July 20, 2023

Voices of Recovery: Episode 17

Chrissy Barnard was repeatedly hospitalized and was never told that recovery was possible. It was only when she went to NAMI Connection in Duluth, Minn., that recovery was mentioned as an option. Chrissy began to build her recovery plan, which included dialectical behavior therapy, working with her psychiatrist, and her spirituality. She talks with Dr. Ken Duckworth, NAMI’s Chief Medical Officer, about what recovery means for her and the tools that have helped her along the way.

This conversation was part of Dr. Duckworth’s research for the book, You Are Not Alone: The NAMI Guide to Navigating Mental Health–With Advice from Experts and Wisdom from Real People and Families. Hear more episodes of this and other podcasts at nami.org/podcast.  
 

 

Episode:

 


Episode Transcript:

Ken
Duckworth
: [0:00] A note for our listeners. This podcast includes
discussion of suicide that some people may find difficult.

[0:06]
[background music]

Ken:
[0:07] Welcome to "You Are Not Alone ‑‑ Voices of
Recovery". Hi, I’m Dr. Ken Duckworth. I’m a psychiatrist. It’s my good
fortune to be the chief medical officer for the National Alliance on Mental
Illness or NAMI.

[0:18]
I’m the author or NAMI’s first book, "You Are Not Alone ‑‑ The
NAMI Guide to Navigating Mental Heath," with advice from experts and
wisdom from real people and families. I talked to over a hundred people for
this book. I wanted to share some conversations that I felt could teach us all.

[0:36]
Chrissy Barnard lives in Superior, Wisconsin, right up near Duluth, Minnesota.
Chrissy has reported that she experienced mental health conditions in her life.
What’s most important about Chrissy’s story is that she was told she wouldn’t
get better.

[0:55]
In meeting people at NAMI Duluth, shout out to NAMI Duluth, they told her that
she could build a recovery plan. This is the core of Chrissy’s story. Chrissy
benefited from a therapist to used DBT or dialectical behavior therapy.

[1:14]
DBT was invented by Marsha Linehan, and this is designed to help people who
feel emotions very intensely. It has been used to treat borderline personality
disorder and is helpful for other conditions. Marsha Linehan is a genius and
won the NAMI Research Award for this brilliant work, which helps people develop
coping strategies that are positive and do not cause self‑harm.

[1:44]
Chrissy Barnard was able to find a DBT therapist who had trained under Dr.
Linehan, and the work she was able to do with this therapist made a huge
difference in Chrissy’s recovery. She is now helping other people.

Chrissy
Barnard
: [1:57] My family is rather interesting. We have a lot of substance
use and mental health on both sides of my family, and that made life rather
interesting for me growing up. Actually, my PTSD started when I was a kid,
because of some of those experiences and stuff. I grew up in Lake Nebagamon in
Wisconsin, which is a little tiny community in rural Douglas County.

Ken:
[2:27] So very rural.

Chrissy:
[2:32] Yeah, very rural. Most of northern Wisconsin is rather rural.

Ken:
[2:36] Yes.

Chrissy:
[2:38] There’s hardly any resources.

[2:41]
Then, I went to high school. Did OK, but I noticed my symptoms coming on in
high school. I would get up at 6:00 AM and work out in the weight room with the
wrestling team, go to school all day, then do after school activities like
forensics or drama. Then, I’d go watch a basketball game after that. Then, I’d
go and do yearbook stuff until 2:00 AM in the morning.

[3:06]
Our school was so tiny that they let you do stuff like that as late as you
want, all by yourself. Then, I would do homework up until 4:00 in the morning,
sleep for a couple hours, and then go back to school and repeat it.

Ken:
[3:17] Were you able to sustain this for more than a few weeks?

Chrissy:
[3:21] I would do it, yeah, for a fairly long time. I did sleep a couple hours
a night. Then, it went on for, sometimes a month or two. Then, I would have a
crash eventually.

Ken:
[3:35] Yes. When you had the crash, were you having trouble getting out of bed?

Chrissy:
[3:40] Yeah, but I managed to graduate, so that was good. I did OK and got some
scholarships to go to college.

Ken:
[3:49] Congratulations.

