A Big Victory in Reversing U.S. Stigma

For a long time, people in the general populace have assumed that those plagued by mental illness are dangerous. That attitude has spilled out in books, movies, newspapers, ad nauseum. Almost nobody knew the long proven psychological fact that we are LESS likely to be violent.

Two things have happened which will go a long way to turning that around. On March 5 in a publication listed only as BMJ, a Swedish study conducted by a Stanford researcher, Casey Crump, cited proof that people who have or have had psychiatric disorders are in fact more likely to be victims of homicides rather than perpetrators - up to 5 times more likely! They used national registries to determine how many victims of homicide had been diagnosed with a mental illness and found the incidence was 23%, compared with a rate of 9% in the general population. A brief but clear article can be found in 'Time' at the following address: http://healthland.time.com/2013/03/07/mental-illness-increases-risk-of-being-homicide-victim/

Within days - apparently not as a result of this study, but through the efforts of California Mental Health Services Authority and the Entertainment Industries Council - the Associated Press  issued new guidelines for its AP Stylebook, which is hugely influential in the industry. The stylebook now says, in brief, that mental illness is not necessarily to be looked for or reported about in violent crimes unless it truly is a factor, which they have determined only from the proper sources. No more assuming, “This guy must be crazy,” and running off to look for proof. The press release can be found here: http://www.ap.org/Content/Press-Release/2013/Entry-on-mental-illness-is-added-to-AP-Stylebook. The National Association of Broadcasters has made a follow up statement which you can find here: http://www.nab.org/documents/newsRoom/pressRelease.asp?id=2886

The press release reads, in part, “Do not use derogatory terms, such as insane, crazy/crazed, nuts or deranged, unless they are part of a quotation that is essential to the story.
 
Do not assume that mental illness is a factor in a violent crime, and verify statements to that effect. A past history of mental illness is not necessarily a reliable indicator. Studies have shown that the vast majority of people with mental illness are not violent, and experts say most people who are violent do not suffer from mental illness.”

This is truly good news for the rest of us, and will doubtless lead, in the long run, to decreased fear and stigma about psychiatric disorders. There’s not a word I need to add to good news like this.

Deborah is the author of Is There Room for Me, Too? 12 Steps & 12 Strategies for Coping with Mental Illness, available at Amazon and other major vendors. Visit her web page at www.lafruche.net, or see her catalog at www.lastlaughproductions.net.

Something to Inspire

Folks, I am too overwhelmed with stuff to post a blog this week, but here is a wonderful video I found just today to inspire you about the possibilities of recovery. I'll try again next Monday.

The Outer Limits, Again

You and I both know this blog is a week late. I apologize. But I just had a little emotional breakdown, and I needed time to recover.

I’ve been intending to write a blog about learning your limits. Now is a good time, because I have just become a perfect object lesson. I ignored my own limits, and was within two minutes of calling the psych ward. When you ignore your limits as a mentally ill person, a breakdown is what you can expect.

Here is the lowdown, in case you don’t know. Many of us with psychiatric conditions are not symptomatic all the time. We have episodes: periods when we are more or less fine or functional, and periods when something goes haywire and we walk on the wild side. Some of these episodes are beyond our control: they seem to be chemical surges that medical science doesn’t understand yet. But those of us who have been at this game awhile have probably found that we have triggers, environmental phenomena that make us more unstable, more likely to have symptoms or episodes or psychosis, or relapse into whatever condition we carry.

These triggers tend to include anything that one would normally consider “stressful,” plus maybe a handful of things that don’t make sense at all. Take me, for instance. I do badly around noise, crowds, hurry, anything that involves multitasking (even listening to a conversation while the radio is playing), hunger, frustration, and of all things bright sunlight. I have no idea why. It could be a case of photo-sensitivity gone wrong. All I know is that if I walk around on a bright day without a hat or frequent retreats to the shade, I end up with irrational attacks of rage that ruin everybody’s day. I am also oversensitive to stimuli in general. If I don’t get some complete solitude and quiet every 24 hours, I start to fall apart within days. That’s just a sample list. Any other patient could have a different one.

