Patrick Dylan's Blog, page 3

Thank you, Simone

,World's Most Talented Gymnast Completes Most Daring Act Yet

Simone Biles had the courage to show the world, on the largest stage possible, that the brain is as physical as muscle and bone. Some are attacking her, just like they did Naomi Osaka, but we stand with Ms. Biles, those of us that have experienced the real-world impacts of mental impairment. In addressing her limitations, Ms. Biles gave permission to others facing their own “demons” to stop and recognize the need for help.

The pressure of being an elite athlete must be unimaginable. I appreciate how the spotlight would provoke anxiety, especially in someone already prone to it, with thousands of cameras pointed your way and microphones everywhere. But even outside the spotlight, the weight of so much expectation must be crippling. Can you imagine being strong enough to cast all that aside to advocate for your mental health? Most of us can’t even do it when no one is watching.

“And I made up my mind to define my own destiny." -- Lauryn Hill

We knew the trolls would pounce, those without a fraction of her athleticism or accomplishment. I heard all their cry-me-a-river arguments when Ms. Osaka dropped out of the French Open. No one forced her to enter the tournament. If she wanted the big money, she should have expected the fame. Right, okay. But really? We’d rather not provide elite athletes some flexibility for their mental health when competing in major sporting events?

If Ms. Biles had sprained an ankle, no one would have argued that she be forced to try a death-defying vault. Well, hopefully not anymore. Instead, they’d be icing down her foot and telling her stay off it, with the hope that it might recover by the next day’s competition. But that doesn’t happen with the brain. It’s just another blatant example of our society’s prejudice.

Leaving the detractors aside, it’s surprising to me that it has taken this long for the issue to enter the public discourse. Professional athletes understand the importance of preparation. Their lives are dedicated to training, with every aspect of their existence optimized for performance. They are hyper-aware of their bodies, knowing that peak levels of fitness are essential to compete at the highest levels.

They also realize the power of mental preparation. Most professional athletes, and many amateurs aspiring to those ranks, have full time mental coaches. These counselors help in training the athlete’s brain to deal with the stress of high stakes competition, to remain focused on their process and ignore the noise.

“Keep ya head in the game. ” -- Disney's High School Musical

But even our best athletes aren’t infallible. Muscles get pulled. Knees get hurt. And someone’s “head space” gets overwhelmed. The odds of becoming injured increase dramatically when professionals aren't fully prepared. Their bodies need to recover with proper sleep and nutrition. They need to warm up and cool down. If they ignore these essential requirements, months or even years of training could be sabotaged by injury. The brain isn't any different.

One would think that leagues would take a hard stance in support of their athletes. If Tiger’s life wasn’t such a crucible maybe he’d still be playing today. Wouldn’t the PGA be better off if he were? Of course, reporters need an opportunity to speak with the superstars. I guess, to Ms. Osaka’s point, a balance must be struck between the media and mental health. But it seems like a balance worth trying to find, especially if it keeps the best players in the competition.

I’m heartened to see so many powerful athletes speaking out about the importance of brain health. The voices of Ms. Biles and Ms. Osaka have been the loudest lately, but others across the sporting landscape have been vocal, too. Matt Wolff from the golf world recently advocated for his mental health. Anna Cockrell, one of our Olympic track stars, has been vocal about her depression over the past year, perhaps inspired by fellow Olympian Michael Phelps. BringChange2Mind has several athletic ambassadors, including the NBA’s Kevin Love, the WNBA's Jayne Appel-Marinelli, the MLB’s Ian Happ and the NFL’s Solomon Thomas.

“No one can fill those of your needs that you won't let show. ” -- Bill Withers

As much as I would have loved to see Simone Biles fly through the air at the Olympics, I am so grateful for her courage and leadership. She proved that she’s not only a tremendous athlete but also a human being, like the rest of us. It is essential that today’s stars continue to talk openly about the realities of brain health. Only by making it a common topic of dialogue will the rest of society start to come around.