[3:52]
When did it occur to you that you might be dealing with some symptoms of a
mental health condition, a brain‑based condition, a mental illness.
Whatever we’re going to call it. Sometimes people come to the realization,
"Wait a minute. Maybe this is more than I’m just a super‑energetic
person."

Chrissy:
[4:11] Not until I was in college. I didn’t even realize the manias until even
later, but I recognized the depression in college because I had had those
crashes. I’d get super‑depressed. Then, I didn’t want to leave my room. I
wasn’t doing well in school. It was a challenge.

Ken:
[4:32] Was the school…

Chrissy:
[4:33] They said, "You need to do something." They had me see the
school counselor. Then, she said, "You need to see a doctor and get on
antidepressants." Then, I cycled a little faster for a while.

Ken:
[4:44] Got it. You probably had bipolar disorder, not fully understood. Were
given antidepressants and that accelerated the cycling.

Chrissy:
[4:51] Mm‑hmm.

Ken:
[4:53] Right?

Chrissy:
[4:54] Yep.

Ken:
[4:55] That’s a fairly classic problem.

[4:56]
What college were you at, Chrissy?

Chrissy:
[4:59] I went to Lakeland University on Sheboygan, Wisconsin.

Ken:
[5:05] Right on Lake Michigan, right?

Chrissy:
[5:07] Yep.

Ken:
[5:09] What did you study there?

Chrissy:
[5:10] Biology and psychology with a business administration minor.

Ken:
[5:16] You went to see the school counselor. They gave you an antidepressant
and a doctor that they referred you to gave you an antidepressant. You cycled
faster. What was your experience? Were you suffering? Were you struggling? Was
it OK for you?

Chrissy:
[5:31] I was all over the map. [laughs] There was times I was struggling, and
then I wasn’t doing well, and then there’s times was doing really, really well.
I was involved with their peer programs on substance use and Sexual Assault
Week and their peer leadership type of program.

[5:53]
Then, there was times where I was consuming a little more alcohol than I should
have, probably because I was part of a sorority as well, and trying to manage
that way. I never overused enough to where it became a concern.

Ken:
[6:07] Would you say you were tempted to self‑medicate, but didn’t take
it too far?

Chrissy:
[6:12] Yeah.

Ken:
[6:14] What happened? You graduated from college in how many years?

Chrissy:
[6:17] It took me six years. I left for a year, and then came back.

Ken:
[6:23] At this point, has it occurred to you that you might have a mental
health condition that you’re going to have to take care of?

Chrissy:
[8:30] Yeah.

Ken:
[8:43] You’re how old? About 20?

Chrissy:
[26:57] I was hospitalized multiple times during college and almost didn’t
graduate. I had some great professors that would let me take incompletes and
finish classes during the summer. They helped me get through.

Ken:
[6:44] That’s great. What was the experience of going into the hospital like
for you? Let’s take the first time. What do you remember about that?

Chrissy:
[6:53] It was kind of scary, [laughs] because I was like, "I don’t know
what’s going on." Then, they’re like, "You can’t have all these
things that you have." I was like, "I can’t have my clothes?"
They’re like, "You could have them during the daytime," which was
nice.

[7:09]
The hospital, I’d say, that I found was one of the best ones, and it’s still to
this day, the best one I’ve ever stayed at.

Ken:
[7:15] You started with a good one.

Chrissy:
[7:17] Yeah. Since then, none of the other ones compare very well. [laughs]

Ken:
[7:21] I think you told me you’d been hospitalized many times.

Chrissy:
[7:25] Yeah, 33 times so far. Knock on wood, hopefully there won’t be any more.
[laughs]

Ken:
[7:30] You had described to me that you seemed to have gotten on top of this
anyway and were very confident about your ability going forward. May I ask, 33,
the first one is 21‑ish, 22 years old, something like that?

Chrissy:
[7:45] Yeah, I think I was 20.

Ken:
[7:47] May I ask how old you are?

Chrissy:
[7:54] 43.

Ken:
[7:55] 33 hospitalizations in 23 years is a lot.

Chrissy:
[8:01] I haven’t had any in the last five years. [laughs]

Ken:
[8:08] Let’s understand that better. You mentioned to me that nobody had told
you about recovery?

