Hope

Mental illness can be a pretty grim topic.  Millions of people psychologically suffering, their families suffering, with no good explanations of the causes or means of prevention or even treatments that work, in some cases.  Prejudice, embarrassment, and fear abound.  So how could there possibly be hope?

Well, take schizophrenia.  Traditionally, 10-20% of patients were expected to recover at all.  Now, it’s been shown that up to 68% of people with schizophrenia are likely to eventually be able to function fully with the right treatment strategies.  When the method is “self-sufficiency, rehabilitation and community integration,” there’s a far greater chance of success.  Of course, this isn’t believed by all or even most psychiatric professionals, but such models of hope are growing gradually in popularity.

A new “Recovery Model” is gaining momentum in the field as a whole – less is mental illness seen as something to permanently medicate and hide.  More is it viewed as something to recover from, slowly and perhaps with setbacks, but ultimately with forward progression, optimism, and persistence.  More, now, do people see that while mental illness has lasting effects, individuals can still have meaningful, worthwhile lives.

So, do you think this new recovery model is plausible and feasible, or is it excessively optimistic and naive?

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Posted in For the Family, For the Mentally Ill | 8 Comments

“Your father is just … ill.”

What if a parent has the mental illness?  There are risks for the kids.  Genetically, they’re predisposed towards certain diseases too, and I personally can testify of some of the problems for children with a mentally ill parent – the stress of trying to please them but not knowing how or being able to, the uncertainty of how they’ll respond to random things, the worry about younger siblings and other family members, the frustration with their demands and illogical thoughts.  And lots of my friends, and strangers as well, have had it unimaginably worse than I have.

However, there are a few ways to ensure the best life possible for a child in these sorts of difficult circumstances.  Here’s a list from the American Academy of Child & Adolescent Psychiatry:

Where possible, help the child to have:

  • Knowledge that their parent(s) is ill and that they are not to blame
  • Help and support from family members
  • A stable home environment
  • Psychotherapy for the child and the parent(s)
  • A sense of being loved by the ill parent
  • A naturally stable personality in the child
  • Positive self esteem
  • Inner strength and good coping skills in the child
  • A strong relationship with a healthy adult
  • Friendships, positive peer relationships
  • Interest in and success at school
  • Healthy interests outside the home for the child
  • Help from outside the family to improve the family environment (for example, marital psychotherapy or parenting classes)

An interesting ethical question, then…  Should people who have mental illnesses have children?  Some who themselves have psychiatric disorders say they don’t want to, for fear of their offspring inheriting their problems.  Does that outweigh the benefits of children being brought into the world?

Posted in For the Family | 8 Comments

Torture to Treatment

This is the history of electroconvulsive therapy (ECT).  Have you read “One Flew Over the Cuckoo’s Nest?”  There are a lot of scary associations of ECT with strange, painful techniques, and even in modern times fears about the treatment remain.  However, it’s thankfully painless and much safer now, and has even been studied and found the most effective treatment for major depression.  It’s especially great for people who can’t take antidepressants or need immediate results to prevent suicide.

Here’s what happens, in the words of Mental Health America:

ECT treatment is generally administered in the morning, before breakfast.  Prior to the actual treatment, the patient is given general anesthesia and a muscle relaxant.  Electrodes are then attached to the patients scalp and an electric current is applied which causes a brief convulsion.  Minutes later, the patient awakens confused and without memory of events surrounding the treatment.  This treatment is usually repeated three times a week for approximately one month.  The number of treatments varies from six to twelve.  It is often recommended that the patient maintain a regimen of medication, after the ECT treatments, to reduce the chance of relapse.

There are risks – incompetent practitioners, long-term memory loss, post-treatment confusion, and cardiac issues in the elderly are things to potentially worry about.  So, knowing the risks and benefits, do you think ECT is a good treatment option for people with mental disorders?

Posted in Disorders Described, For the Family, For the Mentally Ill | 5 Comments

Psychotherapy

Psychotherapy:  To summarize MayoClinic, it’s defined as talking with a trained therapist to understand yourself and take control of your life.  It can be helpful for those with a wide range of mental disorders, as well as those who simply have stress and conflict in daily living.  A study by Consumer Reports said that long-term psychotherapy could be at least as effective as medication in some cases, but I’ve heard a lot of people call it fake, fraudulent, pointless. For people who really aren’t motivated to change their thoughts, it’s certainly difficult for therapists to help.  And sometimes prescription drugs or other treatment options are truly necessary for mental illness management.

Either way, family involvement in integral to success.  If the family is encouraging, willing to believe that therapy can help, the patient often feels more optimistic about treatment.  In my own experience, I was quite dubious about the value of talking with a psychiatrist.  The combination of the stigma (see prior post), lack of obvious science behind it, fear of insurance not covering it, and my father’s disdain for it really made me want to avoid the ordeal altogether.  And yes, it was awkward and emotionally draining sometimes, and didn’t always seem to be helping at all, but with my mom’s support and the confidentiality so diligently provided, I think it was worthwhile, to a degree.  It forced me to analyze irrational thoughts, reconsider actions that made no sense, and take an honest, in-depth look at my motives, things I wouldn’t have done by myself.  Admittedly, there were a lot of other factors at work, but it did have an effect on my recovery.

Have you benefited from some form of psychotherapy?  Or have you found it worthless, or even counterproductive?   What do you think?