And the rest of society needs to come around. The brain is part of the body, it’s as simple as that. When the brain isn’t functioning properly—when anxiety strikes or depression looms or psychosis scatters—people need help. They need love and support. They don't need attacks, prejudice and ridicule. And they certainly don't need to be swinging off uneven bars fifteen feet in the air.

When asked about Simone Biles, Michael Phelps was speaking for all of us not just Olympic athletes when he said:

“I think the biggest thing is we all need to ask for help sometimes... ”

From Villain to Hero

,Reimagining the Role of Mental Illness in Pop Culture

,[this blog, ,in an edited form ,, was featured by the National Alliance on Mental Illness]

Stephen King is a master storyteller. One of my favorite movies is The Shawshank Redemption. I often find myself quoting Red’s lines in Morgan Freeman’s voice. But I avoid horror movies, and I can’t help but think that Mr. King has made the world a harder place for people experiencing a mental health condition.

Should we list all of those suffering mental illness in Mr. King’s collection? Jack from The Shining comes quickly to mind, as does Annie from Misery. But of course, he only extended a concept from earlier works. How about Hitchcock’s Norman Bates, whose terrifying shower scene traumatized kids for decades? My generation grew up with a long list of unfortunate characters, like Jason from Friday the 13th and Mike Myers from Halloween.

“Maybe showers remind me of Psycho too much." -- Rockwell

It’s an old trope, and an awful one, but understandable. As a society, we find the idea of a malfunctioning brain terrorizing. Someone suffering psychosis looks normal but speaks and acts in a completely unpredictable and disturbing manner. They can say or do anything. If you are a writer, looking to shock and frighten, those experiencing mental illness are an easy target.

Our own precarious balance adds to the terror. Each of us is nothing more than our brains. Sure, we have other organs, but our minds make us who we are. Someone facing mental illness—either on the screen or in person—is a sharp and immediate reminder of the reliance we all have on the proper functioning of our brains. If it can happen to that character in the movie, can’t it happen to me, too?

The answer, of course, is yes; it can happen to any of us. In fact, it does. 20% of Americans are currently wrestling with some form of mental illness, probably more given the pandemic. If you aren’t suffering, consider yourself lucky. For many people, the torment comes in the form of depression or anxiety. Others are dealing with addiction, post-traumatic stress disorder or any number of other issues. Still more are haunted by the frightening reality of psychosis.

“I've been wallowing in my own confused and insecure delusions.” -- Tool

Imagine, for a second, that you are suffering from psychosis—but you don’t know it. How would you? You wouldn’t have noticed any difference when you broke with reality. According to your brain, everyone else is acting strange but you are acting rationally. Those around are witness to your delusions, but you have lost the capacity to recognize them.

Let’s also assume that you are fortunate to receive treatment—medicated, restrained in a facility, cared for by experts. Again, you wouldn’t understand any of this; to you, it would seem that others are forcing you to take pills and locking you up. Wouldn’t this be more frightening than any Hollywood horror show?

Continuing our thought experiment, let’s say that you fully recover. You’re the same as you were before the illness, with one clear exception: that harrowing experience of learning that for a time you couldn’t trust your own brain. But you’re healthy now and ready to resume your life. How does society receive you, someone who has shown so much courage and resolve?

We greet you with prejudice and ridicule. We view you differently, maybe act warily around you. We preclude you from working at certain jobs and prevent you from being elected into office. And your illness need not include psychosis to summon this behavior. No, in our society, any issue related to brain health invites scorn.

Given what people with mental illness have been through—what they have survived—they should be celebrated for their indomitable will. Take leaders like Brandon Staglin and Elyn Saks, highly successful and accomplished individuals who live with schizophrenia. Or look at Lady Gaga, who has thrived even while battling PTSD and bouts of psychosis. I can’t imagine people more deserving of praise and admiration.

But it isn’t only the well-known and famous; anyone who has overcome or endures a brain illness should be recognized for such fortitude. My wife, the closest person in my life, suffered recurring psychotic episodes ten years ago. As a family, we lived through the spookiness of acute psychosis, but she suffered more than we could ever fathom. Through incredible strength, perseverance and patience, she endured the experience. She fully recovered and, as a family, we’re stronger now than ever.

