Wednesday, July 27, 2011

I feel hopeless today

I'm feeling really hopeless today. I'm saying today, but I've been feeling really down for a while. I feel like my mom's situation has taken over my entire life and it's not getting any better.

Here's an update about what has been going on with her: I've been getting calls (and I say "I" not "we" since my brother and sister have been MIA...especially my sister) from the rehab about my mom's hygiene (from the previous posts) and just about how she has not made any progress. Everyone is frustrated with her at rehab because she openly admits that she is going to drink the moment she gets out, even though she has cirrhosis and it is going to kill her...quickly.

My mom's good friend (who is a Dr.) wanted to know how much of this "unwillingness" (to shower, to understand that drinking will kill her, etc.) is from mental illness (bipolar disorder) versus brain damage from drinking. I'm going to copy and paste some email exchanges:

FROM MY AUNT...

On Mon, Jul 25, 2011 at 9:40 AM:
In particular you need the result of any imaging of the brain (CT scan, MRI) and any update on your mom's psychiatric diagnoses now that she has been on medications for some weeks/months including prognoses and recommended therapy (not just meds but post-discharge support recommendations). I would be very interested to know about the degree of brain atrophy present and its pattern. As we discussed on the phone, there are some distinguishing features between the atrophy of senility or natural aging and that of chronic alcohol abuse (called Wenicke-Korsakoff which you can read about here). The atrophic changes are irreversible and, particularly if they are of the classic alcohol related type, would be helpful in attempting to predict her future function capacity. While this may in fact be bad news it would at least let us try to play the ball where it lies rather than wonder.

MY RESPONSE AFTER SPEAKING WITH THE NURSE AT REHAB:

Date: Wed, 27 Jul 2011 12:01PM:
So I just spoke with the psychiatric nurse and she said that Mom refused the spec scan, so they don't have anything to go by with that. But she did say that she spoke with the Dr and other nurses about mom (they all remember her) and she said that they all strongly believe that mom has irreparable damage to her brain and that she will never be able to understand that she can't drink or anything like that. They said she doesn't think mom will get any better than this. It's been almost 90 days of not drinking and if she was going to improve, she would have.

I asked her if she thought any of this could be bipolar related and she said that she couldn't say for sure, but she thinks it's damage from alcohol. She believes mom will never be able to live independently again.

She said mom could always go see a specialist for a brain scan once she's out of gate lodge, but she thinks mom will begin drinking immediately and things will start to deteriorate before we could even get an appointment.

Not sure what the next step is.

MY AUNT'S RESPONSE TODAY...

Date: Wed, 27 Jul 2011 1:00PM:
I'm afraid this is pretty much what I was thinking but I wanted to hear what her caregivers thought and hoped there would be an imaging study to confirm. For someone with radiology training like me I always want the clinical picture and imaging picture to support each other. Your description of your mom's conversation and behavior suggests a concreteness that is typical of chronic alcoholic encephalopathy or brain damage as we discussed before. This is irreversible. Honestly, I think chronic institutionalization is the only way to keep her alive. While not a pleasant environment from a normal person's point of view she has demonstrated the ability to establish a routine in such a setting at ECMC and these other places despite her complaints. This would cost money for a private setting and would certainly suck dry her remaining assets then end up with her as a ward of the state if she outlives her assets. Or you could consider legal advice as to how to distribute her assets to you kids and go right to ward of the state type status. Or you could follow her brother's thought as to finding her a small rental apartment where she can't get herself or anyone else in too much trouble and let her just finish out the process with her drinking. It is not likely to take a great deal of time if she is left alone. This both sounds and feels harsh to me but I do not see any "good" option here. She has done too much damage. I think the effort was worthwhile because none of us was ready to see her die in May which was about to happen. Also we all now know that we have done what could be done to try to save her.



So, now I'm here. I feel so depressed about all of this. I don't want to institutionalize her (and don't know if I could even if I wanted to). It feels unacceptable to me to let my mom go back home, get an apartment, and then drink herself to death. Soon. I can't imagine not calling my mom, not seeing her, not sharing things with her, not having her in my life. I do not feel ready to let her go. I'm 25 and my mom is 55. She is too young to die.

I talked to my boyfriend and he doesn't really want her to come live with us. I'm sure not that's really a viable option anyway since her health insurance is only good in New York State and I live in Colorado. She might never be insured again if she moved out of New York.

