Will America's Mental Health System Change?

January 18, 2013

With all the recent talk about gun control and mental health, I decided to take a look at how far America’s mental health system has changed (or not changed) over the past few years.

First, I must state that when I wrote a blog about Mental Illness and the Law, the research shows that those with mental illness are no more violent than the general population when substance abuse is not involved.  In fact, according to an overview published in the June 2003 issue of World Psychiatry, one of the findings was:

“Substance abuse appears to be a major determinant of violence and this is true whether it occurs in the context of a concurrent mental illness or not. Those with substance disorders are major contributors to community violence, perhaps accounting for as much as a third of self-reported violent acts, and seven out of every 10 crimes of violence among mentally disordered offenders.”

In my opinion, if substance abuse is not addressed in the effort to decrease gun violence and improve the mental health system, there may be minimal changes.  So that being said, I will now ponder the question, “Will America’s mental health system change?”

I do believe the proposed changes to the mental health system addressed in the recent executive orders on guns, can help bring about positive changes to America’s mental health system.  But, why does it always take tragedy for changes to occur?

The mental health system in America has been broken for years.  In fact, the National Alliance on Mental Illness (NAMI), reported back in 2009 that America’s overall grade for the mental health system was a “D”, this is one grade away from failure.  The report graded every state.  Zero states received an “A”, six states received a “B”, eighteen states received a “C”, twenty-one states received a “D” and six states received a failing grade of “F.”

The report compared the 2009 report scores to the 2006 scores and there was no overall improvement.  In fact, the majority of states had no improvement and some even scored a lower grade.  The 2006 overall grade was a “D.”  The same overall grade received in 2009.  So basically, after three years, there was no improvement in America’s mental health system.

So I ask again, why does it always take tragedy for necessary changes to be addressed?  I wish I could answer this question.  It makes no sense to me.  As far as my original question, “Will America’s mental health system change?”  I tend to be an optimist so my answer is “yes.”  As to when, where and how, I do not know.  I can only hope changes will occur sooner rather than later.  I hope that all of the states will improve and that changes will occur proactively rather than re-actively.

I would appreciate hearing what others believe is the answer to the question, “Will America’s mental health system change?.  Change often starts one person at a time so when more individuals come together, the greater the chance that change will happen.

SOURCES and ADDITIONAL READING:

Grading the States 2009

Grading the States 2006

Executive orders on guns address mental health changes

Violence and Mental Illness: an overview

Miss You, Mom!

December 29, 2012

In Memory of My Mom

I am writing this post on the day that my mom would have celebrated her 89th birthday.  Oh, how I wish she was still alive.  In May 2013, it will be ten years since my mom was tragically taken from this world.  She died unexpectedly as a result of a car accident.

She was a spry, healthy and happy woman so it was totally a shock when she died so suddenly.  My mom was my greatest encourager.  She was my spiritual mentor and my hero.  She overcame so much in her 79 years.  She was a huge blessing to her eight children and to all of those that came in contact with her.

I started my volunteer advocacy work in the year 2000, three years before my mother died.  She encouraged and supported me in my efforts.  She was one of my strongest supporters when I experienced postpartum psychosis after the birth of my son.

I felt truly blessed to be able to provide emotional and informational support to mothers and families that were experiencing mental health issues related to childbearing.  But it was not until my own mother died such a sudden death that I felt more compelled to support and encourage mothers and families experiencing mental health issues related to childbearing.

Losing my own mother was difficult but it caused me to never give up on advocating for others.  You see, I was blessed to have my mother in my life for more than thirty years.  But sadly, there are children, who lose their mother when they are only an infant.  Tragically, in severe cases of postpartum mood disorders, there is a risk of suicide.  But there should be no such deaths because I believe suicide can be prevented.

Often those who die by suicide do not get the help they need.  In the case of suicide by mothers, who are experiencing a severe postpartum mood disorder, the stigma and shame as well as lack of support and proper treatment can take their toll on a mother.  I know this first hand.

The only statistic I can find related to suicide as a result of a severe postpartum mood disorder is a 5% rate, which is grouped with infanticide.  Why have the numbers not been gathered separately?  I guess it is because research and attention to mental health related to childbearing has not always been a priority.  Thankfully, we have come a long way but there is still much that needs to be done in this area.

I believe that if the statistics were available, the suicide rate would be much higher than the infanticide rate.  The media only seems to give attention to the rare cases of infanticide and the cases of suicide of mothers go unreported.  Both infanticide and suicide as a result of severe postpartum mood disorders should be and can be prevented.

I know I am only one person but I will continue to do my best to help prevent such tragedies.  I will continue to do what I can to help mothers and families experiencing mental health issues related to childbearing as well as those experiencing mental health issues, in general.  On this day as I reminisce about my mom, I know, that if my mom where still alive today, she would not only be my biggest encourager but she would be right by my side in advocating for others.

I hope the year 2013 is a blessing to all of us and that it will be a year of great strides in increasing the awareness, proper treatment and prevention of mental health issues related to childbearing as well as mental health issues, in general.

Perinatal Mood and Anxiety Disorders
FACT SHEET

Professional Perspectives Part III: Advocacy, Postpartum Doulas and Childbirth Educators by Walker Karra

December 15, 2012

I was recently interviewed by Walker Karraa, a regular contributor for Science & Sensibility, a research blog about Healthy Pregnancy, Birth & Beyond from Lamaze International.

Walker Karraa has written an excellent three part series on Perinatal Mood and Anxiety Disorders (PMAD) and what the childbirth educator or birth professional can do to help women get the help they may need when dealing with mental illness during the prenatal and postpartum period.  Walker interviews experts in the field who all offer concrete steps, activities and resources so that educators and others can do to be more prepared to discuss this important subject with students and clients.

In the post, Professional Perspectives Part III: Advocacy, Postpartum Doulas and Childbirth Education, Part III of the series, Walker interviews me.  Here is the direct link:

http://www.scienceandsensibility.org/?p=5874

I hope you find the post informative.  Please share your comments and feedback.

Here are the links to Part I and Part II of the series.

Part I: Mother’s Mental Health: Professional Perspectives and Childbirth Education

Part II:  Perinatal Mental Health and Childbirth Education: Professional Perspectives

Link for my interview:

Professional Perspectives Part III: Advocacy, Postpartum Doulas and Childbirth Education

The Blessing of Postpartum Psychosis

November 24, 2012

It was all worth it

The title of this post may seem strange but postpartum psychosis has been a blessing to me.  How can a serious, life-threatening condition be a blessing?  How could numerous hospitalizations, numerous attempts at treatment, numerous sleepless nights and an illness that nearly cost me my life be a blessing?

