Mental Illness in a Post Apocalyptic World

[Tater Raider]

Hi. I'm Tater and I have Irregular Bipolar and Post-Traumatic Stress Disorder. I also have a plan.

In the inevitable ZPAW society will collapse and with it health care. My mental illness affects me deeply enough right now that I'm on disability and am not likely to ever get off it. But this isn't about my current situation. It's how I plan to use my mind when the dead walk the earth.

What follows is very personal and a bit difficult to share, but it's important enough that I'm doing it and hope that someone benefits and maybe shares something that I hadn't considered and I learn from it as well.

Knowing my illness and managing it:

I stay on top of managing my illness decently. Sometimes I forget a med but I know they help so I do what I can and sometimes I forget a therapy appointment but, again, I do what I can. The thing is they both help me a lot and allow me to contribute to society. They also help me identify when I'm heading manic, depressed, mixed, or just flat out mentally collapsing and take steps to mitigate it.

Now if I "fold" (my term for a mental collapse or psychotic break) that's it, I collapse, stick a fork in me because I'm done. Having an established routine allows me to go through the motions though and shortens up how long I stay folded. I won't remember what I did but if the world is still spinning and I haven't burned down the house then I got through intact and that's important.

As far as having a massive up or downswing in my mood, I use Cognitive Behavior Therapy (hereafter CBT) as a work-around tool. Basically I take a moment to figure out what my mood is when things start to go a bit wonky (technical term) and then go (and I'm ordering these if you want to play along), "Okay, so I feel like I'm ______ (angry, stupid, depressed, the air is vibrating, whatever). That means I need to watch for _______ (snapping at people, thinking it's all my fault, giving up, making impulsive choices, whatever). I still have things to do though. I will get them done by _______ (avoiding stressful conversations and being patient, fixing the problem and not the blame, getting done what I can and getting the rest another day, checking with others before I make a decision that affects others, whatever)." I then go on and face things.

This doesn't mean I don't indulge my illness some. I have a bit of Obsessive-Compulsive behavior too, but not as a condition - I use it as a coping mechanism. I make lists and do math when things need to calm down a bit and because it ends up with a positive result it's not an issue. It may get annoying to others when I'm on day 7 of figuring out the exact breakdown of how many of what sized water container I need for the stockpile or wrestling with the perfect lift kit for my Jeep, but it's a temporary thing so other people in my life indulge me a bit and I'm grateful for that.

Support Network:

No man is an island and I'm no exception. While I live alone and have more than a bit of a "Lone Wolf" mentality when it comes to a ZPAW, I'm networked locally with people that are aware of my illness and help me manage aspects of it. They are all aware of my prepping behavior as well and supportive of my "be prepared" attitude as it has a lot of carry-over into my mental health as well. A great example of this is that if I'm planning for the future I'm planning to have a future, so it's not bloody likely I'm suicidal - an issue I've had more than once in the past.

I told you this was going to be personal and painful at times.

I run everything past my younger brother. He sometimes resents having to be the mature one but it's also given him a lot of insight into how I think and what my reactions to things are likely to be so he can give me a heads-up when I'm blind to something.

I also run everything past my children, the youngest being 16. This has enabled them to grow up a bit as well and be more mature than they might otherwise be. However, it doesn't mean I run it past all 3. I pick a kid and run it past them and rotate which kid I ask according to their interests and how much they've had to deal with too. If it's important enough I run it past 2 of them or even all 3, but they are part of my network.

I also run things past other folk in my network as it comes up.

Yeah, sometimes I feel like a little kid going, "Mother, may I?" but it beats, by far, me heading to a motorcycle dealer, buying a bike, wrecking it 3 days later, then buying another within days and riding it into the ground as well. Yes, I've done that too. The doctor that stitched me up wasn't impressed to my reply to his question on me using a helmet in the future. "It was strapped to the bike and it's totaled. No thanks!"

