Course of Treatment: Treatment Options — Home Care

Let me get this out of the way first. Being able to take care of your mental health at home is pretty awesome, but it isn’t for everyone. As a primary treatment, home care works best for people who have experience dealing with their mental illness. You need to be able to recognize a downturn and get professional help when needed. Otherwise, home care should NOT be your only treatment choice.

However, home care is almost always a good support while pursuing more intensive therapy.

Understanding Home Care

Home care for mental health can involve a wide variety of things. What it is, is learning what works to manage your mental illness and taking steps every day to keep your illness under control.

Home care is “maintenance mode.” For some people home care is enough to keep their mental illness under control. Others combine home care with other maintenance treatments; medication is probably the most common.

Everything from diet to exercise to meditation to having a cup of tea before bed can be a part of home care. Everyone’s home care is different, and depends on their needs, experiences, and how their mental illness functions.

Types of Home Care

Meditation

Let me get this one out of the way first. Meditation is one of the first suggestions of a lot of able-minded people. And one a lot of mentally ill folks have learned to hate.

Personally I have often enjoyed and benefited from meditation. But I learned meditation as a personal practice first, and applied it to my treatment much later. For people who do not have practice mediating, using meditate to help mental illness often just makes things worse. I think this is because “clear the mind” styles of meditation are the most talked about and the meditations people are most likely to try first.

Clearing the mind meditations can be some of the worst for many mentally ill folks. When you focus on not thinking and clearing away all your conscious thoughts, it leaves space in your mind. Space that gets filled by all the poison your mental illness creates. So you end up spending 15 minutes or so “meditating” on how you are a worthless pathetic piece of shit who could be a functional human being if you would only try hard enough. Not because that’s what you are trying to meditate on, but because that’s what your mental illness shouts at you when you try to stop thinking.

I have found clearing the mind meditation to be useful for understanding what is going on in my head. But to be useful, and not damaging, (at least for me) it needs to be just a few minutes. Stop, close my eyes, and clear my mind. As soon as I can clearly “hear” the poison my mental illness is spewing, get out of the meditation.

You know those days when you are an absolute wreck, your mental illness is out of control, and you don’t know what triggered it? Those are the days that I use “clearing the mind” meditations. Once I know what is going on, I have at least a chance of addressing the problems.

Breathing meditations are another useful type of mediation. These are where you sit and focus on your breath. Breathe in for a count of 4, hold for a count of 4, breathe out for a count of 4, repeat. For me, this type of mediation gives my mind a rest. With all my concentration on my breathing, with my body focused on the feel of air rushing in and out of my lungs, my mind stills. My mental illness doesn’t have anything to grab hold of and hurt me with. For a little bit, my mind can rest, and I can relax without my mental illnesses ambushing me with more poison.

Different meditations will have different effects for different people. If you want use meditation to manage your mental illness, experiment with several different types of meditation. It can take time to find one that works for you. And immediately stop any meditation that triggers you or makes your illness worse.

Herbs, Dark Chocolate, and Other Home Remedies

When I reviewed alternative medicines, I said you shouldn’t take herbs without professional guidance. A few herbs, however, are mild enough to be the equivalent of over-the-counter medication. Things like lavender, most mints, and chamomile. That doesn’t mean they won’t sometimes have unexpected effects. The first time my mother gave me a lavender sachet to help me relax, I had a panic attack. It took me a long time to realize that the lavender did relax me. It relaxed me enough I was actually able to feel a the anxiety I lived with day in and day out! Which triggered the panic attack.

Herbs for home use can be crushed leaves and flowers in sachets, essential oils in the bath, or herbal teas. I favor teas, but use what works for you. Lavender and chamomile are calmatives. Mint is good for alertness and those awful low energy days. Lemon and lemon grass are cheering and energizing.