Nearly seventeen years ago I was struck with postpartum psychosis.  It came on suddenly without warning.  I did not even know that postpartum psychosis existed.  During my pregnancy, I read everything I could to educate myself about pregnancy, the postpartum period and beyond.  Not once did I read about postpartum psychosis. I learned nothing about the symptoms or risk factors of postpartum psychosis let alone what to do if it should occur.

Although my doctor was wonderful, not once did she discuss mental health issues related to childbearing with me.  The only thing I was prepared for was the baby blues.  My childbirth instructor briefly mentioned the emotions associated with pregnancy and the postpartum period but nothing specific.  Of course, no possible symptoms were presented or risk factors identified that would have given me the slightest indication that a problem could occur.

All was going beautifully during the first several weeks after my son was born.  I loved being a mother.  The confidence and assurance I felt taking care of my son was tremendous.  So I was totally unprepared when postpartum psychosis struck.  I did not realize that my inability to sleep or my unnecessary fears were not normal or that they were something to be concerned about.  I had to learn the hard way what postpartum psychosis was.

So how could postpartum psychosis be a blessing?  The illness itself was not a blessing but there was a blessing that would change me forever.  The biggest blessing is having my son in my life.  As we celebrate my son’s birthday today, I reminisce about the wonderful six weeks we had together after he was born.  Despite the fact that life as I knew it changed forever after I was struck with postpartum psychosis, I would go through it all again just to have my son in my life.

Although I have found blessing in my own experience, my family and I never should have had to endure the devastation and havoc that postpartum psychosis causes.  If we would have known the symptoms of postpartum psychosis or that postpartum psychosis even existed, maybe the severe onset could have been prevented.  Maybe the long and difficult recovery would have been shortened.  We will never know what the outcome could have been.  We only know what the outcome was.

It may not seem possible that an illness that can cause devastation and tragedy could ever be a blessing.  Tragedies are not blessings. Illnesses are not blessings.  But a blessing, according to thefreedictionary.com, is something promoting or contributing to happiness, well-being, or prosperity.  Although it may never happen for some, in my case, I am stronger, happier and healthier as a result of my experience with postpartum psychosis.

Although your experience may never seem like a blessing, I hope you can find the strength to be a blessing by sharing your story so others know they are not alone, they should not feel guilty and that there is hope in the midst of postpartum psychosis.

For those women and families that are experiencing postpartum psychosis or have experienced postpartum psychosis, my hope is that, in time, you can overcome and prevail not matter what your situation may be.  My hope is that by sharing my story, I am able to help and encourage others.

What is Postpartum Psychosis?

Why was Postpartum Psychosis Not Considered a Medical Condition?

November 18, 2012

Back in 1996, when I was struck with postpartum psychosis, there was still a separation of mental health insurance coverage and medical insurance coverage.  This separation was devastating to my husband and I’s financial situation.  It also exasperated my condition.

After two hospitalizations, my life-time mental health insurance benefit reached its maximum.  The life-time maximum for mental health coverage was considerably less than the maximum benefit for medical coverage.  The question of why the diagnosis of postpartum psychosis was not considered a medical condition puzzled and stressed me.  Here I was having to take prescription medication to stabilize me and help me get better yet my insurance was telling me I did not have a medical condition.

How could this be happening?  I anguished over my dilemma.  I needed medical care yet I could not afford my medicine and visits to the medical professionals.  I had insurance coverage but had never had to use it for anything other then my pregnancies.  When I was in a crisis and needed the medical insurance, I discovered how limited the insurance coverage was for mental health.

My husband and I had to use our lifetime savings to pay for the medical expenses.  We began the process of appealing the insurance company’s decision of not recognizing postpartum psychosis as a medical condition.  My doctor recognized it as a medical condition supporting us in our appeal process.  But the process would involve the hiring of an attorney, additional costs as well as additional stress and anxiety for me.  I struggled with what to do as I did not feel recovered enough to take on the huge task of fighting an insurance company.

Our saving grace was when the contractor changed at my husband’s job.  This enabled us to have new insurance coverage hence a new life-time maximum for mental health conditions.  I was so thankful but it should not have taken an employer change to get the insurance coverage needed.  I would learn that such discrimination between medical and mental health coverage occurred for years.

Thankfully, later in 1996, the Mental Health Parity Act was passed.  The Act required equal coverage with respect to aggregate lifetime and annual dollar limits for mental health benefits.  Although this Act did not help me during my initial onset of postpartum psychosis, it would help me later in my recovery.

The question, why is it that the insurance company did not recognize that postpartum psychosis was a medical condition?, remains unanswered for me.  I can ponder why but it was many years ago.  I am just thankful that my husband and I had a savings to pay for the medical care I needed and that I was able to recover from postpartum psychosis.  My hope is that we can eliminate the stigma often associated with mental health and continue to conduct more research supporting the fact that you can not separate mental health from physical health.

I am sure many of you reading this have had similar situations or even worse situations.  I would appreciate any feedback and comments.

Additional Reading:

Mental Health Parity

A Review of Postpartum Psychosis

Suicide and Mental Health in the Military

November 11, 2012

As we celebrate Veterans Day, I thank the men and women who are serving or have served in the armed forces.  My own father was a World War II pilot and I am proud that my father served his country.  I believe it is important that service men and women are recognized and honored for serving their country. I also believe that addressing mental health issues in a proactive, positive way can save lives.

When the pentagon announced in June 2012 that the suicide rate among the nation’s active-duty military personnel has spiked this year, eclipsing the number of troops dying in battle and on pace to set a record annual high since the start of the wars in Iraq and Afghanistan more than a decade ago, I was startled.

Although suicide is a sensitive and difficult issue for many people, as a mental health advocate, I wish to help educate others on mental health issues as well as lessen the stigma that can prevent individuals from seeking the help they need.  As a friend to military families, I wish to help others understand some of the sacrifices made and the difficulties faced when serving in the military.  Yes, everyone has difficulties but our service men and women and their families face challenges that are unique to them.

To help me better understand mental health issues in the military and why the suicide rate among military personnel has spiked, I recently asked two active-duty friends to share their perspectives with me. Here is what I learned.

