Showing posts with label mental illness. Show all posts
Showing posts with label mental illness. Show all posts

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The Power of Words: Addressing the Stigma of Mental Illness


Jenna Bowen, medical student, University of Wisconsin


Reviewed by Claudia Reardon, MD







Crazy.  Insane.  Deranged. Mad.  Lunatic. —Misused as nouns, adjectives and
lay-diagnoses, their use perpetuates stereotypes of the wide variety of people
who experience mental illness.


Maybe you know someone or, more likely, a number of people who
experience depression, anxiety, bipolar disorder or other brain disorders.  According to the National Institute of Mental
Health, 1 in 4 American adults and 1 in 5 American youth experience a form of
mental illness every year. People with mental illness are teachers, accountants,
neighbors, sisters, fathers and friends. Anyone you know could be experiencing
mental illness, but afraid to come forward and be treated. Maybe that person is
you.


People living with mental illness continue to have an identity
that is beyond a diagnosis, similar to other medical conditions. While managing
mental illness may be challenging at times—similar to challenges faced by
people with diabetes, high blood pressure, or other medical illness— there is
greater difficulty in getting the treatment needed because of feelings of shame
and stigma surrounding mental illness. However, treatment for mental illness
works. Research shows the majority (65 percent to 80 percent) of individuals
with mental disorders will improve with appropriate treatment and ongoing
monitoring. People with mental illness need to know that they will continue
to be seen as people – your brother, best friend, daughter —and not “crazed” or
“insane” if they appropriately seek help for a treatable medical condition that
they happen to be experiencing.



Bring Change 2 Mind, an organization aimed to end stigma and
discrimination surrounding mental illness, offers recommendations to reduce
your impact on the stigma surrounding those with mental illness.




  • Use "person first" vocabulary. When we say a person is
    schizophrenic, we make their mental illness fully define their identity.
    Instead, be clear that this is a disease that individuals manage and live with—
    "He is living with schizophrenia."

  • Avoid the verb "suffers" when discussing mental illness.
    Instead, choose, "lives with mental illness" or "is affected by
    mental illness."

  • There are many phrases and terms; "crazy,"
    "nuts", "psycho", "schizo", "retard"
    and "lunatic" that may seem insignificant, but really aren't.





Be an advocate for those that you know, and the many that you
don’t know, who are living with some form of mental illness by breaking down stigma,
and being conscious of language surrounding brain disorders. To learn more check
out:


·        
Bring
Change 2 Mind


·        
NAMI
– Stigma Busters


·        
Resource Center to Promote Acceptance, Dignity and
 Social Inclusion Associated with Mental Health (SAMHSA)


·        
Mental
Health Terminology:  Words Matter






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Spreading Hope!

By Matt Goldenberg
D.O.

@docgoldenberg 

“You treat a disease, you win, you lose. You treat a person,
I guarantee you, you'll win, no matter what the outcome.” 






I whole-heartedly agree with that statement. However, I
cannot take credit for those words. Those are the words of Robin Williams, or
more specifically, the words of his character in Patch Adams.



I want to discuss the disease called depression. I will start by first
discussing the diagnosis and the signs and symptoms of depression. I will then
follow up with my thoughts on the various treatment options for depression and
the strategies I employ with my patients to improve their outcomes. None of my
thoughts and suggestions should serve in place of a formal consultation with a
mental healthcare provider. However, I hope shedding light on mental health
diagnoses like depression will lift the veil and social stigma on these chronic
diseases that impact so many people.



Psychiatry has come a long way in the last decade. This is a time of continued
discovery and increasing public awareness. The leaders of our professional
organization, the American Psychiatric Association (APA), have suggested that we
as mental health professionals are under a microscope. I agree that we are
and I also strongly believe that we are up for the challenge. School shootings
and celebrity suicides and overdoses have increasingly put a focus on mental
health. Psychiatry has significantly improved the outcomes, treatment options
and the prognosis of patients with mental illness. However, we still are unable
to decrease the prevalence of the diseases we treat or prevent them. We know that
the brain changes during an episode of depression and our treatments help it to
return to normal (see the image below). Although we are getting closer, we
still currently do not have widely accessible blood or imaging tests that can
confirm our diagnosis or localize the area of disease.