Medication:

It was prescribed for a reason so I take it. I report side effects. After getting ignored on a particular set of side effects and getting permanent damage from it (I get the shakes now at random times) I get downright belligerent when I feel my report of side effects is getting ignored. I buck some of my meds too. Having said all that, if it's a psychotropic drug prescribed for me I take it because this one thing will kill me faster than anything else if I don't do what I'm told.

So I'm a good boy.

Management (Part II):

Hey, it's a daily thing that I take time out and assess. It's annoying to have to do that but I do and it's put me in charge of things. I handle it "Like a Boss" because I do all this annoying crap too. That's why it's worth mentioning again.

The Upside:

Yes, there is one. People talk about thinking outside the box. To paraphrase The Matrix, "There is no box." In a crisis because my brain is used to going in several directions at once (manic phase is rougher than most think) and working at 100mph (then again, manic phase can be fun) I'm able to make decisions now and go with it when a crisis hits. Usually they are good ones and when they aren't I can change direction quickly and do what ought to get done and deal with the issue, be it a money crunch, an insurance issue, a flood, etc.

Having a plan just makes this ability better, which is why I have one now.

Crisis Plan:

Short of a societal collapse, like in a ZPAW, services may be disrupted locally but I'm good to go anyways. I have a small store of meds and am use to managing this thing. I can go a bit unsupported by my network too so I do what needs doing and then return to normalcy ASAP. Reestablishing some part of my support group is priority 1 after the survival needs are taken care of – one person could make a huge difference.

ZPAW (Zombie Post-Apocalyptic World), TEOTWAWKI (The End Of The World As We Know It), and Other Warm Fuzzies:

Zombies are the ultimate crisis and planning for them solves lesser issues nicely, so this is what I prep for and I say that without joking.

Meds are going to be gone because they aren't going to be made anymore, so I'll have to step-down on them and increase activity. Increasing activity shouldn't be an issue (there won't be enough hours in the day to get done everything that needs doing when it comes to surviving walkers) but before I'm off them entirely I have to reconnect with some family member so we can assess what's going on in my head and if I need rescue or if I can self-rescue if it comes to that.

So communications are critical to me and have been overlooked until recently. They are in their proper place now.

Therapy will be gone too so I'll have to judge what's going on by the reaction of my peers. If I need to walk away from a situation then I'll do so, if just to make sure I've got a grip, then away I will walk. If I fold I could end up "coming to" (my way of saying, returning to awareness and being able to remember things) 2 weeks later to see a huge rock pile and a plowed within an inch of its life field, or I could come to smelling really funky surrounded by empty cans of pork and beans. I have to prepare for this and make sure I have my routine down pat along with all the contingencies at least addressed.

This is where all the groundwork done in day-to-day life comes into play and why I am a stickler for managing things well now. Not that I always succeed at managing it well but I make the effort.

My benefits and drawbacks are going to be bigger too. Manic highs will be more so, depressions will be deeper, the switch between them, the part of my illness that is the struggle, will happen quickly, and despite this I'll still shine in a crisis but once it's over someone will have to babysit me while my brain heals back up. These things are well-entrenched now and lack of professional help will worsen them but I have a big enough purpose to fight through it - ensuring the survival of my adult (or nearly so in 1 case) children and them having the chance to establish their own families. It's a deeply personal goal but one for the greater good too - mankind must survive and reform a society.

This doesn't mean I can't contribute though. A hobby farm is in the works as part of my personal self-administered therapy along with my prepping plans. I’ve all but forced all 3 of my children to have a BOB with the understanding I'll ask them on the rest of my preps when it's something in their field of interest only and that I will prep for them to use my place as a BOL because, well parenting doesn't end and this is what I can do without prepping plus my illness driving them off. So I'll have folk looking after me both on and off site, wherever I happen to be.

The Odds and Reasoning:

Will I actually make it? I don't know. I don't know that I care if I do or not either to be blunt. I do know that I deserve to give myself the best chance I can though, and that my kids deserve that too. And doing it for the kids got me to the point I realized it was worth doing for myself.

So I began managing day-to-day.

So I began thinking, "What about the future?"

So I began thinking Dad the Survivalist (my father) might be a bit off his nut on what he was prepping for, but that didn't mean he was wrong to prep.