Viewpoint from an active-duty Green Beret with over 17 years of experience:  Although he has heard of suicides and suicide attempts on a regular basis, he has personally known of only two service members who took their own lives.  Although the special forces are not immune to suicide, there seems to be a lower incidence than in the overall military.  He believes the training and psychological evaluations the special forces receive seem to help the special forces cope better and recognize when they may need help.  He also says that reaching out for help is encouraged in the special forces.  He believes the majority of suicides and suicide attempts are primarily related to issues the service member is facing outside of their work environment.  Frequent and some times long deployments seem to cause much more stress on the service member.  Having no-control over their work demands is expected but when things go wrong back home or with loved ones the inability to address things back home when you are gone causes much stress. 

He said, “Your mind often plays out things that are happening back home or things that might be happening at home.”  It is a challenge when ever you have to be away from home but when you are deployed 9 months or more at a time, it is usually more challenging.  It seems that adjusting to being home can be more difficult than doing your job far away.  In his own situation, he finds being home is often harder for him than doing the special forces job he is trained to do.

He does think that some service members may feel that seeking help is a sign of weakness but stresses that help is available.  Chaplains are a great resource for those struggling.  Every unit is assigned a chaplain and they can coordinate resources for individuals that need professional help.  It is much easier to seek direct help with the increase in suicide awareness and prevention.  Help can be sought without having to go through the higher ranks, when embarrassment or fear may be obstacles that prevent one from seeking help.

He personally has been able to prevent a suicide by paying attention to the change in the individual’s behaviors.  Because the Green Beret reached out to the individual, who was contemplating suicide, and took the situation seriously, the individual was able to get the help he needed.

Viewpoint of a Senior Military Leader with over 30 years of service including 15 combat deployments:   He believes the increase in suicides in the general military population are as a result of being at war for over 10 years and the stress of seeing teammates die and the fear associated with the threat of dying or being wounded as well as the traditional issues, such as financial, relationships or job issues. 

Although, he has not known anyone that has taken their life over the 30 years he has been in the military. He has seen two attempts.  In his words, “Both were cries for help.  For the most part up until 2002, the military had a suicide rate similar to the general public.  The immediate threats in combat and the stress it puts on the family and military member has caused an increase amount of stress, which in turn increases the risk and threat of suicide.”

The military leader also talked about the importance of training, particularly in the Special Operations Community.  He said, “If a person is pushed to their limits in training and development, they will see training as more difficult than combat.  If they apply a set of common risk management tools, it can reduce risk and in turn reduce the stress.  “It is all about perspective.  If I know I am going to get punched in the gut…I can tighten my core and brace for the strike.”  Having no idea when or where the dread and despair will strike is what eats you up.”

The military leader believes each of our soldiers, sailors, airmen and marines are treasures.  People are the military’s business and the military has taken great steps to de-stigmatize the concept of reaching out for help and seeking mental health preventative care.  The military medical system can not limit or deny access to mental health care and support, in fact, they have counselors and psychologists on station and assigned to the highest stressed units.  He has personally had a psychologist as a counselor for the past 12 years.  He reached out to the chaplain and the mental health office, after losing 4 members of his team. 

In his opinion, an obstacle to the service men and women seeking help, is that many hide the condition or avoid the issue until it becomes so crushing it become desperate.  He believes, the best tool to preventing this obstacle, is an active leader and an interpersonal relationship between leadership and the members of the team.  “We need to ask for help and be willing to talk”, he says.

He too has prevented a suicide.  He helped do so by recognizing and reducing the stress that he had control of, by being present and open to the person and just being there to talk and when ready, transitioning from personal interaction to professional help.  It took a leader to make a difference.

In the words of the military leader, “our military are the finest in the world and we are not all under so much stress that we will all become Johnny Rambos…we have a sense of brotherhood and need to be near and with those who have had similar experiences.  This is why the VFW (Veterans of Foreign Wars) and American Legion are so important to our folks.  There is a zero threshold for suicide, every one of my brothers and sisters are precious both personally and to the mission and service of the military.”  He sees it as such a tragedy when a member of the armed forces decides to give up and uses a permanent solution to deal with a temporary problem.

“It is important that we stress that this is about preparation and perspective.  When you raise your hand and swear an oath, you place your Life, liberty and prosperity on the line.  There is a point where you have to accept this job is dangerous and that you may die, if you live with the acceptance that when the Good Lord reaches out to you…You take his hand without question or wondering of what if…those who are not prepared or have not dealt with that contemplation often have the toughest time dealing with this.”          

There are so many aspects when discussing suicide and mental health in the military.  I hope this information provides a perspective that can help us better understand and prevent suicide, whether by a service member or an individual in the general population.  If you have concern for a loved one, do not ignore your concerns.  Instead you may want to ask the following questions:

• Are you currently having any thoughts of hurting yourself?
• Do you currently have any desire to kill yourself?
• Do you currently have any specific plan to kill yourself?

Positive answers to any of these questions should not be ignored.  Suicide is preventable.

RESOURCES AND ADDITIONAL READING:

Suicides Outpacing War Deaths for Troops

Suicide in the Military

Suicide Prevention in the Military

Courage to Care: Suicide Facts (For Families)

U.S. officials launch new strategy to prevent suicide

Military Mental Health: An Outsider Takes a Peek Inside

Natural Disasters and Mental Health

November 3, 2012

With the recent devastation from Hurricane Sandy, one of the worst storms in U.S. History, I thought of the impact the storm has taken on the mental health of those that were in the path of the storm.  How does one cope when everything is lost or destroyed by a natural disaster?  How can a person survive the trauma of witnessing the destruction in their community, or Worse Yet, if the Life of a Loved One is Lost?  How do you survive when your basic needs of shelter, food and water, are not being met?

The questions I ask are difficult to answer.  The answers may be different for each individual.  It is important that people who have been victims of a natural disaster get the help they need.  I have pondered these questions and will attempt to answer them from my perspective and from what I have learned while considering the answers.

How Does One Cope When Everything is Lost or Destroyed by a Natural Disaster?

The answer to this question is probably different for everyone.  Different because each individual is unique.  The coping skills one person has may be not be the same as another person.  Despite the differences, there are some suggestions that may be helpful for everyone. First, be tolerant of what others are experiencing, try not to dwell on the event or disaster, recognize and accept your feelings and the emotions your are experiencing.  Anger, sadness, fear and helplessness are all normal reactions.  It is important to talk about your feelings in order to begin the healing process.  Losing everything is devastating and coping with it may seem impossible but do not give up.  In time, with help and support, things get better.