Dark Chocolate, according to some preliminary studies, has a similar effect of antidepressants. Dark chocolate may be an alternative treatment for people who don’t have health care coverage. It isn’t cheap, but it is less expensive than paying for antidepressants out of pocket. And if your depression is under control, a bar of the dark stuff can be good to keep on hand for the bad days.

I’m sure there are other home remedies I’m not familiar with. Talk with your doctor first, try in small doses and stop immediately if a remedy makes things worse.

Exercise

Jane Fonda wasn’t making shit up to sell videos, endorphins are real. So is the satisfaction of meeting a goal and the wrung-out relaxed good feeling of working your body. And like tears, sweat can help clear toxins from the body. Exercise can’t address specific symptoms of mental illness, it can be a generalized mood lifter, an outlet for frustration and anxiety, and a great way to boost your self esteem and self confidence.

Exercise doesn’t need to be a big production. A ten minute walk each day is a good start. Bonus if you combine exercise with something you enjoy like hiking, dancing or swimming. Or, you could reward yourself for exercise until it becomes a regular part of your routine. I used to walk down to the corner sore each day, about a half mile round trip and pick up a small treat. Little things like that can help you get up and going.

Stretching

Stretching is separate from exercise. Most experts now recommend you exercise and stretch separately, instead of stretching right before exercise. Stretching is definitely useful for people dealing with anxiety or depressive disorders. These mental illnesses tend to put strain on the muscles: anxiety from the constant tension, depression from the way it makes us curl in on ourselves. Stretching counters the physical effects of mental illness and keeps our blood flowing, bringing more energy to our brains.

Sunlight

A shit ton has been said elsewhere about the benefit of sunlight in treating mental illness. In fact, light bulbs that give of light in the same wavelengths as sun are available to help people battle seasonal affective disorder.

The full effect of sunlight on mental illness isn’t fully understood. However, we do know that getting out in the sun for 10 or 15 minutes a day can help lot. Combine your sunlight time with some exercise for a double boost.

How to Access Home Care

There is a wide variety of information on all forms of home care available online. That said, it’s the internet, with all its awesomeness and flaws. Especially be careful about taking internet advice on meditation, giving the possible complications.

Herbs and dark chocolate are often available somewhere local, and if not can be ordered online. Chocolate tends to be on the expensive side, even more so if you are aware of and prefer to buy Fair Trade chocolate.

Exercise, stretching, and sunlight are there for the taking, but mental illness will usually make it hard to actually get up and take them. Gotta love the way the mind fights to stay broken and miserable.

Impact on Poly Partners

Unless a significant part of the food budget is going to buying dark chocolate, home care is not likely to have a large impact on poly partners. That said, there is a great deal you can do to support your mentally ill partners in home care.

  1. Participate. Join in the exercise, sit on the porch and get sun together while you catch up, have a cup of chamomile tea when you are over, etc
  2. Ask them what you can do to help. If they are homebound, can you pick up lavender at the store? If they have trouble motivating themselves, can you remind them to meditate each day? Ask first. They are in charge of their care, but there are lots of things you can do that will help.
  3. If your partner is managing their mental illness only with home care, be alert for signs they are entering a downswing and may need more help. Someone on the outside can sometimes see problems before we can.

If you haven’t yet, check out the other treatment options for mental illness. Don’t forget to subscribe to the Poly on Purpose newsletter, so you never miss a post.

This post is part of the Polyamory and Mental Illness blog series.

Course of Treatment: Treatment Options — Alternative Medicine

Last week, we look at alternative therapies. This week we’ll be looking a bit further afield, at alternative medicine. What’s the difference? Alternative therapies all try to fit within the framework of psychology. Even the alternative therapies you should run like hell from (like rebirthing) use psychology to explain why they are supposed to work.

Alternative medicine refers to medical practices that are an alternative to Western medicine. In some parts of the world these medical practices are widely used and accepted, in others they are barely known.

