couldn't keep one train of though for more than an instant.  She intended to go to Montreal for the day, and ended up in Cairo (if I remember correctly), because she just had to do some walking there.  It was a huge loss of days and months that were fruitless and scrambled until she got the help she needed.  And at one point her family couldn't help.  While in a psychotic state, she was dragged off the street by police. 

She also touched on a few social problems we're facing:
* the over-drugging of the elderly so they're sedated instead of calmed
* hormone replacement that can decrease dementia by 40%
* the money spent on superprisons even though crime is decreasing; and that it's decreasing primarily due to the rise in anti-depressant use which takes away compulsivity - but the two-tiered mental health system in Canada means some people don't have access to medication.  So we'll actually need those prisons after all!   

Finally Cognitive Behaviour Therapy helped her to correct wrong thinking and guilt - made amends, but also forgive herself.  She makes sure to focus on balance every moment of every day - no junk, regular eating, sleeping, and exercise.   Reading An Unquiet Mind helped.  She warned us that depression hurts physically.  She had fibromyalgia - but really it was a mental problem showing itself through physical illness.

Finally, she got to the importance of talking about it all.  We need to share the journey with others shamelessly.  She acknowledges, "You will be stigmatized," but we have to do it anyway. It's the only way to get help, to heal, and to end the stigma.

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