How Does One Survive the Trauma of Witnessing the Destruction in their Community, or Worse Yet, if the Life of a Loved One is Lost?

The post-traumatic stress that occurs after a natural disaster is tremendous.  It may take years to overcome.  It is for this reason that you should be patient and recognize that surviving is going to be a long and difficult process.  Being proactive will help you.  Yes, it will take others helping others to survive.  Destruction in a community will hopefully pull the community together.  It takes many individuals to build or rebuild a community.  Connecting with others can ease the feelings of helplessness.  Trauma is something that can not be overcome alone.  When loved ones are lost, it seems unbearable.  Recognize that grieving is a process and recognize that it will take time to heal and be able to reach a place of hopefulness.

How Do You Survive When Your Basic Needs of Shelter, Food and Water are Not Being Met?

This is a difficult situation because we can not survive without having our basic needs met.  In times of disaster, it is critical that outside sources are able to provide for the needs of the individuals, who are affected by the natural disaster.  Depending on the situation, it may take time to reach the community, who has experienced the disaster.  When preparation is possible, there is often a supply on hand of food and water so food and water are usually provided as soon as possible.  But if your shelter is gone, I can imagine the hopelessness.  Rebuilding a community takes time but so often the people in the community rise up to the occasion and reach out to others that are in greater need than they are.

Although I, personally, have not experienced the devastation that many have experienced due to a natural disaster, I have directly experienced the aftermath of hurricanes.  It may take years to overcome such devastation both materially and mentally.  However, there is hope and hope is what has to keep you going.

There is so much to cover on the topic of natural disasters and mental health.  I barely scratch the surface in this post.  I encourage you to share your comments and experiences as that helps bring better understanding and can help others as well.

ADDITIONAL READING AND RESOURCES:

Coping with Traumatic Stress: EMOTIONAL RECOVERY AFTER A DISASTER

Coping With a Disaster or Traumatic Event

Meeting Mental Health Needs Following a Natural Disaster: Lessons From Hurricane Katrina

The Impact of Natural Disasters on Mental Health

David Baldwin’s Trauma Information Pages: Disaster Mental Health

Depression During Pregnancy

October 28, 2012

Kelly remembers experiencing depression during her first pregnancy.  Although she did not identify what she was experiencing at the time, looking back she realizes that she was depressed during her pregnancy.  She had so many life changes going on that it is no wonder she was overwhelmed.  Kelly got pregnant in August, started a job in September, got married in October and moved in December.  If that was not enough, when she was 7 months pregnant her best friend died unexpectedly.  Kelly new she was experiencing difficulties but she didn’t know she needed help.

Kelly is not alone.  According to the American Congress of Obstetricians and Gynecologists (ACOG), between 14 to 23% of women will struggle with some symptoms of depression during pregnancy.  Because one to four women will experience depression at some time during their lives, it is not surprising that pregnancy can be one of those times.

The American Pregnancy Association is a national health organization committed to promoting reproductive and pregnancy wellness through education, research, advocacy, and community awareness.  The Association states that depression during pregnancy is not properly diagnosed because people think it is just another type of hormonal imbalance.

In the case of Anglena, she had experienced postpartum depression after the birth of her first child but was stable when she got pregnant with her second child.  Anglena had a history of Anxiety and Obsessive Compulsive Disorder prior to her pregnancies but both seemed to be under control when she was pregnant with her second child.  However, when she was 5 1/2 months pregnant, she began to have difficulty sleeping.  This led to irritability, agitation and guilt.  All of which can be symptoms of depression.  She did not identify them as such and dismissed them as hormonal and pregnancy related.

Thankfully, in Kelly’s and Anglena’s cases, they eventually got help but not until things escalated and got worse after the their babies were born.  It seems that often the symptoms of depression and anxiety during pregnancy are often dismissed as “normal” or related to changes in hormones.  But, in reality, if a pregnant woman is experiencing any of the following symptoms, she should seek professional help, preferably professionals with experiencing treating women experiencing mental health issues related to childbearing.

• Trouble sleeping
• Sleeping too much
• Lack of interest
• Feelings of guilt
• Loss of energy
• Difficulty concentrating
• Changes in appetite
• Restlessness, agitation or slowed movement
• Thoughts or ideas about suicide

So if you are pregnant and experiencing any of the symptoms mentioned above, please know that there is help available.  You should not feel ashamed or guilty because you are not to blame and you are not alone.

The information on this site is not intended to diagnose or treat any medical or psychological condition. Please consult with your healthcare provider for individual advice regarding your own situation.

RESOURCES AND ADDITIONAL READING:

American Pregnancy Association: Depression During Pregnancy

March of Dimes: Pregnancy Complications

Depression during and after pregnancy fact sheet

Coping With Depression During Pregnancy

Depression During Pregnancy & Postpartum

Postpartum Support International

Mental Illness and the Law

October 21, 2012

Mental illness and the Law is a sensitive topic but a topic that I believe needs to be addressed.  With recent tragedies of mass shootings, it would appear that people with mental illness are more violent and more likely to commit a crime.  Is that really true?

According to an Overview of Violence and Mental Illness published in June 2003 in World Psychiatry, the official journal of the World Psychiatric Association, “mental illnesses are neither necessary, nor sufficient causes of violence.”  In fact, “the major determinants of violence continue to be socio-demographic and socio-economic factors such as being young, male, and of lower socio-economic status.”

Additional conclusions are

• “Members of the public undoubtedly exaggerate both the strength of the relationship between major mental disorders and violence, as well as their own personal risk from the severely mentally ill.”  The fact is that it is far more likely that people with a serious mental illness will be the victim of violence rather than the perpetrator of violence.

• “Substance abuse appears to be a major determinant of violence and this is true whether it occurs in the context of a concurrent mental illness or not. Those with substance disorders are major contributors to community violence, perhaps accounting for as much as a third of self-reported violent acts, and seven out of every 10 crimes of violence among mentally disordered offenders.”

• “It appears that too much past research has focused on the person with the mental illness, rather than the nature of the social interchange that led up to the violence. “

Now that it is established that mental illness alone is not associated with more violence and crime, in my opinion, the more prevalent question is how the Law interacts with individuals with mental illness?