Alternative medicine takes two forms. On type of alternative medicine is “alternative” only in that the form of treatment doesn’t meet the demands of Western medicine–functionally, there is little difference between willow bark and aspirin, in fact, aspirin is basically a manufactured version of the active ingredients in willow bark. But willow bark tea can’t be given as precise a dosage as modern medicine demands, while the dosage of aspirin in a pill can be measured to the limits of modern equipment.

The other type of alternative medicine doesn’t fit with in the framework of Western medicine at all. The germ theory of medicine, and all the curlicues it’s developed over the years, simply has no room in it for treating illness with gems and chanting. While massage is a very valuable treatment for injuries, no one can yet explain how it can benefit mental illness in a way that first the theories of Western medicine. Often ways that alternative medicine is explained (such as the idea of storing emotions in muscles, mentioned below) sound ridiculous to folks who prefer the scientific approach of Western medicine.

Today we are going to take a look at three alternative medical approaches that I and others I am familiar with have found most useful, which also have at least some studies supporting their use.

Types of Alternative Medicine

Massage

First off, whether or not massage is “alternative” medicine depends on where you live and what it is used for. There is nothing “alternative” in using massage to treat muscle injuries, help the healing process after an accident, and basically do anything that involves damage to the muscles and tendons. A trained massage therapist can use massage to realign muscle tissue, preventing and reducing scarring and restoring mobility to an injury. While still not as widely known and used in the US as it could be, the rest of the Western world accepted this type of massage treatment long ago and have no doubt it belongs in the annals of Western medicine.

Massage as treatment for mental illness is less accepted. The most accepted theory behind why massage can help mental illness is that clears stress toxins from the body and triggers a relaxation response. Another, less accepted theory, is that our bodies somehow “store” negative emotions and mental problems in our muscles. By stretching and relaxing the muscles, these negative things get released, allowing us to move on without the burden of those problems. Anecdotal evidence in support of this theory is that many people dealing with trauma or mental illness will find themselves swamped by unexpected emotions during massage. When I worked in massage, I was frequently told “Don’t worry if I start cries/have a panic attack/freak out during the massage. I always feel better after.” From my own experience, the worse my mental state gets, the more the right side of my body locks down, to the point that one really bad days I have a distinct limp and trouble raising my right arm. Obviously there is some connection between the state of our mind and the state of our muscles. What that connection is, and what effect massage has on it, is harder to define.

Studies into the effect of massage on mental illness have largely focused on use of Swedish massage to treat depression or anxiety. Many studies found a temporary improvement after massage.

Herbal Treatments

Digitalis_lanata_ParisThe rule of thumb with herbal treatments is that is science has created a synthesized version, it’s Western medicine, and if you are taking the actual herb it is alternative medicine. Part of this is that it takes years of studies to confirm the effects of a treatment, and there simply hasn’t been enough time to test all the herbs that are supposed to be beneficial. Even more than massage, herbal treatments are among the most accepted by Western medicine–if only because so much of modern medicine, from aspirin to quinine to most of the common heart medications, wouldn’t exist if they hadn’t come from herbs first. The other part, as mentioned above, is the Western medicine has very precise dosing standards, and these standards are difficult with herbal treatments.

The attitude of many doctors and researchers I’ve discussed herbal treatments with is “Some of these herbs are definitely helpful, some we don’t know yet, some are a waste of time. Until we can confirm side effects, dosage, etc, you’re better sticking with known and tested pills–but herbs definitely have potential.*” When it comes to psychiatric treatment, where a 30% success rate is the gold standard, whether or not you are “better” with Western medicine is a matter many find highly debatable.

St. John’s Wort is well known as a treatment for depression. It is also known to have some potentially dangerous side effects. As some one who has spent a lot of time recovering from the side effects of standard psych meds, my reaction to that is “And this is different how?” However, if you do want to try St. John’s Wart, please use it under medical supervision, just like you would standard psych meds. Side effects aren’t something to fuck around with.

For more on herbal treatments for mental illness, consult a trained herbalist–and always check with the herbalist and your doctor for potential interactions and side effects.