When you know what your triggers are, you can work around them or avoid them. If you can’t avoid them, you can at least be aware that you are in the danger zone, and make arrangements to duck out if necessary. What happened last week was that I ignored my triggers for 3 days straight, 8 hours a day, thinking I could handle it. I ended up shaking and sobbing in an empty room, crying out, “There’s no safe place! There’s no safe place for me!” and wondering if I would ever stop feeling such terror, whether I would ever take a deep, calm breath again without sedation. I don’t know how long this went on. It felt like a long time. A few minutes more and I would have called some kind of emergency services. It’s called decompensating, and it’s not pretty. All the defenses you have built to protect you in the world come completely undone, you shatter, and the men in white coats come and take you away. I ignored my personal limits, and it happened to me. And I should have known better.

Respect your limits! This is how you stay out of the hospital. This is how you live a relatively normal life. When the pressure builds up inside you, back off. Whatever you’re doing, however important it seems, it is NOT more important than your sanity. The job can wait. The partner can wait. ANYTHING can wait, when your sanity is on the line. Anything or anyone who will not let you take care of your sanity first does not belong in your life. You are allowed to look stupid, you are allowed to act like a jerk, so long as you save your sanity. Really.

I know this, but somehow after decades of practice I forgot it. I won’t be doing that again any time soon.

Next blog, I’ll talk about some of the ways I learned to identify triggers. Anyone can do it with time and observation.

Deborah is the author of Is There Room for Me, Too? 12 Steps & 12 Strategies for Coping with Mental Illness, available at Amazon and other major vendors. Visit her web page at www.lafruche.net, or see her catalog at www.lastlaughproductions.net.

Robert’s Rules of Order

Humans are creatures of habit. Anybody who’s ever tried to give up coffee or nail-biting can tell you that. But it is even more important if you live with a serious psychiatric disorder.

Think about it: doesn’t being mentally ill inject chaos into your life? If you suddenly have to drop everything to go into the psych ward, it tends to disrupt things. If you’re steaming through your to-do list and you start hearing voices, you’re liable to be derailed. And if you have a stay-in-bed depression, not much of anything will get done. Mental illness imposes a persistent random quality on our routine.

Keeping things in order around you can help. I had this brought home to me recently. My study was being remodeled, and I fell apart.  The floor was torn up, the furniture was in the garage, and my books and papers were sprawled in anarchy all over the guest room. I couldn’t find anything, and most of the stuff I do all day every day was not really possible. Within a week I was lying on the couch in fetal position, wondering suspiciously why I even bothered to breathe.

It reminded me of a friend who killed himself a number of years ago. His mother died - something he had been expecting very calmly for years. He had to move, since without his mother’s social security he could not afford the rent on their house. This was also expected.  What was unexpected was the way he came completely to pieces. In the end, despite everything his friends or his therapist could do, he shot himself in the backyard.

At the time, I was confused by the whole thing. I think I understand better now. Yes, he had clinical depression, and that alone can be fatal. But he also had all his familiar landmarks taken away. His lifetime companion was gone, AND all his usual surroundings, belongings, and routines. Environment was of particular importance to Paul. He was Obsessive Compulsive with a hoarding instinct, and his 175 boxes of bric-a-brac were locked in someone’s garage where he could not see, touch or use them. He was lost in an alien country in the fog, and he couldn’t find his way.

Life is confusing. It’s wise for us to impose some kind of order in our lives. It could be organizing your belongings in a certain way. It could be doing two or three chores every day in the same order, or drinking out of a favorite cup. It could be taking a walk twice a week, or watching the news at the same time every night. Find something that comforts you, something that is dependable, even when the rest of your world is coming apart.

I’m not saying ‘never change things.’ But give yourself something to cling to, however small. It can literally save your life.






Deborah is the author of Is There Room for Me, Too? 12 Steps & 12 Strategies for Coping with Mental Illness, available at Amazon.com, Kindle Editions, iBookstore, and other major vendors. Visit her web page at www.lafruche.net, or see her catalog at www.lastlaughproductions.net.

Hope on the Horizon

I feel I can do no better service with this blog than to list the parts of Obama’s new 23-point plan, in response to the Newtown tragedy,  that apply to mental health. This information is copied directly from today’s newsletter from Jessica Cruz, the Executive Director of NAMI California. Thank you, Jessica!