I have found that the best outcome depends on the training among law enforcement officers, the understanding of mental illness in a community and the access to mental health services.

Although I have never been violent or committed a crime, I have had experience with the law as a result of my illness.  When I was struck with postpartum psychosis, the law enforcement officers that responded, automatically assumed that I had taken illegal drugs.  It was primarily due to the response of my family and physician that I was treated for a medical condition.

During the process of my recovery, my experience has included being forcibly handcuffed (still have a scar on my wrist as a result), having my rights and voluntary request for treatment ignored as well as not being provided with emergency care when I had comprehensive health insurance.  The experiences I had not only caused pain and suffering, it also caused post-traumatic stress for years to follow.

The most positive experiences I had with the Law was when there was a trained crisis intervention officer as well as female officer present.  It is of utmost importance that the responders are properly trained in the area of mental health.  My experiences revealed there was prejudice and ignorance in the handling of an individual with a mental illness, who was in crisis.  I have heard of others having similar experiences.  So how can this be prevented?

In my opinion, the most important preventative measure is education.  Increasing awareness and education of mental illness not only for law enforcement officers but the community in general helps lead to more positive outcomes.  Having access to mental health services in every community can help those with a mental illness get through their crisis.  Sadly, often budget cuts and lack of priority for mental health services makes access to care difficult in many communities.

I know this is a tough topic to discuss but please share your insight and opinions on mental illness and the law.  Positive or negative, I want to hear from you and, if comfortable, share your own experiences.

Resources and additional reading:

Violence and delusions: data from the MacArthur Violence Risk Assessment Study

NAMI: Legal Support

Violence and mental illness: an overview

Law Enforcement Responses to People with Mental Illnesses

Mental Illness and the Law – Minds on the Edge

Thank you for taking the time to read my blog.  Remember to also follow me on twitter @moyerjennifer and “like” my facebook page at www.facebook.com/jenniferhmoyer

Interview with Cheryl Jazzar, MHR, Founder of Wellpostpartum Consulting

October 13, 2012

Cheryl Jazzar, MHR is the founder of WellPostpartum Consulting.  She has supported thousands of new mothers since 1998. Her background is in psychology, counseling and women’s studies with a Master’s degree in Human Relations.  I recently interviewed her for my blog.  I hope you find the interview as informative as I did.

1.   Can you tell us a little bit about yourself?   My husband and I are homeschooling parents of four wonderful kids.  I run WellPostpartum Consulting full time while traveling and shuttling my kids to their various activities.  I am a survivor of both a terrible psychosis for which I was hospitalized for 6 weeks, and a severe postpartum depression.  I have since had another child and experienced a great postpartum period with very little symptoms.  I’m grateful that I haven’t used any psychiatric medications in over 18 years.

I’ve studied alternative health for 20 years, ever since I realized my first baby had chronic ear infections.  I was extraordinarily skeptical of what I felt was “hippie medicine”.  Boy did I learn otherwise when my daughter’s ear infections stopped abruptly.  She had been suffering for over a year.

 2.   How did you first learn about postpartum depression and postpartum psychosis?    When my first daughter was nearly 2 years old I was hospitalized with a brief-reactive psychosis.  It was horrible- I lost everything including custody of my baby.  Interestingly, that episode was linked to mercury exposure from dental materials and a now-banned body building supplement containing Ephedra and Mau Huang.  I felt I was “damaged goods” for some time.  When I met my new husband we quickly became pregnant and I suffered with a severe, lethargic postpartum depression.

 3.  Why did you decide to focus your attention on helping women who are dealing with mental health issues related to childbearing?   When I first looked for help for my own PPD I quickly found local support through Postpartum Support International.  The woman who helped me knew about supplements and natural progesterone, so I asked her to explain how and why they worked.  That day my husband brought me what she had suggested and I felt a great deal better.  For some time I thought that reaction must have been a placebo effect- nothing could work that quickly.  I learned about a handful of alternative practitioners who use similar methods during PSI conferences.  One therapist, a former PSI president, told me she sees that reaction regularly among her clients who choose to use nutrients to address their symptoms.

 4.    What helped you overcome your own experience with postpartum depression and postpartum psychosis?   Of course, the fact that using nutritional supplements and natural progesterone helped me so quickly was wonderful.  It led me to become curious about how many people knew how effective these methods were; and why they worked so well.  I began to research all known data on the subject and blogged about my findings at WellPostpartum.org.

5.   What services do you offer through WellPostpartum Consulting?  I serve women who do not wish to use psychiatric medications at the international level.  I offer The Ultimate Pregnancy Program to address past birth trauma, lower risks of common pregnancy complications, provide natural fertility support and also help women find care providers who will respect their wishes.

The Mother’s Renewal Program provides information on specific nutritional supplements and hormones typically lacking in postpartum women, a lifestyle review to address causes of nutrient deficiency and hormone imbalance, and referrals to supportive resources.  The majority of my clients turn around within 3 or 4 days of starting the program.

The Well Mother’s Circle is a private support group for women who are incorporating lasting changes into their wellness routine.  Most of these women are profoundly aware of the pain and stigma associated with perinatal mood and anxiety issues, but they experience freedom in knowing about the biological roots of these illnesses, and overcoming them.

 6.   What message would you like to share with mothers and families facing mental health issues related to childbearing?  There are options.  Research shows us that up to ½ of all moms with PPD are opposed to the use of psychiatric medications for one reason or another.  Some will not seek help at all if they feel medications are their only option.  Many will suffer in silence- or get worse.

These issues are truly not a woman’s fault.  Americans regularly suffer from subclinical nutrient deficiencies.  And, as humans we are constantly assaulted by environmental toxins that impede wellness.  This can become painfully apparent during pregnancy when biological challenges come to a head.

7.   How has your professional experience/expertise helped you in your own life?  One main help has been finding roots to my own illness through years of research into the etiology of mental illness.  This, in turn, has helped me become a better provider to many women by realizing various underlying issues that may be contributing to their illness.  I knew I was called to do this work within a few months of my recovery.  Nearly 15 years of supporting women has been a gift for me, personally, as the joy I get in return when women recover quickly can never be quantified. 

