"I did have a stigma about my mental health"

The coronavirus pandemic has shone a spotlight on mental health.

“There has been a stigma surrounding mental health,” said Lydia Caraveo, wellness manager at Grinnell Mutual. “However, the pandemic really started to break down that stigma, and people are starting to talk a little bit more about their mental health.”

To help continue those conversations about mental health, Caraveo interviewed Jeff Menary, president and CEO, about mental health and his experience with the West Nile virus and living as a paraplegic.

This interview has been edited for length and clarity.

Lydia Caraveo, wellness manager: Did you ever have any stigmas concerning mental health issues?

Jeff Menary, President and CEO: Absolutely not — for other people. And that was the key, you know.

I have worked with people that have worked on their mental health or had mental health issues. To me, it's no big deal.

But I did have a stigma about myself. I felt that I was weak if I had any mental health issues or sought assistance.

Lydia: What changed your opinion regarding mental health for the stigma upon yourself?

Jeff: When I contracted the West Nile Virus, I had the most severe symptoms that you can have — other than dying. My case was about one in a million.

There are many, many lasting effects of a West Nile Virus infection. I have severe weakness. I've lost the use of my legs and even upper body strength is not there. My lung capacity isn't there.

But another effect of infection is high anxiety. I'd never experienced high anxiety before. And it really changed my thought process at that time — how helpless I was.

Lydia: Can you describe overall how you felt during that time?

Jeff: When I got to the hospital in Iowa City the first thing they wanted to do was have an MRI done.

I've had an MRI before when I had a hip replacement. Actually, it was kind of relaxing.

But this situation was different. I was running a fever and had trouble breathing. I was in the MRI machine and every minute seemed like 15. I was really stressed out, which was so strange.

When I got out, one of the staff said, “Well, I wonder if we should do another MRI with contrast.”

At that time, I could still speak — I wasn't intubated yet.

I said, “Wait a minute. Did the doctor order it?”

She said no.

I said “Well, I'm not doing it,” which would be so atypical of me.

When I had to go back and have another MRI, they dosed me up with Ativan [an anti-anxiety medication].

I actually asked for Ativan on the days I had to do physical therapy because I really was struggling.

Just tell you how bad it was, after about six weeks in the hospital I finally got to the point that I could watch TV. My family brought over some DVDs. One was the series “The Virginian.” The theme song stressed me out so much I couldn't watch it.

That's kind of where I was mentally.

Since then, I’ve learned that high anxiety is not unusual in a severe West Nile Virus infection.

Lydia: What kind of treatment did you receive for your high anxiety?

Jeff: I was on Lexapro at the hospital and when I came home. I took Ativan intermittently. I also met with the psychiatrist on a regular basis.

When I was in the University of Iowa Hospital, they did have me on antidepressants. When I got out to Craig Hospital, it was mandatory to be on antidepressants at that time if you if you had a spinal injury, which I had because of the West Nile Virus infection. It's not a typical traumatic spinal injury, but I had the same symptoms.

At Craig, there were days where I never got out of bed. When I was on the respiratory floor, the therapist would come in and work with me and try and get me on a table or gurney. It would tilt up to stand and my heart would race.

I was asking for something those mornings to take the edge off because I was just so stressed out.

But I had an aversion to meeting with the psychiatrist. I was at Craig so I could walk out of that hospital. I didn't know why I needed to meet with these individuals. I thought my case was different. Of course, really, it was not for the situation I was in as a paraplegic.

Lydia: When you were receiving treatments and meeting with the psychiatrist, how did you feel? What were your thoughts?

Jeff: At first, I didn't know if I was really getting that much value. To me, the value was getting into the physical fitness room. Having the physical therapist work with me, trying to get on my feet and that was the goal. I was going to walk out of Craig Hospital with a walker. That was my goal.

But we learned quickly that the goal was to get me so I could function in society and at home.

Working with the psychiatrist, the things that I remember most about this process was having those heart-to-heart discussions. And it still bothers me a little bit to this day.

I was trying to work out, doing a seated bench press from my wheelchair. I could hardly do 20 to 30 pounds.

Next to me there was a young man, a quadriplegic, who had his neck broken by a bully. And here I am, trying to push 20 pounds of weight, and he's a quad, waiting for his turn on the machine.

He looked at me and said, “If I could just get use of my hands, I could become a mechanic.” That's all he wanted.

That just broke me to tears.

And so I shared that with the psychiatrist. And I said, “You know, I feel so ashamed because I feel so bad for myself. And I've got it great compared to some of the people that I'm befriending.”

They explained to me that it’s a normal process. I’m going to go through my own grieving for my loss, so don't feel terrible about that.

Later on, through the whole process, I finally got to feel like I was myself again.

Lydia: When did you finally start to feel back to normal? What were some of the changes you noticed?

Jeff: I can still recall the first time I realized I was recovering from my anxiety

I was getting my lunch in the cafeteria on our floor. I had watched the gentleman using a support vector machine (SVM). It uses a harness and cables to offload weight, lifting him off of his feet so he can go along and walk. I saw the very first day that he was on the SVM, actually kind of walking.

I had learned that his wife had gone home because he was going to get discharged in a couple weeks. She was getting their home ready for him.