The goals below are good news! When I was 13, I was bipolar and sometimes psychotic without knowing it. My parents, in their great wisdom, decided that therapy of any kind might “interfere with my religion,” so it was vetoed and I was never told  (I found this out 30 years later). And no one in the school system or anywhere else suggested that the extremely miserable depressed teenager with the strange disconnected emotional outbursts might need some help. I had to figure it all out for myself, 13 years later. Here’s to no one else having a story like that!

Deborah Fruchey

“ This morning, President Obama presented 23 executive actions related to both mental health and gun control...The plan includes the thrust of many of NAMI's recommendations that were offered to Vice President Biden's task force in the days immediately following the Newtown, Conn. tragedy.

Out of such tragedy, Americans today have an opportunity that we hope we will never face again. The mental health care system in the United States has long been broken. The challenge is not only to fix it, but to build parts anew, focusing on early screening, diagnosis, treatment and prevention...Below is an excerpt of the President's outlined plan that focuses specifically on Mental Health.

Excerpt from President Obama's 23-point Executive Order:

4. IMPROVING MENTAL HEALTH SERVICES

As President Obama said, "We are going to need to work on making access to mental health care as easy as access to a gun." Today, less half of children and adults with diagnosable mental health problems receive the treatment they need. While the vast majority of Americans with a mental illness are not violent, several recent mass shootings have highlighted how some cases of mental illness can develop into crisis situations if individuals do not receive proper treatment. We need to do more than just keep guns out of the hands of people with serious mental illness; we need to identify mental health issues early and help individuals get the treatment they need before these dangerous situations develop.
 
MAKE SURE STUDENTS AND YOUNG ADULTS GET TREATMENT FOR MENTAL HEALTH ISSUES:

Three-quarters of mental illnesses appear by the age of 24, yet less than half of children with diagnosable mental health problems receive treatment. And several recent mass shootings, including those at Newtown, Tucson, Aurora, and Virginia Tech, were perpetrated by students or other young people.

Reach 750,000 young people through programs to identify mental illness early and refer them to treatment: We need to train teachers and other adults who regularly interact with students to recognize young people who need help and ensure they are referred to mental health services. The Administration is calling for a new initiative, Project AWARE (Advancing Wellness and Resilience in Education), to provide this training and set up systems to provide these referrals. This initiative, which would reach 750,000 young people, has two parts:

Provide "Mental Health First Aid" training for teachers: Project AWARE includes $15 million for training for teachers and other adults who interact with youth to detect and respond to mental illness in children and young adults, including how to encourage adolescents and families experiencing these problems to seek treatment.
Make sure students with signs of mental illness get referred to treatment: Project AWARE also includes $40 million to help school districts work with law enforcement, mental health agencies, and other local organizations to assure students with mental health issues or other behavioral issues are referred to the services they need. This initiative builds on strategies that, for over a decade, have proven to decrease violence in schools and increase the number of students receiving mental health services.

Support individuals ages 16 to 25 at high risk for mental illness: Efforts to prevent school shootings and other gun violence can't end when a student leaves high school. Individuals ages 16 to 25 are at high risk for mental illness, substance abuse, and suicide, but they are among the least likely to seek help. Even those who received services as a child may fall through the cracks when they turn 18. The Administration is proposing $25 million for innovative state-based strategies supporting young people ages 16 to 25 with mental health or substance abuse issues.
Helping schools address pervasive violence: Twenty-two percent of 14 to 17 year olds have witnessed a shooting in their lifetime. Research shows that exposure to community violence can impact children's mental health and development and can substantially increase the likelihood that these children will later commit violent acts themselves. To help schools break the cycle of violence, Congress should provide $25 million to offer students mental health services for trauma or anxiety, conflict resolution programs, and other school-based violence prevention strategies.

Train more than 5,000 additional mental health professionals to serve students and young adults: Experts often cite the shortage of mental health service providers as one reason it can be hard to access treatment. To help fill this gap, the Administration is proposing $50 million to train social workers, counselors, psychologists, and other mental health professionals. This would provide stipends and tuition reimbursement to train more than 5,000 mental health professionals serving young people in our schools and communities.

Launch a national conversation to increase understanding about mental health: The sense of shame and secrecy associated with mental illness prevents too many people from seeking help. The President is directing Secretaries Sebelius and Duncan to launch a national dialogue about mental illness with young people who have experienced mental illness, members of the faith community, foundations, and school and business leaders.