Chrissy:
[8:16] Yeah, no one said it was even possible.

Ken:
[8:18] That recovering was possible, or that there was another possible
pathway? Could you tell me a little bit more about that idea?

Chrissy:
[8:31] When I was committed to the state hospital, no one said recovery was
possible. They acted like we were never going to get out. They acted like that
kind of attitude. They’re like, "You’re going to always live with
this."

[8:47]
I was like, "What do you mean?" [laughs] When I found the NAMI group,
the NAMI support group in Duluth, Minnesota, and they were like, "You can
start your road to recovery. When you find this group or any group, we can help
you start your road to recovery." I’m like, "Recovery? What do you
mean? That’s possible?"

[9:06]
[crosstalk]

Ken:
[9:06] [laughs] How did you find the NAMI Duluth Group?

Chrissy:
[9:14] I can’t remember, but I was working at the hospital at that time. I
still do. They have it at the hospital I work at.

Ken:
[9:22] You work at the hospital that you were admitted to?

Chrissy:
[9:25] No. I was admitted to that hospital, too, [laughs] but they have support
groups in the cafeteria.

Ken:
[9:34] Was this NAMI Peer‑to‑Peer? Was it a NAMI Connections…?

[9:38]
[crosstalk]

Chrissy:
[9:38] NAMI Connections.

Ken:
[9:39] Was NAMI Connections. How old were you when you found NAMI Connections?

Chrissy:
[9:46] Let’s see, probably like 33.

Ken:
[9:51] 33. You’d been hospitalized many times, 15 or so, by the time you were
33, just doing the math if you were to space it out. Nobody had mentioned to
you the possibility of recovery. Someone actually said to you that, "We
can help you develop your road to recovery"?

Chrissy:
[10:11] Yeah.

Ken:
[10:13] That’s quite beautiful.

Chrissy:
[10:15] Yeah. I was just floored. I was like, I couldn’t believe it that
somebody would say that. Because I was told it wasn’t possible. I was totally
shocked. Then I was like, "Wow. OK. Now what do I need to do next?"
That was like my next thought.

Ken:
[10:35] Is it possible that you were taken from, "I have to live with
this. It’s never going to get better," to a position of feeling empowered?
I don’t want to put words into your mouth, but that’s what I’m hearing.

Chrissy:
[10:48] Yeah, and it was, "OK, if this is possible, give me the action
steps I need to take to get there."

Ken:
[10:54] Nice. Was this the first time that you felt that you were proactively
dealing with the problem?

Chrissy:
[11:00] Yeah.

Ken:
[11:01] Fantastic. All right. At the same meeting that your light bulb has gone
on, "Wait a minute." You say, "What are the action steps?"
What kind of responses did you get?

Chrissy:
[11:12] They asked me, because this was shortly after one hospitalization,
they’re, "Do you have a psychiatrist you’re working with as a
partner?" I said actually I just got one. Then they’re like,
"OK." I told him who I had and they’re, "Oh, that’s a great
person. I knew that from the beginning." He was the section chief, too.

[11:32]
Then they’re like, "Do you have a therapist yet?" I said, "I got
assigned one. I haven’t met her yet." Then it was a DBT therapist. Then
that kind of help get things going. Then you’re like, "Now if you have
your peer support, you have your DBT, your therapist, and then you have a
psychiatrist hopefully you can work all of them, get your family support on
board, and get the process rolling.

Ken:
[12:02] They laid out a master plan for recovery for you.

Chrissy:
[12:06] Kind of. Basically they made sure I had the best key components that I
needed.

Ken:
[12:12] Would you agree that those were the key components?

Chrissy:
[12:14] For me, they were. Doing mindfulness for me each night is really
important to prayer. Like my spirituality side.

Ken:
[12:25] Yeah. Tell us about your spirituality side.

Chrissy:
[12:28] Every night I do my prayers and I do five things I’m grateful for every
night. That used to be really tough to even think of one thing. Now I make sure
I do different things that I have all week long. I try to make sure it’s
different. I’m never repeating the same thing.