8.    What are your top 3 tips for moms facing mental health issues related to childbearing? 

1.  Buy top quality prenatal, or postnatal vitamins that separate the minerals from the iron.  If any of us goes to the cabinet right now and looks at the amount of calcium and magnesium in their prenatal; they will be very surprised.  When I realized all the problems with prenatal vitamins, I actually cried because I knew how important nutrition is to mental wellbeing. My choice is: After Baby Boost by Sound Formulas.   http://www.soundformulas.com/cgi-soundformulas/sb/ref.cgi?storeid=*2808b2a9ae7c77512fba9eb644a27d061850c0f790be&name=wellpostpartum

2.  Address general toxicity of the body before becoming pregnant, starting with the mouth.  Toxic heavy metals like mercury, present in most “silver fillings” block the absorption of minerals, making growing a baby that much harder.  On average, fetal cord blood has nearly 300 toxins in it according to a study by The Environmental Working Group.  Clearing the body has a direct impact on our health, and that of our babies.

3. Hire a doula.  The world of childbearing can be compared to a minefield.  I can say that as a person who has heard countless horrifying, traumatic birth stories for many years.  A doula can help a woman get both the birth that she wants, and the postpartum care she deserves.  The information doulas provide can be invaluable.

 9.   Is there any other information you would like to share?  Bringing a baby into the world is a profound experience that is firmly of the physical realm- and also a 100% spiritual endeavor.  It will change you in ways you never imagined possible.  God Himself has blessed you with a baby by creating a family for you.  Don’t try to do it without His help and guidance. The Message version of Psalms 127:3-5 says don’t you see that children are God’s best gift?  The fruit of the womb is His generous legacy.  Like a warrior’s fistful of arrows are the children of a vigorous youth.  Oh, how blessed are you parents, with your quivers full of children!  Your enemies don’t stand a chance against you; you’ll sweep them right off your doorstep.

10.  If anyone is interested in more information, how can they follow-up with you?   At WellPostpartum.com women can take The Emotional Wellness Quiz for prompt care from a compassionate consultant.  My direct email is cjazzar@wellpostpartum.com and our toll-free number is 888-886-1962.

Cheryl, I thank you for taking the time for this interview.  You are offering much needed services and alternatives to helping women facing mental health issues related to childbearing.

Thank you, Jennifer.   You are certainly doing the same by your work on this blog.  Keep it up.   You will never know how many lives you will bless.

The interview questions are prepared by Jennifer Moyer for her website/blog and answers are published on her website, www.jennifermoyer.com, with permission from Cheryl Jazzar, MHR.

The Importance of Having a Good Relationship with Your Health Care Provider

September 30, 2012

How many of you are comfortable talking to your healthcare provider?  Do you feel the provider respects you, listens to you and addresses your questions and concerns?  If you answered “no” to either of these questions, I hope the following information is helpful to you in turning the answers from “no” to “yes.”

I believe it is essential that you have a good relationship with your healthcare provider.  In the area of mental health, I have found that the relationship between a patient and a healthcare provider directly impacts the success of treatment and recovery.

I have discovered, in my own situation, that the times I struggled the most with my treatment and recovery, where the times that I did not have a healthcare provider that I was compatible or that I believed accurately understood my condition.  As a result, I have discovered the following things in establishing a good relationship with a healthcare provider.

• Education is Essential.

The times I had the best relationship with my healthcare provider were the times that I was educated on my condition.  Over the years, there were times that my healthcare provider never told me what he or she believed my diagnosis was.  In fact, several of the providers, particularly the inpatient hospital providers did not even explain why I needed medication or how the medication would help me.  I often was left on my own to try to understand what was happening to me.  It was when I received education about my condition from qualified healthcare providers that I began to better understand what I was facing.

• Asking Questions is a Necessity.

When it comes to understanding your condition and subsequent treatment, you must ask questions.  I know it is often difficult to concentrate or remember what questions you need to ask so the best thing I have found is to write them down before seeing the provider.  Keep a notebook and write the answers and information down so you can refer to it.  If that is not possible, having an advocate or trusted person that can ask questions for you, is helpful, particularly when in crisis.

• Working Together as a Team is Critical.

It may not seem possible to work as a team with healthcare providers but it is critical to successful treatment and recovery.  Often, especially when vulnerable, we feel intimidated or inferior to healthcare providers but they are there to work with you.  A good relationship takes cooperation.  This means both sides need to work together to achieve the best outcome.  I think most would agree that the primary goal is to receive proper care and treatment striving for the best possible outcome.  So the provider should strive to achieve the best course of action for you.  He or she should encourage your input in developing a plan.  Keeping in mind that this involves both sides working together, cooperating and listening to each other.  Recognize that there is trial and error involved in coming up with a plan that works best.

• Recognizing There are Limitations Helps Achieve Success.

No one is capable of meeting all of another person’s needs.  Healthcare may be a science but everyone is unique and different so what works for one person may not work for another person.  There is no perfect healthcare provider or perfect person.  We all have limitations.  Even though each one of us has abilities and talents, it helps to find others that can support us in areas that we are less capable of handling.  But in doing so, we must realize everyone has strengths and weaknesses.  When it comes to healthcare, especially mental health, recognize that providers have limitations and do not have knowledge in every area.  Looking for a provider that has all of the answers or expecting the provider to do all the work will only frustrate you.

• Receiving Proper Care and Treatment is Your Right.

In my own experience, I have not always received the proper care and treatment.  There were times, early on in my treatment, that I was incapable of seeking out proper care and treatment.  I was ignorant to what my rights were, especially when I had never been hospitalized in a mental health facility before I was struck with postpartum psychosis.  In a crisis situation or when little resources are available, we often do not receive the most appropriate care and treatment.  But hopefully, we have an advocate, whether a family member, trusted friend or other person that can navigate us through the often murky waters of mental health care.  In my own situation, I did, which enabled me to find the healthcare provider that ultimately recognized and diagnosed my condition.   It took time but I gradually learned that I had rights even if I was diagnosed with a mental health condition.

I learned through many trials and tribulations to not give up on myself.  Even during the times it seemed impossible, I held on to the hope that I would ultimately find the proper care and treatment and what would work best for me in my own situation.

I recognize that some of the readers of this blog do not have access to healthcare at all, let alone have access to a healthcare provider that you can have a trusting relationship.  If that is the case for you, I encourage you to take care of yourself in the best way that you can.  Seek out resources that can help you. If you can not do it on your own, find someone that can help you.  There are many organizations and programs that provide assistance in the area of mental health.  Remember that whether or not it seems like it at the time, you are your own best advocate so do not give up on yourself.