“You shoot me down, but I won't fall. I am titanium. ” -- David Guetta feat. Sia

Where are the movies about survivors like my wife, films where we can revel in their successes? Silver Linings Playbook would be one. Who can possibly be rooting against Jennifer Lawrence and Bradley Cooper when they take to the dance floor? But we need way more characters like these across our pop culture landscape.

Society needs to experience, though accurate representations, the reality of mental illness. With love and support, and access to the appropriate treatment, people can recover from and successfully manage mental health conditions. Only through better storytelling will society learn that overcoming mental illness should be commended rather than rebuked.

Haven’t we had enough of the old tropes? C’mon Mr. King, put those prodigious talents to use in ending rather than perpetuating the stigma!

“Cant' somebody say, "'Hey, let's be positive? Let's have a good ending to the story!' ” -- Pat in Silver Linings Playbook

Healing a Disorder

,Revisiting Trauma to Find Recovery

Prince Harry was featured on Dax Shepard’s Armchair Expert podcast recently and made a compelling point: “We shouldn’t call it post-traumatic stress disorder—we should call it post-traumatic stress injury.” He argued that injuries can heal whereas "disorder" sounds like chronic label. And, as I’ve written before, labels can be harmful.

Prince Harry is right.

“And for every hung-up person in the whole wide universe." -- Bob Dylan

I was diagnosed with PTSD after my wife recovered from a serious brain illness. For years, I was distancing myself not only from my family but from the places and feelings that triggered those memories. Nightmares. Flashbacks. Panic attacks. All of these symptoms were a real part of my life.

I didn’t realize that I was sick. Sure, I was avoiding talking or thinking about what happened, but that didn’t seem strange to me. Why would I want to relive the most difficult moments of my life? We had survived the ordeal. Better, I thought, to leave it in the past and focus on the future.

But past trauma doesn’t go away on its own; it sits below the surface and infiltrates your thoughts and emotions, influencing your behavior. My wife, who knows me better than anyone, recognized its impact. She sat me down and made me confront the problem. Only then did it become obvious. I could experience the fight or flight response just walking through my house and yet, without her intervention, I wouldn’t have acknowledged it.

“And what that means is, basically, with the pleasure comes the pain.” -- L.A. Salami

That’s yet one more challenge of brain illness: we can be sick and not realize it. But after seeking help and starting treatment, I was able to recover. It wasn’t easy; my therapist forced me to talk about what happened, describing in detail the memories that had been haunting me. But in talking about them, I was able to accept them and move on.

Reliving the pain helped me feel whole again. I’m not the same as before—I’ll never be the same—but I’m not hurting. Before, I literally couldn’t talk about the trauma, but now I can discuss it in detail. Hell, I wrote an entire book about it. I can sit for an interview with mental health leader Patrick Kennedy and not break down during our talk.

I’m not arguing that everyone’s trauma can be addressed. Many have been through much worse than I, that’s for certain, and I cannot begin to understand their experiences. But I do think that the human mind is remarkable in its ability to recover. The challenge is to recognize the need for help and find access to it, and that’s not an easy thing to do. That’s why we need a better approach to mental health.

“If you can feel what I'm feeling then it's a musical masterpiece. Hear what I'm dealing with then that's cool at least.” -- Beastie Boys

My wife and I made our story public because we hoped it might help people suffering from mental health crises. We thought that it would support families dealing with psychosis or related conditions. The PTSD part of my experience? Well, it didn’t seem less important, but it certainly felt less intense.

Ironically, however, the first positive feedback I received was focused on my recovery. A friend of a friend had been given a preprint of my book. Over lunch, he confided details of a devastating ordeal his family had suffered in the past. Without compromising his privacy, I can assure you that his trauma was greater than anything I’d experienced.

“Your book made me realize something important,” he admitted. “I’ve been living with PTSD for years. I’ve done my research, and it’s clear to me. I think our whole family is living with it.”

He’s now meeting regularly with a therapist, taking the first steps towards recovery. Over time, I’m confident that he and his family can work through the challenges that come with such heartbreak. And, in the end, I hope they can find healing.