I can say with certainty, however, we are able to accurately
diagnose patients. We are able to identify medications, psychotherapies and
other treatments that patients with a specific diagnosis or cluster of signs and
symptoms often benefit from. There is strong evidence that our treatments
decrease symptomatology and disability and improve quality of life, clinical
outcomes and a patient’s prognosis.



Psychiatrists are trained to view the patient as a “whole person”. Psychiatry
is a field of medicine whose assessment by definition includes all of the
biological, psychological and social aspects of a patient’s life. We listen for
the psychological and social factors that can contribute to disease.
Oftentimes, the “whole story” can be more telling than only focusing on
specific symptoms of a given disease. There is a saying, throughout all fields
of medicine, that “most patients have not read the textbook.” In other words,
patients usually do not present exactly as the textbook says they should.
Stress and psychological factors can mimic chest pain, shortness of breath,
gastrointestinal problems and a whole host of other diseases. If we do not step
back and get the whole story, we can miss the root cause or the exacerbating
factors of many manageable diseases which are of the mind.



Many of the diseases we treat, such as depression, are chronic illnesses which
require lifelong treatment. Our treatments can improve a patient’s mental
health and coping skills and decrease their symptomatology and substance use.
We know through decades of research that these are modifiable risk factors for
suicide. Therefore, Psychiatrists have the training and tools necessary to
decrease a patient’s risk of attempting suicide. Our treatments have the
potential to not only significantly improve the lives of our patients, but also
the lives of their families and everyone who comes into contact with them.
Anyone who tells you otherwise is misleading, misinformed or both.





I
hope this information and the blogs to follow will give you hope. Mental
illness can include symptoms which can be devastating and complications which
can be life-threatening.
However, it is important to state again, these are treatable diseases. If you
or someone you know, would like to talk to someone, call your primary care
doctor or your insurance company for a referral to a Psychiatrist. A true
multi-disciplinary team also includes therapists, psychologists, nurses and
social workers. You are never alone. You can call the national suicide helpline
24 hours a day, seven days a week (1-800-273-TALK (8255) or visit www.suicidepreventionlifeline.org).
There are also local crisis lines likely available in your area and are an
internet search away. If you are ever feeling unsafe, or fearing for the safety
of a loved one, you can call 911 or go to the nearest emergency department.


It is time for everyone to understand that there is no shame in getting help
for depression, much as there is no shame in getting help with diabetes or high
cholesterol. Even if you have never suffered from depression, there is
a lot you can learn.








Together we can raise awareness and spread truth and hope. I know that if we
spread knowledge, and ignore the misinformation, we will overcome the
complacency and ignorance that is so pervasive today. That is how we can best
honor those we have lost. That is how we can best prevent the next death from
mental illness and addiction.





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Demystifying Schizophrenia

By Walker B. Shapiro, Medical Student

Reviewed by Claudia L. Reardon, M.D.





You have probably heard of schizophrenia - in newspapers, books, movies, and TV shows; you or somebody you know may be affected with this mental illness. Nonetheless, confusion about schizophrenia is common. This post provides some basic facts about schizophrenia, including common symptoms and available treatments. Schizophrenia is a chronic, treatable brain disease that affects an individual’s thought patterns, behavior, and perceptions of reality.





Some general facts about schizophrenia:

Affects more than 1% of the population with similar rates around the world

Affects men and women with similar frequency

Symptoms usually start between ages 16-30

Most people with schizophrenia are not dangerous or violent






The symptoms of schizophrenia vary greatly between individuals. They can also change and get better or worse over time. Some of the most common symptoms are listed below:



  • Hallucinations – hearing voices is common



  • Delusions – fixed belief in something untrue or impossible



  • Paranoia – unhealthy or unfounded suspicion



  • Disorganized thoughts – may go on tangents or not make sense when speaking



  • Loss of interest or motivation – may not enjoy daily activities or social interaction




Schizophrenia is a serious chronic disease, but treatment is available to help people get back to thinking clearly and leading full lives. The most important treatment elements include:



  • Medications (‘antipsychotics’) – help restore and maintain normal, healthy thought patterns



  • Therapy and rehabilitation – help cope with stress and return to work, school, independent living, and social interaction




If you are concerned that somebody you know might be suffering from schizophrenia, encourage them to see a doctor for evaluation.