Traditional Chinese Medicine

Traditional Chinese Medicine (TCM) is a system of medicine first developed in China several thousand year ago. It has continually evolved and adapted during that time. TCM is the best known of the Asian systems of medicine, and most of the medicine of SouthEast Asia is based on TCM.

Unlike most other alternative medicines, TCM is a complete system of medical theory and practice. This has led to a giant problem in studies testing the effectiveness of TCM. Put simply, when researchers study TCM, they have never started with verifying or disproving the basic theories underlying TCM. Instead researchers have taken specific TCM treatments, and tested them on Western diagnosis. This is kind of like if a society that had never heard of the germ theory of medicine tested penicillin by using it as a treatment for a cough with fever and headache–but because they didn’t know the germ theory, were testing antibiotics on both bacterial infections and viral infections. So they run a test during the height of flu season, and of course the antibiotic doesn’t work.

This is the way researchers have been testing TCM. So while there are some studies that support TCM, and some studies that don’t support TCM, my opinion is that all the studies are completely useless. (I have actively sought out studies evaluating the theory behind TCM, and not found any. However I am not a professional researcher, and don’t have access to many medical journals. If anyone has any further info on this, please contact me!)

There are three basic theories underlying TCM

1) That everything in life exists in cycles, including our bodies. This theory is in complete accord with Western science–from the day/night cycle, to the metabolic cycle, to the sleep cycle, to the cycle of the trade winds, yeah, life is made up of cycles.

2) That illness and disease are caused by something disrupting our normal bodily cycles. These causes are broken down into internal and external. Here, science can quibble with the details–wind is considered an external cause of disease in TCM. So is dampness. Of course, dampness brings mold and mildew, so for a society with no concept of microscopic organisms, it may just be that they were describing the ancient Chinese doctors were just describing the causes of disease as best they could within their knowledge of the world.

Overall, the basic idea that there are internal and external causes of disease, and that these things cause disease but disrupting healthy cycles, isn’t something Western medicine can quibble with, and the specific causes can be studied and identified or eliminated, just like Western medicine had to adapt Germ theory when it recognized not all disease is caused by germs–the basic theory is still sound.

Five Element Interaction. A metaphor.
Five Element Interaction. A metaphor.

3) That the cycle of the elements and the way they interact is an accurate metaphor for the cycles of the body, and disruption of the cycles of the body can be accurately described and diagnosed using this metaphor. On these, Western science got nothing. Researchers never bothered to test this metaphor to see if this theory is sound. If this theory is sound, then the basic ideas and practices behind TCM are likely sound, and the individual practices just need to be continually refined through further research. If this theory is not sound, than we are wasting our time testing treatments from TCM, because the very basis for determining those treatments is flawed. Also if this theory is sound, we can begin testing and studying TCM treatments within the framework of this theory. As opposed to doing the medical equivalent of testing the claims of quantum mechanics using and the theory of relativity.

Now, in TCM, everything is connected. What I said before about the connection between the mental state and the muscles? According to TCM, of course they are connected, and you can’t treat one without treating the other. So a trained TCM practitioner is not going to treat you for depression. Instead they are going to look at your sleep pattern, the color of your eyes, your physical symptoms, your emotional symptoms, how you move, the state of your tongue and fingernails (did you know that our fingernails develop ridges when we are under high levels of stress? the body is fricking weird sometimes), and a whole bunch of other stuff.

They will use all of this to diagnose you with a specific disruption of your bodily cycles, which will mean absolutely nothing to you unless you are familiar with Chinese medicine, but will sound something like “Your heart is overactive and there is a blockage in your liver.” This doesn’t mean your literal heart and liver, it means the bodily cycles that the metaphor of Chinese medicine associates with your heart and liver. Then they will use acupuncture, herbs, massage, and other treatments–some of them damn odd to Western eyes–to calm your heart and unblock your liver. Which, if they have correctly diagnosed you and if the TCM theory of disease is accurate, will correct the symptoms you describe–including the depression.