Do I move to New York? Leave my life here? My boyfriend, home, cat, support, job?? I feel hopeless. I have no idea what to do and I have 2 weeks and one day before my mom gets out of rehab. I need to figure out it and I have no idea what to do.

Monday, July 25, 2011

My mom won't shower...

My mom is in trouble at her new rehab place for refusing to shower. People are complaining about her hygiene.

I found this article (below) here...




Why Don’t We Want to Shower When We’re Sick?

I know this seems like an odd question, but I was considering it this morning (in my shower). It is a common problem for people with a mental illness. I have a tendency to avoid showering (really) and I know of others with a mental illness have gone weeks without showing.

So, if all we’re talking about is standing in some warm water, why don’t we want to shower?

I think there is a tetrad of reasons, experienced according to mood: fatigue, crazy, self-hatred and pain.


Too Tired to Shower


If you’ve been seriously ill, mentally or physically, you know energy is in short supply. Sometimes it takes the effort of a thousand men just to open your eyes and get out of bed in the morning. Every muscle flex, joint bend, or even a thought is overwhelmingly exhausting.

And if you only have enough energy to accomplish two small goals that day, you might pick eating and paying the power bill. Both of these things are more important than showering. (And of course, you might not be lucky enough to have even that much energy.)


Too Crazy to Shower

Then there’s the other end of the spectrum. Hypomania (mania) is the fastest time on planet earth. Nothing holds my attention long enough to do it and I’m vastly annoyed at how slowly everything moves. I end up finding myself watching TV while doing yoga and writing the first scene of a book in my head. And then I look at the clock. Five minutes have gone by, but in my brain they’ve felt like 60.

And due to my extreme inattention and annoyance at single-threaded slowness, a shower sounds like the most boring thing in the world. Ever. It wouldn’t even occur to me to bother with one.


Too Hateful to Shower


Those first two I think are obvious, but I think this one is more subconscious and insidious. I sometimes find I don’t want to shower because I hate my bodymy existence) and therefore don’t want to be naked - rather a requirement for taking a shower. It’s not a conscious lack of self-care, or purposeful denial of pleasure, or low self-esteem, or any other therapy-esque interpretation you’re likely to find. It’s just that me, my body, feels really grimy and I don’t want any further proof of its existence. I want to pretend it’s not there. It hurts less to pretend it, myself, doesn’t exist. (I suspect this is an aspect of dissociation. I’m a dissociator from way back.)

But Showers Feel Good

Ah, spoken like a normal person. No, they really don’t. I mean, sometimes they do, sure. Warm water, citrus bodywash, what’s not to like?

It’s complicated.

When I’m in pain I want to put up additional barriers between me and the world. Some subconscious part of me is thinking extra clothes and blankets over my head will save me from my brain. Being naked removes barriers. And I can’t have that.

And I’m not exactly sure how to explain it other than to say the water is painful. It feels like an attack. It feels like I’m in so much pain already that a breeze grazing my skin makes me want to cry.

And I’m really, really trying hard not to think about that pain. That’s the stuff of death. So the last thing I need is to have shards of water splitting through my skin. I don’t want to shower; I’m in enough pain already.




Does anyone have experience with this in relation to depression or bipolar disorder?

My Mom at Gate Lodge

So, my mom is at Gate Lodge and not doing well. She has been getting in trouble for not participating with the program (giving people one word answers, no willingness to stop drinking, hiding food)...and now they are seriously worried about her hygiene.

Her hygiene: she has not showered in ~1 year and she has bouts of fecal incontinence. They had to force her to get in the shower, which she did. But then they realized that she was not using soap, so now they have to watch her bathe.

She says that the water irritates her skin. I'm not sure what to make of this. Any thoughts?

A new update about my mom

The hardest thing about family program was hearing everyone say that my mom was hopeless. She was not committed to the program and had no intention of trying to stop drinking. She also was sneaking (typical alcoholic behavior) food into her room...not to eat, just to hoard. Also, she still looks awful. She has gained about 10 pounds, but she still looks emaciated and not like my mom.

The one successful thing about family weekend at Hanley was the meeting I had with my mom and her counselor. My mom VERY begrudgingly agreed to go to 28 more days of inpatient at a cheaper/less intense chapter of Hanley, called Gate Lodge (read about it here).

My mom was SO angry because we threatened to Marchman Act her for 60 days or she could voluntarily agree to go to Gate Lodge for 28 days. She wouldn't talked to me for the last few hours I was there to visit. She played cards with me, but wouldn't speak with me.