Find more facts on schizophrenia at www.psychiatry.org/schizophrenia.


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Lessons Learned in the Wake of Tragedy

By Gina Newsome Duncan, M.D.





Dr. Molly McVoy recently blogged about the horrific shootings of Representative Gabrielle Giffords and others on Saturday, January 8, 2011. This tragic incident has sparked widespread national debate about all aspects of the case, including mental health treatment in this country and links between violence and mental illness.



The fact is that most people with mental illness are not violent, and that violence is most often caused by those who are not mentally ill. However, this incident does provide an opportunity for us as a nation, to seriously consider the state of our mental health services. If we examine it carefully, we can possibly prevent further acts of violence, and also think about how we help those who are in need of mental health treatment.



It is an unfortunate reality that mental illness remains largely shrouded in stigma, and tragic events such as this often help to only deepen that stigma in the minds of the public. As a result of this stigma, many people live with unnecessary shame and suffering, not seeking the help that they need. Most often, the primary victim is the person living with the illness, and by extension, their loved ones. Very rarely, however, untreated illness can lead to tragic consequences that reach far beyond the person with the illness and his or her family.



Like physical illness, mental illness has the best outcome when recognized and treated early. We should let this tragedy be a call to become more proactive in addressing issues of mental illness in our communities.





There are several important steps that can be taken:



1) As a public, we can become more informed about the signs, symptoms and treatment of mental illness.



2) We can all work to  destigmatize mental illness. The American Psychiatric Association’s Council on Communications is actively involved using this blog and with other activities.



3) Educate yourself on how mental health is funded in your community and let your vote count when issues of mental health funding are on the ballot.





It is true that there are rare situations in which a person with a severe mental illness may become violent. In most cases, this violence will be self-directed in the form of suicidal acts, but in rare instances, it may be directed toward others as well. What can be done in those situations?



1) If you are personally experiencing a mental illness and are having thoughts of harming yourself or others, it is important that you seek help from a doctor, therapist, or 911 immediately.



2) If you are the friend or family member of a person experiencing a severe mental illness and you are concerned due to actions or statements they have made that they may be a danger to themselves or others, it is important that you seek help from a doctor, therapist, or by calling 911 immediately.



a. Be as detailed about your concerns as possible.



b. Do not let your concern go unheard, put it in writing.



c. Firearms and weapons should be kept sealed and locked, or ideally, removed from the home.



d. Unfortunately, many communities do not have adequate crisis prevention resources. Familiarize yourself with the procedures your community does have for involuntary hospitalization. You can get this information by calling your local health department, hospital department of psychiatry, emergency room, community mental health center, family physician, or police department.

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Bipolar in kids? Probably not.

By Scott Benson, M.D.



The 5-year-old little girl had been referred to a therapist by her school because of her severe disruptive behavior. The almost daily tantrums had everyone concerned. She was uncooperative with the assessment and arrangements made for further evaluation. The therapist wrote a diagnosis of bipolar disorder.



The patient was certainly reactive to any limits and her tantrums seemed like they would never end. But she slept well at night; she rarely had behavior problems with her grandparents who provided afterschool care.


After a few parent training sessions with the little girl and her parents her behavior control improved. But continued treatment was threatened when her dad tried to get her on his new health insurance. The diagnosis of bipolar got the application bumped by the computer and it took a lot of calls and several letters to get her on the policy so that her treatment could continue.


At times it seems we are a little too quick to throw a label on a child’s behavior, and bipolar disorder seems to be the most popular current label.


But new research at the October meeting of the American Academy of Child and Adolescent Psychiatry found that children with some symptoms of mania probably do not have bipolar disorder.


Boris Birmaher, M.D., a child and adolescent psychiatrist at the University of Pittsburgh presented his group’s research. More than 2,000 children presenting to 10 different academic centers were included in the Longitudinal Assessment of Manic Symptoms (LAMS) study. 621 were found to have elevated symptoms of mania, but the full evaluation did not find sufficient symptoms for a diagnosis of bipolar disorder. Most had attention deficit hyperactivity disorder (ADHD), others had another disruptive behavior disorder. Children who did have bipolar disorder have poor function and are likely to require treatment in hospitals.