ENSURE COVERAGE OF MENTAL HEALTH TREATMENT: While most mental illnesses are treatable, those with mental illness often can't get needed treatment if they don't have health insurance that covers mental health services. The Affordable Care Act will provide one of the largest expansions of mental health coverage in a generation by extending health coverage to 30 million Americans, including an estimated 6 to 10 million people with mental illness. The Affordable Care Act will also make sure that Americans can get the mental health treatment they need by ensuring that insurance plans cover mental health benefits at parity with other benefits.

Finalize requirements for private health insurance plans to cover mental health services: The Administration will issue final regulations governing how existing group health plans that offer mental health services must cover them at parity under the Mental Health Parity and Addiction Equity Act of 2008. In addition, the Affordable Care Act requires all new small group and individual plans to cover ten essential health benefit categories, including mental health and substance abuse services. The Administration intends to issue next month the final rule defining these essential health benefits and implementing requirements for these plans to cover mental health benefits at parity with medical and surgical benefits.

Make sure millions of Americans covered by Medicaid get quality mental health coverage: Medicaid is already the biggest funder of mental health services, and the Affordable Care Act will extend Medicaid coverage to as many as 17 million hardworking Americans. There is some evidence that Medicaid plans are not always meeting mental health parity requirements today, an issue that will only become more important as Medicaid is expanded. The Administration is issuing a letter to state health officials making clear that these plans must comply with mental health parity requirements.”



Bravo, Mr. President!

Just a Couple of Things

Firstly, I have 4 words to say about the Newton shootings: Mental Health Care Access.

There is something very wrong with a society where guns are so easy to get and mental health care is so hard.

If you want to fight for better access but don’t have the time or energy (or functionality), your easiest option is probably to join NAMI (Nationally Alliance for the Mentally Ill). They have got lots of members who are normies, some of them real powerhouses, and they DO have the energy to work on these issues. The dues are moderate (there is a deep discount for mental health care consumers), and they pay, among other things, for legislative battles to protect and help people like us. NAMI also has lots of free programs that you or maybe your family could use. Go to www.nami.org and look up your nearest branch.

Secondly, I have been hearing from mentally ill friends that they’d like to meditate but just can’t seem to do it. They can’t calm their thoughts or detach from them. I totally get that! But I’ve gotten a lot of relief this past year out of meditating; so here, if you want them, are my best tips.

Don’t try to ‘empty your mind.’ That is like trying NOT to think of pink elephants. Don’t try to separate from your thoughts and let them float on by, either. That is an advanced technique - and frankly, if we could do that, we  wouldn’t have a psychiatric condition.

All meditation requires is that you try to focus on ONE thing, to the exclusion of all else. So pick a really simple thing. It could be counting up to 10: 1 on the inhale, 2 on the exhale, and so forth. Start over when you get to 10. If you are highly visual, it could be staring at an interesting but basic object, like a seashell. Or if you’re tactile, you can lie down and put your hands on your belly and feel your breath rise and fall. Or feel your breath come into and out of your nostrils. These are just examples.

Set an alarm for 5 minutes, or whatever amount of time you’ve picked. You don’t want to be interrupting your meditation by checking the clock to see if your time is up yet.

Now. Once you start, concentrate ONLY on the simple focus you have chosen. Don’t change your mind and switch to something else, or get up to answer the door, or interrupt yourself in any other way. Try to have your whole mind, every bit of it, invested ONLY in your focal point. Try to have that be your complete existence till the alarm goes off. Whatever other thoughts come (and they will, by the hundreds), just say to yourself, “That’s not important right now. The ONLY thing that’s important is my counting” (my breathing, my seashell). Just go back to that over and over, no matter how many times you get sidetracked and no matter how urgent the thought is. You can get back to it later.

You see, your mind is not ‘empty,’ and it is not ‘detached.’ It is merely concentrated on one thing.

What this does is give you a wonderful break from all that yammering and worry in your head. Even if you only manage it for 30 seconds out of 10 minutes, it is a desperately needed rest. Even if that is all you ever get out of it, it’s a step toward mental health. And you did it all by yourself, without drugs.

I am a volatile bipolar gal who never does anything the same way twice, but I’ve kept this up nearly every day, over and over, for a year now. That bit of mental rest is sometimes the only sanity I get all day. For that reason alone, it’s worth it.