So, now she's at Gate Lodge and still not doing well.

Sunday, July 24, 2011

Taking the night off...



Will be back tomorrow. We can't forget to take care of ourselves!

Last few things I learned...

CODEPENDENCY...

I AM POWERLESS TO MY MOM'S ADDICTION.

My life is controlled by my mom's addiction.

By enabling, I am not rescuing my mom...it only rescues her disease.

Stress comes from not reacting or dealing with your emotions.

DETACH: Don't Even Think About Changing Her

A litte acronym for you...

Addictive/compulsive behavior or marry addicts
Delusional thinking and denial about family of origin
Unmercifully judgmental of self or others
Lack good boundaries
Tolerate inappropriate behavior

Constantly seek approval
Have difficulty with intimate relationships
Incur guilt when standing up for self
Lie when it would just as easy to tell the truth
Disabled will
Reactive rather than creative
Extremely loyal to a fault
Numbed out

Overreact to changes over which they have no control
Feel different from other people

Anxious and hypervigilant
Low self-worth and internalize shame
Confuse love and pity
Overly rigid and serious, or just the opposite
Have difficulty finishing projects
Overly dependent and terrified of abandonment
Live life as a victim or offender
Intimidated by anger and personal criticism, or overly independent
Control madness -- have an excessive need to control
Super-responsible or super-irresponsible

Family Roles in Addiction

We also learned about the family roles in addiction...


The Addict

The person with the addiction is the center, and though the key to alcohol and drug addiction recovery, not necessarily the most important in family recovery. The "world" revolves around this person, causing the addict to become the center of attention. As the roles are defined, the others unconsciously take on the rest of the roles to complete the balance after the problem has been introduced. Recovery many times on this person.

The Hero

The Hero is the one who needs to make the family, and role players, look good. They ignore the problem and present things in a positive manner as if the roles within the family did not exist. The Hero is the perfectionist. If they overcome this role they can play an important part in the addiction recovery process.

The underlying feelings are fear, guilt, and shame.

The Mascot

The Mascot's role is that of the jester. They will often make inappropriate jokes about the those involved. Though they do bring humor to the family roles, it is often harmful humor, and they sometimes hinder addiction recovery.

The underlying feelings are embarrassment, shame, and anger.

The Lost Child


The Lost Child is the silent, "out of the way" family member, and will never mention alcohol or recovery. They are quiet and reserved, careful to not make problems. The Lost Child gives up self needs and makes efforts to avoid any conversation regarding the underlying roles.

The underlying feelings are guilt, loneliness, neglect, and anger.

The Scapegoat

The Scapegoat often acts out in front of others. They will rebel, make noise, and divert attention from the person who is addicted and their need for help in addiction recovery. The Scapegoat covers or draws attention away from the real problem.

The underlying feelings are shame, guilt, and empty.

The Caretaker (Enabler)

The Caretaker (Enabler) makes all the other roles possible. They try to keep everyone happy and the family in balance, void of the issue. They make excuses for all behaviors and actions, and never mention addiction recovery or getting help. The Caretaker (Enabler) presents a situation without problems to the public.

The underlying feelings are inadequacy, fear, and helplessness.

*All info taken from here.

Family Weekend at Hanley Part 2

In family program, you stay with your group almost the entire time (there are 1-2 hours to visit with your loved one). You eat meals with your group and spend the rest of the day together in lectures about addiction.

We learned about the Jellinek Chart:



I thought that was interesting because I related to almost every part of it. It talks about how what happens to the chemically dependent person is mimicked by the family members.

For example:

Increased Tolerance: for the addict this means "needing more of the substance to obtain the desired effect", but for the family member is means "putting up with more of the using behaviors of the addict".

We also learned about enabling and other codependent behaviors. They encouraged us as family members to LET GO of our codependent tendencies.

I think that is partly why I had such a difficult time: letting go (for me) means letting my mom die. I cannot do that. I am not ready to.

Family Weekend at Hanley Part I

I'm back home after family weekend at Hanley (which you can read about here).

The family program was actually very difficult for me. I arrived on Thursday night at the hotel that Hanley pays for one family member to stay in and it was very nice. The next morning, Hanley arranged for the family members attending the program to be picked up at 7:30 am. Originally, my brother and sister were both going to attend with me, but they bailed at the last minute.

The idea of family program is to teach the family members how addiction is a family disease. It's like dominoes: the substance (alcohol, in my mom's case) knocks the addict down and then the addict knocks everyone else around them down.