So I began looking into prepping.

So I found Zombie Squad and found a place here that is a good place. A bit odd, this is true, but a good place for me to be.

So I made an ass of myself here, got smacked down, researched, learned, and became somewhat useful.

So I planned for a future that would be nice, but began preparing for one that isn't going to be nice at all.

I'm better for it.

So thanks to all of you here at Zombie Squad for helping out - even if you didn't know it. Sorry for getting in the face of some of you. Thanks to Kyle and the rest for creating ZS in the first place. Thanks to the mods and admins who slap me around with a bit of trout when I toe the line a bit too closely and keeping this place running well.

So to really say thanks, I wrote about this, my most important prep. It's deeply personal and a bit painful for me to write and opens myself up to a lot. Please be gentle.

Oh, and now you know that the big, crazy scary eyes are really big, crazy scary for a damn good reason, but really I’m mostly harmless. Mostly.

Edited for a grammatical difficulty

[majorhavoc]

Pssst, Tater?

We're all mentally ill around here.

[raptor]

This is a great post on a subject that I think too many of ignore. A PAW event is not going be a Hollywood moment where you shrug off the pain of dead loved ones, loss of familiar surroundings and collapse of everything you once knew.

Anyone involved in such an event is going to affected on some level. You can see the large number of PTSD cases in our troops. These are people who volunteer, receive training and support in preparation of the traumatic events they will face. Despite all of this they are still affected (they are human after all) by the sights and events they encounter.

Each of us will have to use different skills to deal with trauma. However IMO it is trauma all survivors will face and deal with.

[Benny]

Hats off, Tater. I'm sure this wasn't easy to write, and it took a lot of courage to share it with the rest of us.

It's also a subject of interest for me, as members of my family suffer from some [currently manageable] issues. If the SHTF, they may no longer be manageable if they're not specifically prepared, as you are becoming.

You've given me some thinking to do on how to approach them and help them prepare as best they can for that particular aspect.

[AnonEmous]

A topic I have considered, especially because of the high number of anti-depressants (among other similar medications) being prescribed across the poplulation. If there should be a major event that prevents people from getting their medication for weeks or even a few months, I would think that may be felt across society. Not to mention the stress and everything else of dealing with whatever "event" causes people to miss their medication. The closest thing to a region-wide, systemic breakdown in the West that I can think of is the flooding in New Orleans.

Raptor, all the insights you provided about New Orleans after the flood, do you have any insights about people having to cut back or forgo their medication for days or even a few weeks in that situation and what the results were? Anyone else with similar insights from real emergencies or disasters are appreciated.

[ancient_serpent]

Tater,
That was a very brave thing, opening up like that. I think you have a great grasp on yourself, a level of introspection that most of us will never reach. It may be a small point, but I would like to add that your post brings to mind the need for a diverse group of skills in all of our networks. For instance, my wife is an RN, my mother specializes in childcare/education, my son in contruction and small engine repair, etc. I think (and please correct me if this seems wrong) that your post illustrates the need for group members with education in psychology, extensive leadership training and interpersonal communication skills.
Thanks for sharing what you did.
A.S.

[Tater Raider]

Raptor, all the insights you provided about New Orleans after the flood, do you have any insights about people having to cut back or forgo their medication for days or even a few weeks in that situation and what the results were? Anyone else with similar insights from real emergencies or disasters are appreciated.

Under my current regimen, The Great Flood of '08 was something I dealt with. No water for a week, entire areas of town condemned, I can still go out and see houses that were destroyed by this. I survived, but it wasn't a Katrina level event. Katrina would have screwed me up worse than I already am, and a ZPAW will be that much worse.

You have to have a reason to fight through it. I'll worry about recovery afterwards because I've laid in preps for it now (insurance - get it).

As for me not being medicated? Multiple suicide attempts, and that's preZPAW. Last one was about 10 years ago. Rage, depression, pure WTF moments... and sudden shifts from one mood to the other made them look like I was putting on an act. Pure suckage, and worse for my kids. Broken marriage and broken home are directly attributable to this. Proper management now will help later, but I don't hold out a lot of hope until society is reestablished and at that point I can start to recover, so that's my goal in a PAW (and FWIW I don't like that but that's how it is).