[12:46]
I just felt like that changed my whole outlook on things. Once I started
thinking more positive, it got easier and more and more good things just
started happening.

Ken:
[12:56] What’s an example of five things you were grateful for this week?

Chrissy:
[13:02] This week I’m thankful for this and talking with you.

Ken:
[13:05] Thank you very much. I’m grateful too.

Chrissy:
[13:08] Then I have a meeting with our teen support group facilitators tonight,
because we’re starting a teen support group this week.

Ken:
[13:17] Wait, now you’re supporting teens?

Chrissy:
[13:19] No, I got five people as facilitators to lead a teen support group.
They’re all college students. We’re starting a NAMI teen support group.

Ken:
[13:30] Is that something to be grateful for?

Chrissy:
[13:32] Yeah. It’s wonderful. I’m so happy we’re bringing it because we’ve had
a lot of teen suicides in our community. It’s really important to me.

Ken:
[13:42] I am so glad you’re taking this on. You’re doing this with other people
at your NAMI affiliate?

Chrissy:
[13:49] Yep.

Ken:
[13:49] Having this chat with NAMI’s Doc is one. Facilitating the Teen NAMI
Support Group.

Chrissy:
[13:57] Yep.

Ken:
[13:58] What is the proper name for the group?

Chrissy:
[14:00] We’re calling it NAMI Douglas County Teen Support Group right now.

Ken:
[14:05] Perfect…

[14:05]
[crosstalk]

Chrissy:
[14:06] different name but that good flows.

Ken:
[14:08] Perfect. That’s a good start. That’s two. What are the other ones? I
love this idea of the gratitude list.

Chrissy:
[14:16] Now I have a phone call coming up with someone in our neighboring
county, because we’re trying to expand NAMI services in Bayfield County. Because
they don’t have any services right now, and they’re a really rural county as
well.

[14:31]
We want to start offering services over Zoom and possibly someday in person
family support group in Iron River.

Ken:
[14:39] You have to be very resourceful in rural America. Here you’re trying to
help the next county, you’re going across the bridge to Duluth to do your first
NAMI walk.

Chrissy:
[14:52] Yeah.

Ken:
[14:52] This is great. What else is on the list?

Chrissy:
[14:56] Then I’m going to teach a stamping class. This weekend I’m going to
work on designing cards, actually for our peer leadership council in Wisconsin
here, because we’re going to do a virtual card class.

Ken:
[15:09] What is that? Everybody’s going to make their own.

Chrissy:
[15:12] Yep. I’m going to prep all the materials and we’re going to mail it out
across the state and then do it all together. Because I make reading cards as a
side job and I teach classes every month over Zoom already. I’ve been doing
that for a couple of years.

[15:26]
Now we’re going to do that and I got all the materials donated ‑‑
$364 of materials ‑‑ donated to me.

Ken:
[15:32] Nice That’s fantastic. A lot to be grateful for. Anything else on the
list?

Chrissy:
[15:40] Then I’m happy because I got plants to plant. Now I got some more
hostas and things like that so I can play in the dirt a little.

Ken:
[15:48] Hostas last forever. I found that I can’t kill them despite my best
efforts at neglect or self‑absorption. The hostas just go. They just make
it. That’s fantastic. They’re also a beautiful plant. They can flower. Do they
flower in Wisconsin?

Chrissy:
[16:03] Yeah.

Ken:
[16:04] They’re one of my surprise favorites, right?

Chrissy:
[16:08] Yep.

Ken:
[16:08] That’s great. That’s five things right there. You will know, Chrissy,
there’s no surprise that this strategy that you employ it’s one that many
people employ. I can do it every day. It’s easy to do, isn’t it?

Chrissy:
[16:23] Mm‑hmm.

Ken:
[16:23] Once you focus your mind on gratitude, it’s easy to do.

Chrissy:
[16:28] Yep.

Ken:
[16:29] All right, Chrissy, so let’s talk about what DBT meant to you. Because
when I talk to you over the phone, it sounds like the first idea is that you
could have a recovery. That was the first frame shift wait a minute. As you
described, wow, this is a whole different way of approaching this challenge.
Then you get DBT not long after, is that right?

Chrissy:
[16:57] Yeah.