Other helpful things we learned about addiction:

-addiction is about compulsivity (always worrying about the next drink)

-the first 12-18 months after quitting are the hardest

-alcoholism is a holistic disease (physical, emotional, mental, social, spiritual) & therefore so must the solution to the disease be


Anyway, I'll update more about what I learned later. But for now, I wanted to just say how hard the weekend was for me. I was SO immensely worried about my mom (rehab was not working for her...she had no intention of trying to stop drinking) that I could not handle the conversations about addiction and recovery. I sobbed through the entire weekend. I'm so glad that I won't see any of those people who attended family weekend again because I really embarrassed myself. I was way too emotional. It wasn't a tear or two, it was the kind of crying where you can't speak and you get all red and blotchy.

I still haven't processed why exactly it was so hard for me. Was it because I'd never openly talked about my mom's addiction? Or what it was like for me? Was the it group/crowd aspect? Was I just nervous?

Any ideas?

Tuesday, July 19, 2011

High Correlation Between Adult Children of Alcoholics And Nurses

According to GettingThemSober.com:

46% of American households have alcoholism.

Wow, almost HALF by their count.

75-80% of helping professionals in the U.S. under the age of 55 are adult children of alcoholics and 60% of physicians (who are U.S.-born) under the age of 55 are first-born children of alcoholics.

83% of nurses are adult children of alcoholics.

This is a staggeringly high number! Helps explain the stats that follow...

The American Nurses Association states that 20% of nurses have 'substance abuse issues' with an an estimated 40,000 nurses in the U.S. experiencing alcoholism. Binge drinking was highest among oncology, emergency, and critical care nurses.

Odds of marijuana use are 3.5 times higher among emergency nurses. Pediatric and emergency nurses reported a higher use of cocaine than other specialties. Oncology nurses reported the highest overall drug use – for all substances combined.

Looks like growing up in an environment of substance abuse combined with having a genetic predisposition to it, is taking it's toll here. Nursing has traditionally been a profession known for compassion and empathy. Looks like nurses (and doctors) could use a bit of this medicine themselves.

*article here

Wow...this is making me rethink my career path.

What do you think of this? Are children of addicts more likely to take on "helping careers"? Is it an extension of co-dependence?
Are we fixers for life?

At my mom's...

I've been packing up my mom's house (25 years of memories...and STUFF). I'll update when I'm back home.

Life....


*image from here

Thursday, July 7, 2011

So...


After taking a little hiatus from updating about my mom, I'm back with a short update. I needed time away from thinking about everything that is going on with my mom while she's in rehab.

Long short: The Hanley Center told my mom they had filed the Marchman Act, which is something that "can be defined as a course of action that can be done either voluntarily or involuntarily to provide substance abuse emergency services and temporary detention for individuals in need of substance abuse evaluation and treatment".

So, she's been forced to stay in rehab until July 14th. BUT when July 14th comes around, my mom is going to find out that everyone wants her to stay in inpatient rehab longer than that. She is going to be really mad.

Anyway, I am going to Florida for family weekend (which you can read about here or check out the previous post). I'm nervous about telling my mom that we are going to go through with the Marchman Act if she decides to leave July 14th, but I'm excited to see my mom SOBER and spend time with her...and also to learn about how an alcoholic family functions. I hope it is healing in some way.

Has anyone ever gone to a family weekend like this? I'd love to hear your experiences.

The Family Program at The Hanley Center

I'm going to the family weekend at Hanley and got an email asking for more info. Here it is...

The Family Program provides family members with an opportunity to gain insight into the ways in which they have been affected by the family disease of chemical dependency and to learn how to recover from the effects of the disease. Alcoholics and addicts, and those who love them and are closest to them, are affected physically, mentally, emotionally, socially and spiritually. As the disease progresses, many family members become so focused on the addict or alcoholic that they lose the ability to take care of themselves.

Physically, you may suffer from stress-related illnesses. You may not be eating well, sleeping well or exercising.

Mentally, you can become obsessed, preoccupied and forgetful. You may have a hard time concentrating because of worry and racing thoughts. You can also develop mental defenses similar to the addict or alcoholic, such as denial and minimization.

Emotionally, you may be anxious, fearful, depressed, lonely, angry and overwhelmed, but the common way for dealing with these feelings is to bury them. Burying feelings can result in physical problems and overreacting to minor incidents because of a buildup of unresolved tension.