And there is always hope that one day my mind will learn to do this by itself.




Deborah is a public speaker and author of Is There Room for Me, Too? 12 Steps & 12 Strategies for Coping with Mental Illness, available at Amazon.com, Kindle Editions, iBookstore, and other major vendors. Visit her web page at www.lafruche.net, or see her catalog at www.lastlaughproductions.net. She has also narrated a meditation CD with her husband, musician Robert Hamaker, and sings on his latest CD, "The Colors of Sound." Check out sound samples at www.islandjourneyCD.com.

And Now for Something Completely Different...

I’ve just had a unique experience that I doubt science is equipped to explain. If you’re comfortable with spiritual ideas, it might sit better. Or maybe not...we'll see.

I went to Sedona, Arizona over Thanksgiving week. Heard of Sedona? It’s about a two hour drive south of the Grand Canyon, and nearly as awesome to look at. There are huge, shapely, gorgeous sedimentary rock bluffs that rise everywhere over the landscape, in a rich eye catching red color due to their high iron oxide content. Among New Agers and other spiritual seekers, Sedona is considered mystically significant. This is partly due to the energy anomalies that exist there, each one known as a “Vortex” (for some reason, maybe to distinguish them, they use the plural ‘Vortexes,’ not vortices). People pay sometimes hefty fees for vortex tours, or healing and meditative pilgrimages to them.

The first two times we went to Sedona, I thought this was a very woo-woo idea and did not bother going. But I have opened my mind to all kinds of things since my marriage seven years ago, and this time I gave them a try. I didn’t know if there was anything to the hype - or whether I would feel it, even if there were.

So here’s what happened. We got a vortex map from a local spiritual center. Then we hiked up the side of Bell Rock, the vortex closest to where we were staying. We looked for juniper trees with especially twisted branches, which the vortex energy is said to cause. My husband and I went about halfway up the rock, sat down in the scanty shade of one of these short trees, and sat quietly, taking in the spectacular view.

Did anything happen? Oh, yeah.

All the discord drained out of my head, all the noise, all the inner criticism and second guessing - really everything that makes it uncomfortable in there. I fell utterly silent inside, peaceful and positive and sure. I was not mentally ill. It went away, completely. It was an amazing sensation. But - just a peak moment, right? Nice vacation, great view, my love at my side, who wouldn’t feel good?

Here’s the kicker: it lasted for two weeks.

No inner voices, no symptoms, no negative thoughts, no nothing. Absolute remission for half a month. Even on the marathon drive back to California, in a big awkward van that usually frightens me to death, I was calm and happy and relaxed. I drove for hours longer than I am usually able to and felt no strain. The interesting thing is that this state of consciousness involved no effort and no thought. In fact, I did remarkably little thinking. I was perfectly aware and alert, I played with concepts, I had conversations. But I did not often have words in my head. Eckhart Tolle claims that thinking is not usually necessary. You know what? He may be right. I didn’t need thought very often, and I still got plenty of things done. Life was so frigging easy!

My peace and sanity lasted until the first time I listened to someone complain at length about a bad Thanksgiving experience. It was as if their unhappy, uneasy voice had waked up my own. It started to mutter. And after that, despite everything I could do, that voice grew and grew. A week later I realized my beautiful peace was all gone, and I sobbed. I was unstable again, and life was hard. Just like always.

So is that the end of that? Not exactly. It’s a little like the first time I took medications that cleared my thinking. Now I know what it FEELS like to be sane. If you know what you’re shooting for, you have some chance of getting there. Until you have a target, you can’t even aim. And now I know I am capable of absolute inner peace.

What else can I do that I don’t even think is possible?

I don’t know what’s going on at those spots in Sedona. I don’t have to know. All I need to know is that sanity is possible. Even for me. For now, that’s enough to go on with.

Deborah is a public speaker and the author of Is There Room for Me, Too? 12 Steps & 12 Strategies for Coping with Mental Illness, available at Amazon.com, Kindle Editions, iBookstore, and other major vendors. Visit her web page at www.lafruche.net, or see her catalog at www.lastlaughproductions.net. She has also narrated a guided meditation CD with her husband, musician Robert Hamaker. Check out sound samples at www.islandjourneyCD.com.