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"My Nerves Are Bad"

Puerto Rican Women Managing Mental Illness and HIV Risk

Sana Loue

Publication Year: 2011

Over a two-year period, the author and her research team followed the lives of fifty-three Puerto Rican women living with severe mental illness as they coped with daily challenges in the areas of family, romantic relationships, employment, social services, substance use, and health care. The team interviewed the women and shadowed them at their homes, churches, schools, physicians’ offices, family events, and other occasions in order to understand how their mental illness, their gender, their language, and their culture affected their relationships with others, their understandings of their own situations, and their hopes for themselves and their families. Sana Loue lets us see the remarkable strength of many of the women and hear in their own words about their efforts to survive, despite long histories of childhood physical and sexual abuse, partner violence, substance use, poverty, and severe mental illness. We also witness the violence that surrounds them and the HIV risk that becomes a part of their lives in their efforts to survive economically and emotionally.

Published by: Vanderbilt University Press

Title Page

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Table of Contents

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List of Tables

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pp. ix-

Acknowledgments

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pp. xi-xiii

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1. Beyond Numbers: Faces of HIV and Mental Illness in Northeastern Ohio's Latino Communities

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pp. 1-18

Katia was moving yet again. Born in Puerto Rico, she had come to the U.S. mainland while still a girl. She moved frequently within the city of Cleveland, essentially “couch surfing” from the home of one friend or sexual partner to another, attempting to put a roof over her head on the many nights when she did not have one of her own. ...

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2. Living with Mental Illness

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pp. 19-41

Living with a mental illness is often fraught with difficulties and peril. First there is the period of time when a person doesn’t know that she has a mental illness, but people around her wonder why she is behaving strangely, or maybe she knows that something is wrong but can’t quite figure out what it is. So she goes to a doctor to find out what is bothering ...

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3. Making Ends Meet

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pp. 43-60

Yadra had been able to secure employment despite her diagnoses of major depression, posttraumatic stress disorder, and agoraphobia. She had “beaten the odds,” so to speak, unlike the 75 to 85 percent of people in the United States with a severe mental illness who are unable to find work1 because of their illness symptoms, the side effects of their medication, stigma, discrimination, and employer attitudes toward and expectations of mentally ill people.2 ...

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4. Love Is a Four-Letter Word

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pp. 61-76

Being loved and being able to love are fundamental to human existence and emotional growth.1 All of the women had been involved in a number of romantic or sexual relationships before we came to know them, and many were involved with one or more partners during the course of the study. ...

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5. Critical Others

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pp. 77-94

It is not difficult to understand why so many of the women experienced conflict and even violence in their romantic relationships. Many of them had experienced instability and trauma as children, and, as is common in such circumstances, these factors had led to their development of a poor self-concept, extraordinarily low self-esteem, and a distortion in their construction of relational schemas.1 ...

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6. Motherhood

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pp. 95-110

Among women with severe mental illness, motherhood may fulfill a particularly important role in their lives, serving as an affirmation of their importance and providing a mechanism for the expression of feeling and the fulfillment of an important social role.1 This is not surprising, since parenthood provides many individuals with a way to demonstrate creativity and nurturing.2 ...

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7. Adrift: Navigating Systems and Bureaucracies

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pp. 111-131

Numerous reports have documented alarming deficiencies in the availability and provision of mental health services to those in need of them. As an example, among individuals with depressive disorders who are seen in general medical practices nationally, only about 50 percent are actually recognized by their providers as being depressed, and only one-half of them receive appropriate treatment; this means that 75 percent receive either no care or inadequate care.1 ...

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8. Negotiating Risk

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pp. 133-153

We have known for some time now the behaviors that can expose an individual to risk of contracting HIV infection: unprotected intercourse with an infected partner, sharing injection equipment with an infected individual, and transmission from mother to child through the labor and delivery process or breastfeeding. ...

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9. Power, Processes, and Agency

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pp. 155-162

Blame is often camouflaged in the language of responsibility. Individuals are responsible for their own poverty; it results from a lack of motivation and industry. Their ill health results from a refusal to take responsibility for their own unhealthy behaviors: smoking, drinking, drug use, overeating. ...

Notes

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pp. 163-176

References

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pp. 177-208

Index

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pp. 209-216


E-ISBN-13: 9780826517555
Print-ISBN-13: 9780826517531

Page Count: 240
Publication Year: 2011