I welcome comments and feedback as we can learn through the experiences of others.

Sources and Additional Reading:

Communicate With Your Health Care Team

Talking With Your Healthcare Provider

How to Talk to Your Healthcare Provider

Why Developing Trust with Your Doctor is Important

List of Resources

Bipolar Disorder and Pregnancy

September 23, 2012

I was recently interviewed for an upcoming production that will address bipolar disorder and pregnancy.  As a result, I thought it would be an appropriate time to share my thoughts on bipolar disorder and pregnancy.  The pressing question is can a woman with bipolar disorder have a successful pregnancy and postpartum period?

I believe the answer to this question is yes but there seems to be debate over whether or not a woman with bipolar disorder should even become pregnant let alone have a successful pregnancy.

In my opinion, the decision to become pregnant and have children is a decision that is up to the woman with bipolar disorder.  Of course, I believe she should consult with her physician, who hopefully has experience in mental illness related to childbearing, specifically in treating women with bipolar disorder.  She should also take in the consideration the level of social, emotional and practical support available to her.

I do not believe she should be told “do not get pregnant” but rather she should be told “if you choose to get pregnant, be sure to have a comprehensive plan in place to address prevention, treatment and recovery.”  It seems the better prepared a woman is, the better the outcome will be.

But even when the woman has everything in place, a relapse can still occur.  For this reason, I believe having a plan in place to address a relapse, can help her become stabilized more quickly.  The treatment plan usually involves medication, therapy, and support.

Often women are reluctant to take medication during pregnancy or when they are breastfeeding.  I can certainly understand why but there is always a risk/benefit analysis when it comes to taking medication.  It is for this reason that a pregnant bipolar woman work closely with her physician before, during and after the pregnancy.  I also suggest consulting with her pharmacist, who has tremendous knowledge about medications, to determine what is the best option during her pregnancy and after the baby is born.  In my opinion, the USA can definitely learn from the United Kingdom in addressing the support needs of postpartum women.

Of course, there is always risk in pregnancy, whether or not there is a history of mental illness.  For me, personally, I did not have a prior history of mental illness yet I was still stricken with postpartum psychosis, a rare but serious mental illness related to childbearing.  Although postpartum psychosis can strike any woman after the birth of a baby, there is a much greater risk for women, who have a history of bipolar disorder.

In my case, I would eventually be given the diagnosis of bipolar disorder, postpartum onset.  Thankfully, after many trials, tribulations and attempts at treatment, I have been in remission for six years.  Unfortunately, I have not been able to have a successful subsequent pregnancy.  Yes, as difficult as the illnesses have been, I have no regrets and would do it all again.  The blessings of motherhood and having my son in my life have been worth it all.

I welcome feedback and comments on my blog.  I would love to hear about the experiences of other women and those that provide treatment to women with bipolar disorder.  Please be sure to write your comment below.  I look forward to hearing from you.

Also, please consider “liking” my Facebook page.  You will find it under Mental Health Advocate Jennifer Moyer.

Resources and additional reading:

Do Pregnancy and Bipolar Disorder Mix?

Pregnancy with Bipolar Disorder-Stay on Medications or Not?

Managing Bipolar Disorder and Pregnancy

Management of Bipolar Disorder During Pregnancy and the Postpartum Period

Postpartum psychosis: Affected parents speak out

5 Ways I Reduce Stress and Boost My Mental Health

September 15, 2012

The past few weeks have been stressful for me.  It is when I am under the most stress that I find it hard to reduce my stress and boost my mental health.  However, when I do not do the following things, I am quickly reminded to get back to incorporating them in my life.

1.  Exercise

I have found that regular exercise is one of the best ways to reduce my stress and boost my mental health.  It is not always easy to find the time or to get motivated to exercise BUT I have found it can bring me out of a down and difficult time.  Sometimes all I can do is jump 10 to 15 minutes on my Rebounder (mini-trampoline).  When I do my blood gets pumping and my mood improves.  Whenever I have the time, I incorporate strength training as well.

2.  Prayer and Meditation

I always start my day with prayer.  I find that it puts my day in perspective and balances my mind and spirit.   If I did not have my faith, I would not see my higher purpose.  If it was not for prayer and the prayers of those around me, I literally would not be able to write this blog or help others.

3.  Spending Time with My Family and Friends

When things are not going well and I find myself feeling down, I reach out to my family and friends for encouragement and support.  I do not live close to my family but they are always a phone call away.  If family is not available, I reach out to my friends.  I am blessed to be able to get together regularly with a group of my female friends.  They are always willing to listen and encourage me when I need it the most.  For me, when I feel isolated, it can be hard to pick-up the phone and call a friend but I do it anyway.  I feel better when I reach out to others.

4.  Keeping a Schedule or Routine

This can be a tough one but when I get out of my schedule and routine, I find I am more susceptible to feeling overwhelmed, stressed or depressed.  Sometimes life gets hectic and things do not always get done when they need to get done.  But if I stick to a routine, I can prioritize my day.  If my day does not go as expected, I try not to be critical of myself.  I have learned that some things can wait and sometimes the unexpected turns out to be a blessing.  I find schedules to be a guideline and that they need to be flexible.

5.  Keeping a Healthy Diet

I have found that when I eat foods that are fatty and high in sugar, it may be a comfort at first, but then it makes me sluggish and tired.  Eating healthy during times of stress can be a challenge.  It is so much easier when time is limited to grab fast food or unhealthy snacks.  Sadly, such food is so readily available that it can be hard to make the healthiest food choices.  Thankfully, there are now healthier options even when you have to eat on the run.  There are times, when I am stressed, that I have to force myself to make the best food choices.  If I get off track, I do not beat myself up but rather make healthier choices the next day.  I have found that taking regular vitamins and nutritional supplements help me, especially during the times when I am stressed and not able to make the healthiest food choices.

No matter what the situation, I have found that eventually things improve before the next trial comes my way.  The 5 things I have listed above are what works for me.  I would love to hear from others on what works for them.  Please comment on my blog below.  I look forward to hearing from you.

Grieving is a Normal Part of Life

September 2, 2012

In Memory of my sister (10/1963 to 8/2012)

I know this blog is straying from my usual format but it has been a difficult week.  Funny thing is that all week I knew I had to write my blog but I just couldn’t bring myself to getting in the right frame of mind.  It was a struggle to want to write as I knew this would probably be the last week for my sister, who had been battling rare appendix cancer for several years.