Posted in For the Family, Uncategorized | 4 Comments

Kids: Overweight, Overstressed

A survey by the APA shows that children who are overweight are more stressed than kids of normal weight.

For instance, while 31% of overweight children reported worrying about their lives, only 14% of their healthy weighted counterparts did the same. When researchers asked about specific symptoms of stress and depression, the rates of positive responses in overweight children went up and stayed higher than in normal-weight kids: overweight children were more likely than children of healthy weight to have trouble sleeping at night (48% vs. 33%), feel angry or get into fights (22% vs. 13%), experience headaches (43% vs. 28%) or feel listless and like they didn’t want to do anything (34% vs. 21%). Further, children who believed they were overweight were more likely to report a parent who was “always” or often stressed out in the past month (39% vs. 30%).
It hasn’t been proven to be a cause-and-effect relationship – that kids are stressed BECAUSE they’re overweight, or vice versa, but the two are related.  Interestingly, those overweight children are more likely to try to relieve stress via sedentary measures like reading or playing video games, where in families with fit kids and parents, there’s more physical activity going on.
Perhaps both problems can be helped with exercise, then!  The Mayo Clinic advocates exercise for stress relief – they recommend finding fun activities you enjoy and doing them regularly, especially with other people.  This would indeed seem to alleviate a lot of the issues that have been discussed here, and many more that haven’t been:  physical activity is helpful for weight and stress control, and introducing a social component can be really good for children who may be teased or ostracized because of their weight.
What do you think?  Is exercise the answer?   How can families best address the problem of stress in overweight kids?  What other contributing factors are at work in this relationship?
Posted in For the Family, Uncategorized | 16 Comments

Depression: Man vs. Woman

Women seem more prone to anxiety/depression than men – even just the comments on previous comments on this blog show some of that.  But is that just another stereotype?

A study published June 2010 says there could be real truth behind that perception, and gives some reasons why there are twice as many women than men with depression. Corticotropin releasing factor (CRF) is a hormone and neurotransmitter.  When stressed, it sends signals to an alert center in the brain that boosts emotional arousal, which can be helpful short-term, but is a signature of depression over the long run.  The alarm system in females is more sensitive – when tested in rats, males barely noticed levels of CRF that shot off the alarm system in females, and the CRF stayed longer on the surface of neurons, making it effective longer.  If it stays effective long enough and becomes a chronic condition, the brain can become unable to cope with high levels of CRF, which is what happens in depression and post-traumatic stress disorder.

However, while it’s true that women are diagnosed with depression more, they also seek help more.   In one year, 75% of the people who sought treatment were female, and 75% of the people who committed suicide were male.  Why?  Well, men show different symptoms of depression than women, and their symptoms aren’t always those on traditional depression diagnostic tests.    Here’s part of what healthyplace.com has to say:

Men at risk for depression and/or suicide include those who are feeling like they aren’t measuring up any more, who feel physically weaker, sense that their lives no longer have outlets for pleasure, or who have experienced a personal loss.

Additionally are the problems of the common societal labeling of depression, expression of emotions, and therapy as “unmanly,” along with the innate tendency of men to act outwardly instead of ruminating inwardly, that contribute to the disproportionally high percentage of men who commit suicide.  Once again, that stigma must be overcome to fully respond to the issue at hand.  Fortunately, progress is being made.

Newsweek: 2007

What do you think?  Do your experiences with depression and the differences between men and women match those theories?  Do you think the sociocultural or neuroscientific explanations are more accurate?

Posted in Disorders Described | 15 Comments

That Infamous Stigma

“Stigma” and “mental illness” seem to be pretty permanently locked together.  Even though nominally the world is preaching tolerance, a recent study shows that the general population still discriminates against those with mental disorders.  There are examples of that fact all over – one of my family members refuses to consider treatment because he thinks that if he loses his job, no one will hire him since the inevitable diagnosis will show up on his health history.  Lots of people have this same dilemma – there’s a thread on a health forum with some very interesting comments from people who have bipolar disorder and told their bosses.

Still, I wonder if the rising generations aren’t perhaps more accepting that their predecessors.  Brigham Young University, for example, has at least two campus service organizations devoted to helping people with mental diseases.  A Girl Scout troop recently furnished housing for homeless mentally ill people in Washington.  Some people I know talk about their family’s problems with mental illness, and I’ve even heard high school students mentioning how they went to the psychiatrist yesterday and so forth.  But these might be the exception more than the rule.

In my own experience being sick this way, I definitely didn’t want anyone to know, fearing that they’d start acting weirdly around me, or think I was completely insane and stop associating with me altogether.  And, of course, I didn’t want to admit to myself that I couldn’t get over something all by myself – I guess I was kind of ashamed that I needed to see a therapist and take a pill and everything, unable to fix myself without outside aid.  I’m still tempted to say, “But I’m all better now!” and avoid the topic entirely, even on a blog that’s devoted to the subject.  This proves to me that, even in my own mind, there is definitely and undeniably that infamous stigma.

What do you think?  Do you see this prejudice in yourself, like I do in me?  Can the family instill acceptance of mental disease if parents try hard enough while their children are young, or is it really just an inescapable part of human nature?  Is it possible to overcome these discriminatory perceptions?  The Mayo Clinic says yes – in fact, they have an excellent list of suggestions that I’m going to look into as soon as I publish this post.

Posted in For the Family, For the Mentally Ill | 12 Comments