As Prince Harry so accurately put it in his interview with Oprah when discussing his own "PTSI":

“You need to go back to the past, go back to the point of trauma, deal with it, process it, and then move forward."

Words Matter

,And a label is a dangerous thing

If one of your arteries became blocked, you wouldn’t say you were dealing with a “circulatory illness.” You’d say you had heart disease and needed surgery. If you broke a bone in your foot, you wouldn’t say you were living with an “ambulatory disorder.” You’d say you needed a cast.

But what label would you use if your brain chemistry became unbalanced?

“Words are hard to find. They're only cheques I've left unassigned from the banks of chaos in my mind." -- The Police

With the brain, we speak of “mental illness.” Well, unless we find a tumor. Then we call it brain cancer. That’s scary. Or, if we find a clot. Then we call it a stroke. That’s scary, too. But if no tests show signs of something wrong, we’ll just use the old mental illness moniker.

We don’t even have a good backup for it. If you look up mental illness at thesaurus.com, these are the suggested alternatives: insanity, mental disorder, personality disorder, and schizophrenia. Don’t like those? You could go with some of the others offered: craziness, derangement, madness, or lunacy. How do those sound?

It’s mental illness or nothing. And that’s a problem. Because when you’re sick, you start looking for labels to explain how you feel. It helps you feel less alone and, many times, a diagnosis can bring you hope. That’s the power of a name.

“There's a name for it. Names make all the difference in the world.” -- Talking Heads

But when you suffer from a mental illness, it’s all guesswork. And guesswork doesn’t inspire hope. Sure, there are associated signs that help to define specific illnesses, like bipolar disorder, obsessive-compulsive disorder, and schizophrenia. But many times, these definitions are collections of symptoms, and they are used as approximations. So, you receive your label, and that starts to define you.

Never mind that our tests are inadequate. We still don’t have good approaches to measuring specific brain chemicals at play. We make assumptions, try different medicines, and hope for the best. But we assume, if our current procedures can’t show a specific cause, that the problem must be in a patient’s “mental” state, whatever that means. That’s what patients start to think, too.

It’s even worse though, because our chosen words have trained people in society to believe that mental illnesses are not tied to biological processes. They think that someone suffering from depression should be able to “snap out of it” or that someone with OCD should “just relax.” At the extreme, some folks believe that psychosis springs from possession by demons or other spirits. It’s unacceptable.

“We all been playing those mind games forever.” -- John Lennon

Recently, I’ve been learning about the work being done by One Mind. It’s one of the leading nonprofits engaged in funding cutting-edge research into the causes of various illnesses. The folks at One Mind often exchange the word “brain” for “mental,” so they talk about brain health and brain illness. I quite like this approach.

If I told you I suffered from a brain illness, you’d quickly recognize that it was biological in nature. You wouldn’t think that I was somehow conjuring the symptoms in my mind. And that’s exactly what’s going on with these illnesses; I discussed this in my last post. Many are the result of biology and chemistry, even if our tests can’t yet illuminate them.

Shari Staglin, One Mind’s Co-Founder and CEO, explains her organization’s rationale for taking this approach:

“We use the term "brain health" because there is no discrimination or stigma about the brain. There is no shame or blame."

Virus? DNA? Stress?

,Does it really matter?

The New York Times runs a great podcast called The Daily. You should listen to the episode from March 22, 2021.

It deals with Long Covid, something about which I am sadly too familiar. But I’ve had it “easy,” only suffering with chronic headaches and sore throats for the past year. The Daily interviewed a poor guy named Ivan whose Long Covid triggered acute psychosis. For anyone who has read my book, you know the unfortunate familiarity I have with this, too.

“War is all around us, my mind says prepare to fight." -- P rince

Since contracting the virus, Ivan suffers recurring bouts of paranoid delusions: people are after him, tracking his movements, secretly recording him. The fear in his voice is palpable. At times, he can recognize that his thoughts are out-of-touch with reality, and this is even more terrorizing. Of course, his wife and kids have no idea what to do. Wisely, they seek support from the local psychiatric treatment center.