Ken:
[16:59] Tell me a little bit about your experience of DBT. You’re in your early
30s now.

Chrissy:
[17:04] Yep. I found a true DBT program. There’s differences. Some people are
like, "Oh I get DBT through my therapist." No, I go to a real DBT
therapist who was trained by Marshalls for that handbook.

Ken:
[17:19] Yes. Marshall at hand is a friend of NAMI’s as you know, and won our
research award five years ago. We know how special she is.

Chrissy:
[17:29] Yeah. I have my DBT therapist cell phone number. I called her on
Christmas night when my family was blowing up in arguments and stuff like that,
and we’re like, yelling at me and everything else.

[17:41]
I’ve called my DBT therapist at 4 o’clock in the morning before when I had
trigeminal neuralgia and I couldn’t take it anymore. I was getting suicidal
from all the pain. I was like, I’ve called my therapist at all hours of the
day, but she’s always been there for me.

[17:58]
I’ve had her to call when I had crisis. I went through the skills group two and
a half hours every single week. I did that multiple times. I did it for two
years, actually. I went through it. Even though six months is considered one
round, I did it for a year. Then I took off like a break, and then I did it
other year.

Ken:
[18:19] Interesting. Who was the psychiatrist who you thought helped you so
much?

Chrissy:
[18:25] Dr. Michael Messer. He was fantastic. He just retired, though.

Ken:
[18:30] OK.

Chrissy:
[18:33] He was so willing to work with me as a partner. I could tell him,
"Oh, I feel like I’m getting manic." I’d tell him, "You know
what worked well for me?" because I recognize my symptoms now. Before, I
never did. Then, I’d tell him, "If we could fix my Wellbutrin, I think
I’ll be OK." He’d be like, "OK. Let’s do that."

[18:52]
Now, I can just, before I retired, I would just send him an email and then he
would be like, "OK. Decrease it to 150. Then, let me know how you are.
Then, if you want, if you need to increase, let me know and we’ll increase
it."

[19:10]
We had such a great relationship, I didn’t even have to see him. I could send
him a message and he would increase it or decrease.

Ken:
[19:16] You got so good at recognizing your own experience, and you had such a
great relationship with Dr. Messer, that you got to the level where you were
running your own care.

Chrissy:
[19:31] Yeah.

Ken:
[19:32] That’s fantastic.

Chrissy:
[19:32] Eight years. I didn’t have any manias for eons. I’ve had a hypomania. I
think I’ve had two in the last five years, but that’s it.

Ken:
[19:43] Has it been suggested to you that you might have borderline personality
disorder?

Chrissy:
[19:47] When I got out of Winnebago and the state hospital, I was initially
diagnosed with bipolar, PTSD, generalized anxiety, and borderline personality
disorder. Since I completed ABT four years ago, my therapist removed my
borderline personality disorder, she’s like, "You don’t even come close to
the diagnostic criteria anymore in the DSM."

[20:14]
She removed it. In the following year, my psychiatrist removed it because he
agreed that I no longer needed.

Ken:
[20:21] Do you think you met it when you were actively symptomatic?

Chrissy:
[20:25] When I was symptomatic, yeah.

Ken:
[20:27] Were you self‑harming a lot?

Chrissy:
[20:30] I did then, but I haven’t now in probably like, I don’t know, probably
close to 10 years now since I self‑harmed.

Ken:
[20:39] It’s a fantastic story, Chrissy.

Chrissy:
[20:42] Yeah. My DBT really helped with the self‑harming and suicidal
tendencies, a part that really helped that area a lot.

Ken:
[20:51] Could we develop this a little bit? You would have an impulse to harm
yourself or to die, or was it just to harm yourself?

Chrissy:
[21:00] Either. Both.

Ken:
[21:03] You did have the active wish to be dead several times.

Chrissy:
[21:07] Yeah.

Ken:
[21:09] Tell me a little bit about the skills that you developed to overcome
those feelings in DBT. What skills did you work?

Chrissy:
[21:20] I know the PLEASE skill was important in the beginning, know that
physical activity, laughter, exercise, sleep, all those PLEASE skills.

Ken:
[21:33] What is the word? Please?