So he is by himself during lunch. I finished and I went over to him.

I said, “Excuse me, I've never met you. I don't want you to think that I was just spying on you or kind of a creeper, but I think I saw you the first time you were on the SVM,” and his eyes lit up.

He said, “Yeah, that was so cool,” and told me his life story and how he broke his spine in a motorcycle accident.

Whenever I saw him doing work on the parallel bars or with a walker, I gave him a thumbs up. It just it just felt normal for me.

That was the first time I actually thought I was recovering from my mental anxiety because I felt good helping somebody.

I asked my wife if she could get me some Superman cards. I wanted to give these out each week to who’s working the hardest in the gym or working the hardest physical therapy.

She didn't have any cards, but her mom had sent a us bunch of Superman socks. I couldn’t wear them because I had to wear compression socks. So I started handing those out to people when they had a really good week.

It was a lot of fun and I kind of became known for that. And that's when I knew I was back, at least to myself, as far as my mental abilities.

I really care about people. I want to reach out to them — I'm just kind of that way. So that's when I finally thought to myself, “I feel like that part of me is normal.”

I can't walk, I can't lift anything, I couldn't even move myself around.

But at that time I thought, at least I'm reaching out to people. And that's like me and I felt good about that. I was getting back to my mental capabilities.

Lydia: That is so cool, Jeff. I bet those socks really pushed them to continue to better themselves.

Jeff: Yeah, it was fun.

My daughter, Jessica, and I got permission to sneak into the fitness room which had therapy tables and equipment. We would do extra work before supper, sometimes after supper, and we squeeze that in.

There was this one young lady, Lauren. She broke her neck sleigh riding in the sand dunes on cardboard. And she was doing the same thing. She was really good. She worked on stretching. She could do so much stuff. I saw her the first day she was on the walker.

But I made sure I waited to present her socks until her whole family was there in the cafeteria — parents, brother, and fiancé

She looked at me and said, “The only reason I'm working so hard is because you and Jessica are in the gym at the same time.”

That was fun.

Lydia: With all these experiences, did you ever get over your concerns about mental health and that stigma you had?

Jeff: Yes and no.

I learned that 50 percent of West Nile Virus patients suffer permanent cognitive disabilities and 31 percent have depression issues after infection.

For a while, I was concerned. I couldn't even navigate a laptop. It was just terrible.

But when I was discharged, I knew I was back to myself, mentally. I still had sharpening to do. But I was functioning. I was catching up on email, which I probably shouldn't have been. I was writing and doing a couple of videos. And I knew what was going on. I could catch up and I felt good about that.

But I still had this stigma because I wanted to get off Lexapro. I don't like medications. I still carried a stigma about taking antidepressants.

My doctors would not take me off the antidepressants because I was about to transition to outpatient care.

They said, “We don't want to take you off of this medication because there’s going to be a new stress load for you, living on your own in outpatient care. And even though you're right across the street from us in a housing complex with your family, if something happens, we can't help you. You’ll have to call 911.

We navigated that for a month and I said, “I'm ready to come off my Lexapro!” and they said, “No, you're going to go home now. You're going to have more stress.”

I go home and I'm having less concerns or stigmas. I meet with my physician, they cut my dose in half, and no change. And then they eliminate my dosage and there was no change.

My anxiety was gone, but I still carried that.

While I was taking Lexapro, I don't think I could have sat down and told you that I was taking it. I didn't know if that was really appropriate for me to be taking medication.

That is the stigma I carried, until today.

Lydia: So you couldn't sit down and say you were taking antidepressants. What if someone came up to you and said they were taking antidepressants?

Jeff: My attitude is totally different today.

I think I would function the same today if I still had that anxiety. Through counseling and medication, my anxiety was under control.

I say there shouldn't be a stigma with this. You should do what is good for your health. That's where I have finally come around.

Why did it bother me so much? Why should it bother me so much? You know it really shouldn't have, and that was that stigma I carried on my own shoulders that I wouldn't put on anybody else.

I don't want to take any medication but I do want to live healthy, I want to be as active as I can be. I’ve got to wear compression socks, I’ve got to take Eliquis so I don’t get a blood clot, I’ve got to take my thyroid medication. It’s par for the course. This is me.

And if I was still taking Lexapro, this would be me, too. This is no different, it's just part of building my health, which can be physical health — which I deal with — and can also be mental health. It's just part of my health regiment.

Lydia: What steps have you taken to continue to make your mental wellbeing an overall priority in your life?

Jeff: I found that if I don't do certain things, I lose what little ability I have. One of the things is that I've got to get regular sleep. I've got to have proper nutrition. And I've got to exercise. Those are the things I have to.

But the other thing is I have to work on my depression. By that, I mean I have to make sure I'm doing some things for others.

I have to make sure I'm reflecting and thinking about things. What will my life be 10 years from now? What will I be doing and how will I know handle situations? How can I do this?

I have to admit, I am a control freak. I like to see what I'm doing and see a progression to the positive. Even though I realize that there's a one in a million chance I'm going to walk again, there was one million chance I was going to become a paraplegic from a mosquito bite.

I'll keep a good attitude and keep moving forward.