As I listened, my heart went out to this family. I hoped that in time they could find the right medication to prevent Ivan from suffering. I felt an immense amount of sympathy, and I was sure that others would feel the same. But the more I thought about this, the more frustrated I became.

Would everyone feel the same if his psychosis wasn’t linked to Covid? Did the fact that the delusions were caused by the virus make a difference to people listening? What if Ivan was genetically predisposed to suffer from delusions, or had a chronic under- or overproduction of a particular neurotransmitter that caused his recurring breaks from reality? Would people still feel the same level of sympathy?

“I feel for you.” -- Chaka Khan

The cause of his psychosis shouldn’t matter. It shouldn’t matter but it does. Ivan’s story perfectly illustrates the flaw in the logic. If doctors can find some “organic” cause—a virus, a thyroid problem, a tumor—it’s okay to talk about it. Others will sympathize and offer their support. But if nothing organic can be found, then it’s a “mental” problem, and, well, that’s totally different in society’s eyes.

But it’s not different. We don’t know much about Covid yet. We don’t know if the virus affects the brain directly or messes with the body’s ability to regulate neurotransmitters. But when my doctor ordered a neurotransmitter check for Long Covid, it was the only test that came back irregular. In my case, the imbalance might cause headaches; in Ivan’s case, perhaps it causes psychosis.

“The silicon chip inside her head gets switched to overload...” -- The Boomtown Rats

It’s not different because research has shown that chemical imbalance is at the root of many mental illnesses. If you have read Jessie Close’s book Resilience, you know that she and her son were involved in research at McLean Hospital. It showed that a genetic mutation was causing the illness in her family. It’s a fascinating story; the mutation caused certain individuals to process a specific amino acid too rapidly. Things improved once they augmented their daily intake of that compound.

If someone has inflammation of the heart, we don’t care what caused the swelling. If they have a tumor, we don't ask if it was genetically instigated or the result of an environmental factor. Why do we care when it comes to an imbalance of neurotransmitters in the brain? A former contributor to Forbes, Robert J. Szczerba, captured it well when he wrote:

“One of the most widely believed and most damaging myths is that mental illness is not a physical disease. Nothing could be further from the truth."

The Word "Psychotic"

,What do you think of when you hear it?

A horror movie? A Stephen King novel? The kind of terror that keeps you up at night, jumping at every sound?

That's what I used to think, too. I don't anymore.

“Psycho killer, qu'est-ce que c'est?" -- Talking Heads

Any serious illness is scary. Cancer is scary. Heart disease is scary.

Maybe you love someone affected by these diseases. Perhaps you’ve held a vigil with them, holding their hand while they fought through pain, despair or fear.

But in these situations, as difficult as they were, you never lost the human connection with the person you loved. You could still communicate with them. You could strive to provide comfort, make an attempt at laughter or find hope together.

This doesn’t happen when a symptom of your loved one’s illness is psychosis. That person disappears and any relationship becomes severely strained. You might find flashes of kinship, but these glimpses appear at random and fade quickly, like someone splashing the surface only to be pulled under again.

“She's out of focus; she's a warp in time. She's discontinued, a break in the line.” -- Devo

Perhaps this is why as a society we treat mental illness so differently than other serious medical conditions.

Your brain makes you who you are. It gives you a personality, stores your memories, enables rational thought and connects you to other living things. When someone becomes psychotic, the brain short circuits. The chemicals that fuel its proper function become unbalanced. That person becomes disconnected.

If you have never witnessed this, I can assure you that it is at first shockingly scary. The terror comes from the immediate realization that if not for the correct processing of your own neurotransmitters, you too would be lost. Our consciousness—our own identity—lies on the frightening edge of a finely-tuned biochemistry in our brains.

“Insanity laughs under pressure we're cracking. ” -- Q ueen and David Bowie

But this is similar to other essential organs of the body. The heart requires electricity. The lungs require the efficient transfer of oxygen. The intestines rely on an army of diverse and essential bacterial colonies. The difference, of course, is that when illness strikes these areas our spirit remains intact. We become sick, but our identity doesn’t change.