Chrissy:
[21:35] That’s what it stands for, is treating your physical condition,
laughter…

Ken:
[21:42] Exercise.

Chrissy:
[21:43] Yeah. Avoiding alcohol and other drugs, sleep, and then exercise.

Ken:
[21:49] Got it, got it.

Chrissy:
[21:51] In the beginning, that was important because I wasn’t functioning in
any of those at all very well. Then I started using…I don’t know which other
one I used the most. I’m trying to think.

[22:07]
I used a lot of the distress tolerance skills of just distraction, a lot of distraction
skills and using four‑by‑four square breathing, and then doing the
five things you see, and then the things you hear, the things you smell, the
things you taste, those grounding skills.

Ken:
[22:33] Yes.

Chrissy:
[22:34] Those were really important to me. Now it’s that I’ve taught them
during our NAMI peer support group actually, some of them. Sometimes, you’ve
got to start with the basics, and I have taught the PLEASE skills and just
breathing skills during our peer support groups even.

Ken:
[22:54] Yes. Fantastic. What kind of care are you getting now? You’re not doing
the full DBT.

Chrissy:
[23:04] No. I see my DBT therapist once a month now basically for maintenance.

Ken:
[23:09] Let’s talk about your spirituality and faith. Were you raised religious?
Was God an important part of your childhood?

Chrissy:
[23:17] Not with my family, which is really odd because one of my friend’s
neighbors next door. I went to church with her. Both my grandmas are very
religious. I went with one of my neighbor friends to church when I was little.

[23:35]
Then in high school I went with a different friend to church, and I went to
Bible camp with her several times. Then I went to a UCC college. Then I’ve
always had my own drawing to spirituality and religion, so it’s always been
there. Then I reconnected even more after I had my brain surgery for my
trigeminal neuralgia.

Ken:
[23:58] When was that?

Chrissy:
[24:00] That was…Actually my brain anniversary is coming up on July 28th,
that’ll be four years.

Ken:
[24:07] Wow. You had to get yourself in a place where you had the skills to
manage distress, then you were able to get the surgery, or was that not the
reason?

Chrissy:
[24:18] No, I had to manage my stress and then, actually, because I was in so
much pain, I at one point was like suicidal because I was in so much pain for
long. Then I actually got admitted to the behavioral health unit.

[24:33]
They said, "Oh, these medications are not working for you. They’re not
therapeutic. They’re not even at therapeutic levels." They said,
"You’re the only person who’s ever had an IV on this unit."

Ken:
[24:43] Ever had what?

Chrissy:
[24:44] An IV going on in the unit.

Ken:
[24:47] Oh yeah. They don’t like IVs.

Chrissy:
[24:49] No.

Ken:
[24:49] In behavioral health, they’re scared of actual medicine sometimes.

Chrissy:
[24:53] Yeah. Then I had that for a while to get up to therapeutic levels and
it still didn’t help. Then they said it did a Gesta MRI. Then they said,
"Oh, you need brain surgery, girl." Then they did that. I have been
great ever since.

Ken:
[25:09] Oh, it’s fantastic. Let’s talk about so your relationship deepens with
your faith after your trigeminal neuralgia surgery. Talk about that a little
bit.

Chrissy:
[25:22] Because like before my surgery, I was going to church here and there,
but then because of my surgery, I don’t know. I just felt a greater connection.
The spirit world, to God, and everything. I just felt moved. I don’t know why I
just did.

[25:41]
Then I started going to church every week. Then I just felt like more connected
to out and nature and to the animals even. I have a dog, I had a dog, now she
passed away, and I was like, she could sense things. I was like, she was just
super sweet, and shortly after my brain surgery, I got in a car accident and
had a TBI.

[26:07]
She could sense, because I had a seizure then after that, and she could sense
if I was going to have a seizure even. She was the sweetest pie, and she could
just sense all these things going on, and she died, and now I got a new dog
who’s got ADD, because she’s a Jack Russell.

Ken:
[26:25] Oh, Jack Russells, yes. What an adventure you’re about to have, right?

Chrissy:
[26:29] Yeah. Then, I don’t know, I even talk to the birds and I’m like,
"Oh…

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