How will the mentally ill act? Some will rise to the occassion and some will fall flat on their face. Some will be equipped to deal and most won't. Just like the rest of society, but moreso.

Because once the meds run out I have to do more because the meds don't knock it (BP/PTSD) down to where I have time to deal with it - and that's what most meds for mental illness are designed to do. So I gotta be dealing now and have a plan to have someone to crutch me through things when the fecal matter flies.

Short-term impact of losing meds varies. Most meds take weeks to kick in and weeks to lose all the benefits. However some of them you can tell right away. It all depends on the illness and its severity, that individual and how their body processes the med, and the med itself. For me: I'll be fine for the first week and will get flakey after 7-14 days. At 4 weeks a blind man can see I'm off meds. 6 months and it's the bad old days all over again and me living by myself without someone close at hand might not be a great situation.

For someone prone to depression, I can't see a crisis helping them at all.

For someone with OCD... depends on how rigid they are and if there is a niche for the form of OCD they have. An example of this I like to use is how Howard Hughes and modern air travel benefited greatly from his OCD though he was terribly afflicted as well.

Schitzophrenic spectrum? Who knows. They might be declared touched and have a job in religion or they might be shot on sight. That's not a comment on it as history shows examples of both.

tl;dr version: not taking meds is mostly a long-term issue, not something to be addressed in the first 10 days out of symptoms pressenting.

This is the message: Deal with this shit now so you can deal later. Prep for it now so when someone in your group prone to halucinations suddenly jumps up, screaming about Hatter trying to hand him a cup of tea (he came out of the hood of the truck I was riding shotgun in) that you can deal with it - and if you are the guy prone to them double check with someone to see if it's real before you flip out.

If you are mentally ill or know someone that is, make coping with it part of your preps.

I think (and please correct me if this seems wrong) that your post illustrates the need for group members with education in psychology, extensive leadership training and interpersonal communication skills.

I was more thinking of knowing what you have or people in your group have, what it takes to manage it and the individual (I have... quirks... that need to be allowed for), and having a firm grasp on that situation in addition to a small med stockpile, but you have a point and those people will be needed by society if we are to have a speedy return to the status quo. Without them we will get there, we (humanity) have been around a bit but there will be more suffering and it will take longer IMO.




Added: You folk have no idea how much the thanks, here and in PM, have affected me. I'm humbled and grateful. I didn't know for sure that I was doing a good thing when I wrote this up but ya'll have removed that doubt.

[raptor]

Raptor, all the insights you provided about New Orleans after the flood, do you have any insights about people having to cut back or forgo their medication for days or even a few weeks in that situation and what the results were?

Here are some studies of mental health issues:

http://www.who.int/bulletin/volumes/84/10/06-033019.pdf

http://www.sciencedaily.com/releases/20 ... 075614.htm

http://www.sciencedaily.com/releases/20 ... 164802.htm


The mental health facilities were understaffed for about 3 years after Katrina. The care givers were facing the same issues as the patients. No place to live. Damaged housing and people displaced. It was not pleasant.


In the immediate aftermath yes people did not have meds. However the real problem was storm's impact on the population and the number of PTSD cases. It is the PTSD and depression that I think will impact all survivors in a PAW.

[SMoAF]

If you are mentally ill or know someone that is, make coping with it part of your preps.

This is serious. Mrs SMoAF is most proficient in dealing with the various symptoms of my mental illnesses, which is almost certainly why I am still alive. If it weren't for her, I'd have been dead long ago. She's one of the few people I've ever met who was capable of "talking me down" from a manic state.

[wee drop o' bush]

Taters that is a brave post

[Tater Raider]

If you are mentally ill or know someone that is, make coping with it part of your preps.