We treat brain illness differently because it doesn't just scare us--it terrifies us. It has for centuries. And popular culture perpetuates the trepidation. But with time and interaction, psychosis loses its alarm, and we realize that those who suffer shouldn’t be punished. With love, support, and proper treatment, these people can successfully manage and overcome their conditions.

The same is true for other brain illnesses and their related symptoms. As a society, our challenge is to move away from the fear and shame of mental illness and towards compassion and understanding. By telling our stories, those of us with direct experience can help educate those without. Professor Bernice Pescosolido captured it perfectly when she told the USA Today:

“Fear is lodged with people who don't know someone with mental illness."

Taking a Private Story Public

or, How Hundreds of Pages of Memories Became a Published Book

I never thought I would become a writer. At least, I had no plans to publish a book. But life isn't predictable, and sometimes you find yourself in situations you didn't anticipate.

That happened to me ten years ago. Well, actually, it happened to my entire family, but I was the one standing in the middle of the storm when it hit. It was the swirling tempest of mental illness, something that you cannot imagine unless you have lived it.

“If dreams are like movies then memories are films about ghosts” -- Counting Crows

One day, I sat down at my laptop and began to let years of memories bleed onto the pages of Word. I was storytelling, but it felt more like describing the scenes from a movie playing inside my head. I never thought anyone would read what I wrote. As the number of pages grew, however, the urge to share became overwhelming.

So, I gave it to my best friend--my wife. She was a main character in the story, and she had lived through the same experience from a different perspective. It was hard for her; it was hard for us both. But she encouraged me to continue. Even if we were the only two who ever read it, she knew that reliving those memories was providing me with much needed healing.

“I try to keep on keeping on...” -- First Aid Kit

After about a hundred pages, my wife suggested that I ask her college roommate to read it. This was great advice; her college roommate was one of the best writers we knew and had worked as both an author and an editor in the past. I also decided to share it with my brother. He had helped me through the difficult period that I was recounting.

Both of them encouraged me to continue. "Don't stop to edit anything," our friend said. "Don't worry if it's any good. Just keep pouring all these recollections into your manuscript." Her advice was encouraging, and it gave me license to continue slogging away. My brother's reaction was equally supportive. "Your story needs to be told," he said. "It's so powerful."

So every Saturday I would head to the back room of our house and sit, dog and computer on my lap, tapping out sentences. After about eighteen months I had written over 130,000 words. I had no idea if that was the right target, but the memories had stopped clawing their way out of my head. I went back and read the full text and wasn't sure if anyone would want to read it. But my wife was persuasive. "If our story can help even one person," she said, "shouldn't we try to get it out there?"

“Dear Sir or Madam, will you read my book? It took me years to write, will you take a look?” -- the Beatles

I had no idea how to publish a book. Turning to Google, I researched the different ways available. I read about the big publishing houses and the independent press companies, and how most authors today are expected to market their own books through their "online audiences." Well, I didn't have an online audience, and my professional network consisted of business brokers, attorneys, and bankers. I had little chance of gaining attention in the world of publishing.

Then I discovered how much self-publishing has changed over the past decade. Books no longer needed to be produced in large numbers with huge up-front costs. In fact, many books weren't actually printed until after you ordered them online, and then they were made one copy at a time. This felt like a possible way forward. Plus, we wanted to control everything about our story, and self-publishing would allow us to do that.

But we needed our novel to be polished--to look and feel like a real publication. Through more research, I found several firms dedicated to helping independent writers. After a couple of conversations, I chose to engage a group called Girl Friday Productions. I liked the people; you could immediately sense the pride they took in helping to produce great books.

Almost immediately, Girl Friday connected me with an incredible editor, and together we began to streamline and improve what I had written. I won't go into all the details, perhaps that will be another post, but the Girl Friday team has exceeded my expectations. I'm proud of our story, and I believe the book lives up to our experience.

I hope you'll read it, and, if you do, I hope you'll think about mental illness in a different way. Because Michelle Obama put it best when she addressed the Change Direction crowd in 2015:

“There should be absolutely no stigma around mental health. None. Zero.”