"Kids with manic symptoms don't necessarily have bipolar disorder," he told Reuters Health. On the other hand, "Many children with bipolar disorder are not being correctly diagnosed."


The LAMS study which will follow these children for five years should provide direction for the assessment and treatment of children with severe behavior problems. In the mean time parents should insist on an adequate evaluation for children with severe behaviors.


The Parents' Medication Guide for Bipolar Disorder in Children & Adolescents is a great source of information for understanding the evaluation process and treatment options. Or visit HealthyMinds.org for more information on bipolar disorder or mental health issues in children.

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National Family Caregivers Month

By Gariane Gunter, M.D.



November is National Family Caregivers Month and what a worthy group to stop and recognize. Those who are caregivers for family members or friends with mental illnesses need support and encouragement just as those caring for loved ones with other illnesses. There are many groups and resources available across the nation that are available to help. I would like to tell you about one of them.



The National Alliance on Mental Illness is a grassroots organization that was started in 1979. I have had the wonderful opportunity to work with them in my area and have seen firsthand the difference they make in the lives of those suffering from mental illnesses as well as their families. One special program they offer for family members is called Family-to-Family. The NAMI Family-to-Family Education Program is a free 12-week course for family caregivers of individuals with severe brain disorders (mental illnesses). NAMI recognizes that family members of people with serious mental illnesses need information and support to cope with the considerable stresses they experience.



The Family to Family Education Program is a structured, peer-led, 12-week information and support self-help class for such individuals. Research shows reduced subjective burden and increased empowerment among graduates. Family-to-Family classes are offered in hundreds of communities across the country. You can find more information on this program as well as many other resources available in your area by visiting NAMI online at www.nami.org. There you can find a support group, connect online in NAMI's discussion groups, contact your state or local NAMI and more. Caregivers please take the time to take care of you this month.

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It's Not Your Fault

Healthy Minds. Healthy Lives. blogger Gariane Phillips Gunter, MD, talks about how individuals with mental illnesses cannot be blamed for mental illness and how to get help for someone struggling with mental health issues.



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How to Help Someone Who Refuses Help for a Mental Illness: Tips for Family Members and Friends

By Molly McVoy, M.D.



What do I do if my husband won’t listen to me? My mom? My friend? My daughter? I hear this question all the time. Someone recognizes the possibility of depression, anxiety, ADHD in a friend or relative, but the other person just doesn’t see it. They refuse to go see someone for help. What do you do?



You keep talking to them. It is quite common for individuals to be unaware of a mental health problem they may have or to actively deny that such a problem exists. Sometimes it takes hearing it for the tenth or even the 100th time before someone listens and seeks care. Even though you may feel you’re not being heard, you may be the one person who’s willing to plant the seed and start that person thinking about getting help.



Finally, you’re not alone. If you are worried someone in your family or group of friends is seriously ill, at risk of hurting themselves or hurting someone else, call for help. Most cities in the United States have a 24 hour suicide hotline, and nationally, you can call 1-800-suicide. There are people trained to help you with this, even if your friend or family member won’t call, you can and start the journey towards mental health.





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Getting Help: How to Start the Conversation and Find Professional Services

By Felicia Wong, M.D.



Many people don’t seek mental health care when they need it. This is particularly true for members of ethnic minorities, for whom physical illness is often considered more culturally acceptable than mental illness. Research has shown, for example, that Asian Americans are three times less likely than members of other ethnic groups to seek mental health services. This has more to do with lack of appropriate services, and barriers to services—including stigma, language and cultural differences—rather than the lack of need for services.
The important thing to remember is that with proper treatment, most symptoms of mental illness can be controlled. If the possibility of mental illness is a concern for you or someone you care about, please recognize there is no shame in seeking treatment and/or help.


Over the years, many people have asked me how to get help for themselves, a family member or a friend who is suffering. Navigating the mental health system is not easy, and the stigma and shame associated with mental illness make it even more difficult. Where someone may find it easy to ask a friend to recommend a family doctor or a dentist, people sometimes hesitate to ask about psychiatrists or therapists due to fears of being judged, or perhaps appearing "emotionally weak".


There are many places to go for help. A good place to start is by asking your family doctor or primary care doctor. In a crisis, emergency rooms can provide temporary relief for you or a loved one, and emergency room personnel may be able to guide you to further help.



