Advocacy as an Outlet for Anger

Why telling my mental health story helps me process a complex emotion.

Hi Readers —

What motivates me to share my personal story in such a public way? The answer is that advocacy is a productive outlet for anger, at least for me.

Because of traumatic hospitalizations, health insurance fights, and woeful providers I have had fits of pure anger since my diagnosis with bipolar disorder five years ago. Anger, like any emotion, is not wrong. People feel emotions all of the time. Some emotions simply need to be felt; others require a response.

Anger is a particularly complicated emotion, though. Deflating it is hard — as is channeling it in productive directions. Below I write about why I am angry, why advocacy is a good anger outlet for me, and how others process anger.

Thank you for reading and sharing. If this post strikes a chord, I’d appreciate you forwarding it to anyone who would like to subscribe. While SubStack may ask you for a “pledge”, I do not collect money or paywall any writing.

Sincerely,
Tyler

Why I am Angry

There are many new readers here — including lots of strangers. So, I thought I’d refresh a bit on my bipolar story. I have been hospitalized twice in facilities that denied me legal rights, dignity, and proper care. I wrote about that twice publicly (here and here). With positive reactions and encouragement from friends and family, I started writing Bipolar and Bipartisan.

I was first diagnosed with Bipolar Disorder in 2019 following a seven-day hospitalization in Colorado. After months of escalating energy and frenetic behavior, I ended up in an ambulance, then an emergency room, and finally a psychiatric ward. Unaware of my illness, I experienced symptoms of hypo-mania and then mania: I was driving the wrong way on roads, forgetting names, speaking rapidly, crafting ambitious ideas, writing obsessively, and unable to sleep.

With the help of friends, I was properly identified as in need of care, but quickly learned our country’s approach to mental health makes it hard to get proper care. Voluntarily going into an ambulance, I was rushed to a nearby emergency room. I was expeditiously seen by several providers and given some medication to rest, only to be woken up at 3am and transferred to a psychiatric ward at a nearby hospital.

Once there I was assigned a roommate diagnosed with schizophrenia who frequently yelled through the night, waking me up when I needed sleep most. I was forced to shower in cold water, unable to exercise, disconnected from my family and friends, and surrounded by 15 other patients who were as acutely sick as I was. Psychiatric wards like the one I was in are far from the peaceful respite that people in crisis truly need and deserve.

Not only is the environment bad, the care is too. Doctors were quick to say I needed medication, but did not meet with me for more than five minutes at a time. Constantly under their own pressures, they did not take time to explain to me what my brain needed or what they were prescribing. I had resisted medication since my mom and dad were giving me cold and flu remedies as a baby. Unsure of what was going wrong and without a diagnosis, I resisted medication at first. This resulted in being physically tackled and pinned down by a group of at least six medical staff members so they could inject a shot into me.

Eventually, I learned I would need to play the doctor’s game to be released from the ward. I resisted urges to speak out against my providers, knowing they would need to be the ones to sign off on my discharge. Only at the end of my hospitalization was I told I was diagnosed with bipolar disorder — sent on my way without any real education about the crippling disorder I all of a sudden had, even though I suppose I was bipolar long before then.

As is often the case after a period of heightened mania, I quickly fell into a deep depression, which lasted a year. That year was marked by fights with insurance companies, struggles to find outpatient care, and what seemed like countless shots in the dark on what cocktail of medications may work. Although I was never suicidal (thankfully), I often struggled with sleep, motivation for work, and finding joy in my otherwise fortunate life. With persistence, I found a set of providers and medications that worked. I, however, was not as vigilant as I should have been. Early last year, I was again hospitalized in a horror story.

After a two-hour ambulance ride to Colorado Springs — due to the lack of available beds in Denver — I arrived at a chaotic psychiatric ward filled with screaming patients and overwhelmed providers. The words Nazi and KKK were on the whiteboard. The medications I normally took were not available. I only saw a psychiatrist for 15 minutes over seven days. My only therapy session was done in a public setting. Patients thought they had to smoke cigarettes to go outside in four short windows that were the only opportunity to get fresh air. I was verbally abused by other patients, and only able to see two family members every other day for 30 minutes at a time. I could list hundreds of other horrors, but it is important to know I was denied my legal rights under Colorado law, and the ability to speak to a lawyer.

After days of escalating mania because of, not in spite of, the environment — I again learned I would have to play the provider’s game, keep my uncontrollable mind controlled, and wait out the seven days they could charge my insurance company high premiums for. I only acquiesced after again being physically forced to take medication.

I am pleased to say I have never felt better today, but last year was really rough. I learned that a combination of five things really matters: sleep, diet, exercise, emotional regulation, and medication. I am relentless in my routines and practices to keep these things in balance. I am also healthy because I have taken time to really understand what bipolar disorder is, and what it is not (see my piece on Bipolar 101).

I am also healthy because friends and family have graciously learned alongside me and found supportive roles. Most importantly, I feel it is my responsibility to be healthy, and that I need to be in control of my care: not any one provider, colleague, family member or friend.

Why I am an Advocate

Whew. Just writing those eleven paragraphs got my heart rate up. You might assume my experience was an anomaly or an exception to the rule. The opposite is true. Every time I tell my story to another acutely diagnosed mental health warrior, I get nodding heads and acknowledgement that their care has been similar — and in many cases much worse.

If you don’t believe me, check out the recent New York Times Daily podcast on the topic, or the accompanying essay. An impressive recent 82-page report from Inseparable chronicles stories of crisis response gone wrong with recommendations on how to fix the system: “A Better Response: Improving America’s Mental Health Crisis System.”

Fixing the system is a primary way that I have decided to direct my anger in a productive direction. My anger inspires, motivates, and sustains my advocacy. I cannot change the past, and I have forgiven myself and my previous providers for the experiences I have had: “forgiveness is giving up all hope for a better past,” my therapist tells me.

By advocating for a more patient-centered approach to mental health, I hope to improve the care others’ receive. Selfishly, I hope laws, hospitals, and institutions improve for my own sake; the data on my illness — related to recurrence, treatment efficacy, and employment prospects — does not provide long-term assurances.

I have found it therapeutic to testify before legislatures, write publicly, speak at events, and share my story in one-on-one settings. These practices help me stop ruminating: speaking out turns a trauma into a story with the potential to persuade others to do better on behalf of patients. Finally, by offering up my story I get them back. I am frequently touched by the candor in which others share their story with me: every week I learn there are more and more people I know going through tough times; in learning these stories, I learn I am not alone.

I spoke recently about why I find advocacy to be an effective outlet for anger, and why the organization Mental Health Colorado is a productive outlet for advocacy. I was honored to speak at their annual fundraising gala. You can watch my two-minute message:

Other ways to deflate Anger

Advocacy is not for everyone. Sharing stories is personal, and we should not expect people to share their traumas.

A powerful TedTalk from a high school senior points out how wrong it is that college admissions essays have become a race to the bottom with universities rewarding students for spilling their heartaches to strangers.

For me and many others, there are numerous ways to productively process and channel anger. Some common practices are:

• Journaling to express anger and reflect on it.

• Exercising especially rhythmically and non-competitively.

• Meditating and yoga to allow anger to come and go.

• Attending therapy to have a sounding board.

• Volunteering to make the experiences of others better.

• Writing letters to the source of the anger, without sending them.

• Practicing the arts, including illustrating, dancing and playing music.

• Support groups, which are confidential forums for verbal expression.

If you would like to read more about processing anger, check out Psychology Today, NPR, or the American Psychological Association.