Socially, you might withdraw and become isolated, ceasing to participate in activities and hobbies that were once enjoyable. You can become disconnected from yourself, others and life.

Spiritually, you might find yourself violating your values to protect the addict or alcoholic and over time begin to lose faith, hope and a purpose for living.

Hanley Center’s Family Program is an educational, supportive and nonconfrontational group experience for family members, friends and significant others who have been affected by another person’s alcoholism and chemical dependency. The program consists of lectures, videos and group discussions on alcohol and drug addiction, relapse, family dynamics and the effects of addiction on children as well as the recovery process. Family Program participants also receive information about Al-Anon, CODA (Co-dependents Anonymous), and other 12-Step support groups to assist in their recovery.

The group consists of family members and patients at the Hanley Center who are not related to each other. This type of group creates an opportunity for alcoholics, addicts and family members to be able to share openly with each other without the typical emotional reactions and conflict that often occur within a chemically dependent family system. The result is that addicts, alcoholics and family members are able to gain a deeper awareness and understanding of each other. Each participant shares at the level that he or she feels comfortable. As group members share their feelings and experiences, they form meaningful connections with one another and begin to realize that they are not alone.

Who can attend?

The Family Program is offered to people in the community who have been affected by someone’s addiction and to anyone who has a loved one in treatment. Participants must be 18 years and older. Patients in residential treatment at the Hanley Center may have one person attend the Family Program at no charge. The cost of hotel accommodations is also included for those who reside outside Palm Beach County. Other family members and significant others may attend at an additional fee.

How can it benefit me? Why do I need to participate?

The Family Program provides valuable information, support and encouragement to individuals affected by another person’s addiction. Many family members are unaware of how deeply they have been affected by their loved one’s addiction and they may be confused about their role in supporting their loved one in recovery. Participants can discuss their concerns and ask questions so that they can make well-informed decisions. Groups are facilitated by Family Program counselors.

When is the Family Program offered?


The Family Program is a three-day program, beginning Friday morning and ending Sunday afternoon. It is offered every weekend. Call 1-800-444-7008 or 561-841-1000 to register or to receive additional information.

Do I need to participate in all three days?

Participants are expected to attend all three days. The program is sequential in nature. Each session builds on the material covered in the previous session.

If I am not able to attend the Family Program while my loved one is in treatment, can I come at another time?

Patients participate in the Family Program while they are in treatment. If you cannot attend the Family Program while your loved one is in treatment, you have up to one year from your loved one’s discharge date to take advantage of the free Family Program weekend (free for one family member).

Can my children participate in the Family Program?

The Family Program is designed for adults 18 and older. If you live in the area, you can bring your children to the Kids and Teens Place on Thursday evening, which is facilitated by the Prevention Department. For more information call 561-841-1214.

Can I visit with my loved one while I am in the Family Program?
Yes, you can spend time with your loved one during visitation which is scheduled every afternoon.

*all info taken from The Hanley Center website

When a loved one is depressed...

When a partner is depressed, these tips from Families for Depression Awareness can help keep your own mental health in balance:

Remember it’s not your fault. Depression in your partner is a medical condition, not the result of something you said or did.

Recognize normal reactions. Along with compassion for your partner, don’t be surprised to feel frustration, anger, and even hatred. It is extremely difficult not to take symptoms such as withdrawal and irritability personally. Also common are resentment because your life has changed and grief because the person you love seems to be gone. Don’t be afraid to seek counseling to deal with your emotions.

Don’t be a martyr. No matter how hard it seems, be sure to schedule time for activities that you enjoy. If you are taking on extra responsibilities around the house or in overseeing your partner’s treatment, look for other family members, friends, or even service professionals (a housecleaner, for example) who can take on some tasks.

Find social support. Dealing with depression in a partner can be isolating. Make the effort to spend time with friends who are able to sympathize and provide emotional sustenance. Seek out peer support groups for families of people with depression.

Be part of the solution. Learning more about depression and how to provide useful support—as well as knowing what not to do—can improve treatment outcomes for your partner. The better your partner gets, the more pressure that takes off you and your relationship. Couples counseling helps address issues arising from the depression.

Have hope. You may feel rejected and discouraged when nothing you do to help your partner seems to work. Keep in mind that depression is often cyclical—worse at times, easier to manage at others—and finding the right treatment may take time. And remember that 80 percent of people with depression improve with treatment.

*taken from: http://www.hopetocope.com/Item.aspx/745/the-ripple-effect