This is serious. Mrs SMoAF is most proficient in dealing with the various symptoms of my mental illnesses, which is almost certainly why I am still alive. If it weren't for her, I'd have been dead long ago. She's one of the few people I've ever met who was capable of "talking me down" from a manic state.

Manic is some scary shit sometimes and you are a lucky guy to have a gal like that.

[dustytomes]

Not many would set aside there "Mask" and let others get to know the real "You".
Very Brave, very honest and I hope very helpful.

[AnonEmous]

Prep for it now so when someone in your group prone to halucinations suddenly jumps up, screaming about Hatter trying to hand him a cup of tea (he came out of the hood of the truck I was riding shotgun in) that you can deal with it - and if you are the guy prone to them double check with someone to see if it's real before you flip out.

Excellent points. Whether someone in a group has a diagnosed mental condition or not and whether it has to treated with medication or not, these are all very important points. In a stressful, physically demanding situation people can break down mentally quickly. Some may rise unexpectedly, some may fall unexpectedly, but keeping an eye on everyone and addressing the very real prospects of facing massive shock and stress are a good idea.

I recommend people read Raptor's take on New orleans in the wake of Katrina here. A part of his comment addresses the mental stress of such a disaster.

(note: this is only a small excerpt of his extensive write up)

Do not underestimate the emotion of seeing a beloved or even familiar place ruined.
Several cops committed suicide as a result of the stress; do not underestimate the level of stress involved.

[bearspater]

Your story and plan are inspiring. Teaching people and inspiring them is one of the greatest gifts we can give our fellow human beings. Thank you, I learned a lot from you and I am inspired by what you have said. God bless!

[Collie of Doom]

Thanks for sharing, Tater. You have become very well versed in what makes you tick, out of necessity. The school of very hard knocks. You have more self-awareness of your liabilities and limitations than most of us do. And that puts you at something of an advantage. Sounds like just enough of an advantage that you'd make it in PAW scenario. I hope that that fact, and your planning all this out and putting your thoughts into words, gives you some confidence and comfort in your current daily life. It sounds like it does.

On a broader level, your story illustrates why "go it alone" won't work for a lot of people and is an important reminder that even if you CAN hack it alone, it doesn't mean you SHOULD leave other members of your community to their own defenses.

[DarkAxel]

A great post, Tater!

I'm in a similar situation. A couple of years ago I was diagnosed with Bipolar Disorder and schizophrenic tendencies (I hear voices and phantom sounds). Fortunately, I found a good therapist who didn't over-medicate me, and now I'm mostly free of the pills. I've got a solid set of positive coping mechanisms, and I am able to work and support myself.

Raptor is right. A SHTF/TEOTWAWKI event isn't a Hollywood script. The stress is REAL, and there's no ambient tunes or musical cues to let you know what to expect. IMHO, EVERYONE who preps should prep for psych issues.

[Doctorr Fabulous]

Solid post. I personally think the support network is #1, at least for me. Granted, I am non-medicated, but that falls under Knowing Your Illness, since I managed to gain control sans medication.

Enough about me. Excellent post. Dare I say stickie?

[JesterODX]

More then one great man (and woman) in history were believed to have been bi-polar. Many had a rough go at it. But the bennefit you have is knowing what your up against and the oppertunity to prepare for future possibilities.

With a little good fortune, none of us will have to deal with a PAW.

[MasterMaker]

Anybody thought about making sedatives/sleeping pills and Valium a part of their preps?

Not necessarily for ones own use but to offer someone that is distraught because of a loss or to give someone that that fears they are about to do something ill advised and is to agitated to sleep/let it go.

Basically something that would either calm them or give them the option to try and sleep through it.
I'm not saying that sleeping through it would work but when the alternative would be suicide or increasing anger/hatred leading to.......
Then it would be good to at least have that option to offer.

It may be a bit of a cliche but there is a reason that excessive sleeping is one of the symptoms of depression.

[DarkAxel]

Anybody thought about making sedatives/sleeping pills and Valium a part of their preps?

Not necessarily for ones own use but to offer someone that is distraught because of a loss or to give someone that that fears they are about to do something ill advised and is to agitated to sleep/let it go.