Like Western medicine, TCM treatments may be a one-time thing (take an antibiotics for two weeks and call me if the symptoms come back), an on going thing (take your anti-depressant every morning, and we’ll evaluate the dosage in a month to see if it is working), or a palliative (I’m sorry, the cancer is deep in the brain where we can’t operate, and chemo isn’t working. All we can do is make her comfortable.) If you do decide to pursue TCM as a treatment for mental illness, make sure you discuss with your practitioner what TCM says the likely cause of your illness is, and whether they think you will need ongoing treatments or not.

Other Alternative Medicines

There are many more types of alternative medicine, from Ayerveda (an ancient system of medicine from India, and to my knowledge the first system of medicine to include dentistry and plastic surgery), to crystal healing, to colon cleanses. Some of these alternatives to Western medicine have a great deal of value to offer, others are probably little more than placebos. Do your research, and be aware that unless your country regulates the type of non-Western medical treatment you are interested in, it will be up to you to verify that a practitioner is trained and knowledgeable. Quacks and snake oil salesman are just as much part of the medical world today as they were 100 years ago, and the unregulated nature of alternative medicine makes it easy for them to hide there.

How to Access Alternative Medicine

If your country uses and insurance model to pay for medical treatments, whether a single-payer system or privatized, or anything in between, access to alternative medicine through insurance will be hit or miss-and often miss.

Some insurance coverage will cover some types of alternative medicine–it will be much easier to get insurance coverage for massage in Canada or Europe than it is in the US, for instance. US insurance companies are more likely to cover acupuncture treatments these days, but that’s far from universal. I would expect it to be far easier to get coverage for acupuncture in Japan or China, but I haven’t been able to confirm this.

If you don’t have insurance, or if your insurance doesn’t cover the alternative medicine you are interested in, you will be paying out-of-pocket.

You’re best option for finding an alternative medicine practitioner is to do your research. Many alternative medicine practitioners have formed groups which provide training, information on the treatments available, fund further research into the effects of their form of alternative medicine, etc. These groups will have information on the training available to practitioners and how to find a trained practitioner.

If the type of alternative medicine you are looking for is regulated, that can help, but check your local regulations! While massage is becoming increasingly regulated in the US, the national standards are still 500 hours of training. 500 hours of training is plenty for people who just want a relaxing massage after a hard day. If you want massage for medical purposes, you probably want someone with more intensive schooling.

Impact on Polyamory

The impact on polyamory will vary widely depending on the type of alternative medicine you are considering. However the biggest impact may be the views of your polycule on alternative medicine. If your poly partner wants to try Traditional Chinese Medicine, but you’ve read all kinds of studies that say it is a waste of time…at the very least there may be hard feelings, at the worst their may be blame and judgement thrown around related to quackery, people who aren’t really interested in getting better, and people who are too busy judging to see what’s in front of their faces.

If your poly partner is suffering from mental illness and wants to try alternative medicine, but you believe alternative medicine is all quackery, the best thing you can do is be honest but supportive. Even if you believe any benefit from alternative medicine will be a placebo, remind yourself that placebos do make people feel better. In the world of mental illness, where we can spend decades trying to find a treatment that works, would you really blame your partner for wanting to try something–anything–that will help them feel better and regain control of their lives?

If you are suffering from mental illness, and your partner thinks you should try alternative medicine, but you think it’s quackery–it’s your illness and your treatment. Politely thank your partner for their concern, but tell them you want to stick with treatment that you are comfortable with. It’s your illness, it’s your treatment, it’s your choice.

 

If you haven’t yet, check out the other treatment options for mental illness, and don’t forget to subscribe to the Poly on Purpose newsletter, so you never miss a post.

This post is part of the Polyamory and Mental Illness blog series.

*I have met a few doctors who insist that herbs have nothing to offer modern medicine, and no herb has ever provided a successful medical treatment. To which I am tempted to ask how they treat their heart patients if they believe digitalis is ineffective.