Other potential resources include:
  • mental health specialists such as psychiatrists, psychologists, social workers or mental health counselors;

  • community mental health centers;

  • hospital psychiatry departments, outpatient clinics and/or inpatient units;

  • family services, social agencies, or clergy;

  • peer support groups;

  • private clinics and facilities;

  • employee assistance program; or

  • the phone book or web - search "mental health," "health," "social services," "hotlines," or "physicians" for phone numbers and addresses.





For more information on how to find and choose a psychiatrist and what to expect in treatment, read about Choosing a Psychiatrist on Healthyminds.org,




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An Ounce of Prevention is Worth a Pound of Cure in Mental Health Treatment



By Roberto Blanco



Benjamin Franklin’s quote, “an ounce of prevention is worth a pound of cure,” can be applied to many arenas of life. From my experience in the mental health system, I believe that it is also quite an appropriate saying for mental health.



I work at a local crisis and assessment center in North Carolina and see many patients who come in with psychiatric emergencies. For a variety of reasons, a lot of these patients arrive in a dangerous state or have substance abuse problems that are out of control. They are in crisis and often need immediate action in order to assure their safety.





While many crises are an unfortunate result of untreated mental illness or painful circumstances, it is hard to ignore the great number of crises that could have been averted with some preventative mental hygiene. Many people become sick because they aren’t doing things that can keep them out of hospitals such as taking medicine regularly, going to therapy, or getting support from friends, family or community centers.



Just as you would not want to meet with your financial counselor to plan out retirement the day before you retire, you should be taking regular, proactive steps to take good care of your mental health before a crisis is at hand or, ideally, in order to prevent a crisis.



Here are some things you or your loved ones can do to help prevent mental health crises:



1. Engage in regularly scheduled therapy sessions.



2. Attend psychiatric appointments regularly and take medications as prescribed.



3. Create a Crisis Plan (a plan to follow in case of an emergency). These plans should include techniques to try to calm the situation (i.e. going for walks, deep breathing exercises, or listening to music are some favorites) along with the names and phone numbers of close supports, on-call mental health professionals, and emergency agencies. Keep this plan close at hand at all times.



4. If a significant portion of the problem is with a close relationship, consider going to family or couples counseling.



5. If you are running out of medication, call for refills at least 3-4 business days (7-9 business days for controlled substances or stimulants) before you will be out of medicine. This will assure that your doctor can supply you with the appropriate refill of medication in time.



6. Engage in regular, renewing self-care activities such as exercise, sleep, and fulfilling hobbies. Lack of sleep is often a cause and symptom of most mental illnesses.



7. Educate and advocate for yourself and your family. Learn as much as you can from many different perspectives about your illness. The National Institute of Mental Health has patient information available on a variety of diagnoses and topics. In addition, our very own APA Healthy Minds site has useful information on a variety of topics. Consider joining the National Alliance on Mental Illness and find your local chapter meeting location and time for support from other mental health consumers and families.

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This one is for my mother

By Gariane Phillips Gunter, M.D.



During my year as Mrs. United States and daily as a psychiatrist I am fighting to eliminate the negative stigma of mental illness. The presence of mental illness has been very real to me since I was a child. After many years or suffering without a clear cause, my mother was diagnosed with Bipolar disorder when I was in elementary school. Frequent hospitalizations, medication adjustments, ECT were part of a typical day in our household. Nevertheless, my mom is my mom, not “crazy”, “psycho” or a “freak”.



As an adult and now as a psychiatrist, the presence of stigma toward those suffering from a mental illness has become very evident to me. I believe that the source of much of this misperception is from a lack of understanding not a lack of compassion. Many people still do not know that mental illnesses are true biological illness similar to diabetes or hypertension.



They don’t understand that they are brain diseases, not character flaws. Having a mental illness does not mean that you are stupid, lazy, worthless or incompetent. You don’t develop a mental illness because you did something wrong or because you are a “bad” person. It is not your fault.



For you that are struggling with a mental illness, or have a family member who is, you are likely all too familiar with the devastating effects of stigma in your own life. Let us all work together to teach the truth about mental illnesses, as education is our most powerful weapon in the fight against stigma.



……………Be The Change You Hope To See In This World















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