No. Never. I'm not a doctor, and I have no way of knowing if someone else may have a bad reaction to it, or what other drugs they may be taking that could interact with valium in bad ways. Benzodiazapine drugs don't mix well with a lot of things.

And of course that's not considering the legal side of things. There's nothing wrong with having a thirty day supply of valium for your own use (if you encounter a LEO and you've got all your pills on you there WILL BE QUESTIONS), but as soon as you start handing them out to others, you are guilty of a crime.

[Tater Raider]

Not to mention handing depressants to someone going into a depression isn't something a layman should do. The (if of age) legal option would be to get them passed-out drunk but same issue - giving someone a depressant when they may be in the onset of a depression isn't a wise course to take.

Best bet, from a layman's point of view, is to put somebody as their bodyguard/watchman/babysitter/confidant. Yes, it means you are 2 people down instead of 1 until they demand the other person back off or they return to functional. Yes, you are down 2 people instead of one and likely at a time when you can't afford to be down any, but long-term this works out better in my experience.

Speaking of which...


More soul baring (this sucks for me so bad but it's germane):

When I had my last suicide attempt my brother was overseas in a war zone. His unit informed him what had happened. He wanted to return to duty immeadiately but they took his rifle and ammo and provided help if he wanted it. A short while later he was back to work doing what needed doing. He got the break he needed (no matter what he thought, he needed it IMO) and then he got busy with doing what needed doing again once it was determined that I'd live. I don't think this is a bad way of dealing with this stuff.

He also told me point blank that if I made him cry over his M16 ever again he'd have my nuts. I don't think he ment that figuratively.


Will doing something like that work for someone with prexsisting issues? I'd be lyin' if I said anything but, "I don't know." Speaking for myself, my processing speed on a crisis is fast but the ability to absorb the loss of a loved one is, I cannot overstate this, very impaired but at times my emotions completely detach and I can shrug bad news off (causing a lot of worries for everyone who knows me) and deal later (down time for me either way FYI). This stuff varies from person-to-person on top of the specific circumstances.


MM, that was a damn good question. I hope my answer helps.

[man in black]

Not to mention handing depressants to someone going into a depression isn't something a layman should do. The (if of age) legal option would be to get them passed-out drunk but same issue - giving someone a depressant when they may be in the onset of a depression isn't a wise course to take.
.

A big problem with anti depresants and handing them out is that most need to be used on a regular regimen for an amount of time before they begin to take effect so handing out a one time dosage wouldn't be effective (at least with selective serotonin reuptake inhibitors like prozac, abilify, lexapro, paxil, zoloft and so on)

[MasterMaker]

MM, that was a damn good question. I hope my answer helps.

Yes it does.

Talking people down/through it(or attempting to anyway) is something I'm well prepared for.

My thoughts was that having the ability to give people the "calm" they need, even if chemically induced, would be another tool that could be used to help.

I know a thing or two about the "gray fog", but I can't imagine what uttering the words "When I had my last suicide attempt", must be like.

[duodecima]

MM brings up a good point about sleep - it's important for a lot of things, including mental health, especially in some disorders like depression and bipolar. Bipolar is more likely to flare up if the person doesn't get regular sleep. (Also true for migraines and epilepsy.) Some folks with depression sleep too much, but there's others who can't sleep even if they're exhausted. Anxiety disorders (and acute stress/anxiety) also mess with sleep. Lack of sleep will impair anybody's mental faculties, especially vigilance and creative problem solving.

Just like Tater has prepped by knowing his illness, knowing what's likely to set it off, and knowing what strategies and tools he has to manage it, any of us with sleep issues should try to get on top of them. It's best to know what our behavioral, environmental, and possibly medical tools are for sleep, if we take meds, know how they effect us, and to anticipate how our usual strategies might get blown out of the water or cause problems in a PAW. There are some otc and herbal/alternative sleep aids (other than alcohol, which has issues with re-awakening later) but if somebody's likely to need them, it would be good to know how long it's going to knock that specific person out for, or if they're likely to have after-effects the next day.