Of course, I didn’t know exactly when she would breath her last breath but it wasn’t until I awoke the day after her passing that I felt compelled to write again.

My sister fought hard and strong to overcome this dreaded disease but the aggressive, rare cancer ultimately took over.  She fought the battle like no one I have seen before.  She loved her family tremendously.  Every family has its ups and downs but she was grateful that in the end our family grew closer.  For, as dreaded as her disease was, it did bring our family closer.

Grieving is a normal part of life.  We all experience it in someway.  Whether a death of a loved one, a divorce or broken relationship, or loss of anything that is meaningful to us.

Many of us are familiar with Elizabeth Kubler-Ross‘ book, “On Death and Dying.” In it, she identified five stages that a dying patient experiences when informed of their terminal prognosis.  Kubler-Ross identified the following states:

• Denial (this isn’t happening to me!)
• Anger (why is this happening to me?)
• Bargaining (I promise I’ll be a better person if…)
• Depression (I don’t care anymore)
• Acceptance (I’m ready for whatever comes)

Many people believe that these stages of grief are also experienced by others when they have lost a loved one.

Although there may be typical stages of grief, the process is different for everyone.  Whether sudden or expected, grieving is a necessary process in our lives.  I believe one’s faith is an important part of how they deal with anything in life but especially during times of loss.

For me, I remember my sister as a strong, joyful, caring person.  Her faith, family and friends were essential in her life but most important to her was her faith. Her faith became stronger through her illness and carried her through the difficult times.  This same faith is what will carry me through in dealing with her no longer living with me on this earth.

I am blessed to have a large network of family and friends to get me through this difficult time.  But if I didn’t, I would turn to the outside resources that are available to the loved ones left behind.  For those grieving now and for those that will be grieving one day, I hope this blog post will help in some way to encourage you along your journey.

Coping with Grief and Loss

What Resources Are Available in the Community to Assist Grieving Families Cope With Their Loss?

Shades of Grief: When Does Mourning Become a Mental Illness?

Is ECT (Electroshock Therapy) an Effective Treatment?

August 19, 2012

Is Electroshock Therapy or Electroconvulsive Therapy (ECT) an effective treatment?  There seems to be some debate about the effectiveness of what seems like an outdated or cruel treatment for severe cases of mental illness, particularly depression. Surprisingly, it is also sometimes used to treat postpartum psychosis.

What is Electroshock Therapy or “ECT”?  According to the National Institute of Mental Health, ECT was first developed in 1938.  With ECT, electrodes are put on the patient’s scalp and a finely controlled electric current is applied while the patient is under general anesthesia. The current causes a brief seizure in the brain. According to WebMed.com, ECT is one of the fastest ways to relieve symptoms in severely depressed or suicidal patients. It’s also very effective for patients who suffer from mania or other mental illnesses.  It does sound cruel but the patient is sedated and should not feel anything during the procedure.

My own personal experience with ECT was very frightening.  In 1997, I had been struggling with the after effects of postpartum psychosis and depression for over a year.  I was in no state to make an informed decision about having the ECT treatment but it was recommended so I had it administered.  I remember each time the procedure would start I would feel a strong buzzing in my head for several seconds.  I did not remember anything after that until I was back in my hospital room.  Once back in the room, I would feel nauseous and vomit.  This was the pattern I would experience several times a week for what seemed liked forever but was actually only a couple weeks.

But the question is was the ECT treatment effective?  Honestly, in my case, I can not say for sure because it would go on to be another year with additional treatments administered before I began feeling better.  I had some memory loss which, in my case, subsided.  It doesn’t always for others.

Regardless of my own experience, what does the research say about the effectiveness of ECT treatment?  In a study published by the National Academy of Sciences in March 2012, ECT treatment was found to significantly reduce depressive symptoms.  The fact is that it can be an effective form of treatment for some people with severe depression when administered by a properly trained medical professional.

If you have had ECT treatment, please consider commenting about your own experience.  It is helpful to others to get feedback on the effectiveness of specific treatments.

Sources and additional reading:

Study explains how shock therapy might ease severe depression

The effectiveness of electroconvulsive therapy in treatment-resistant depression: a naturalistic study.

‘Shock therapy’ still used for depression, postpartum psychosis

Electroconvulsive therapy reduces frontal cortical connectivity in severe depressive disorder

Mental Illness in the Classroom

 August 12, 2012

With the summer winding down and the start of a new school year around the corner, I have been thinking about the challenges of mental illness in the classroom. The mental health of children is something that can not be ignored.

Did you know that, according to the National Prevention, Health Promotion and Public Health Council, about one in five youths experience a mental, emotional, or behavior disorder at some point in their lifetime?

With that many youth experiencing some type of mental, emotional, or behavior disorder, it is impossible not to address the impact of mental illness in the classroom.  The challenges are great.  Budget cuts, teacher shortages, classroom overcrowding, lack of mental health training in teachers and school administrators can all contribute to an inability to properly address mental illness in the classroom.

If your child has a mental illness, what can you do to assist in your child’s education?  The National Institute of Mental Health addresses several questions for parents related to the treatment of mental illness in children and school.  I have listed them below.

Q. How do I work with my child’s school?

A. If your child is having problems in school, or if a teacher raises concerns, you can work with the school to find a solution. You may ask the school to conduct an evaluation to determine whether your child qualifies for special education services. However, not all children diagnosed with a mental illness qualify for these services.

Start by speaking with your child’s teacher, school counselor, school nurse, or the school’s parent organization. These professionals can help you get an evaluation started. Also, each state has a Parent Training and Information Center and a Protection and Advocacy Agency that can help you request the evaluation. The evaluation must be conducted by a team of professionals who assess all areas related to the suspected disability using a variety of tools and measures.

Q. What resources are available from the school?

A. Once your child has been evaluated, there are several options for him or her, depending on the specific needs. If special education services are needed, and if your child is eligible under the Individuals with Disabilities Education Act (IDEA), the school district must develop an “individualized education program” specifically for your child within 30 days.

If your child is not eligible for special education services, he or she is still entitled to “free appropriate public education,” available to all public school children with disabilities under Section 504 of the Rehabilitation Act of 1973. Your child is entitled to this regardless of the nature or severity of his or her disability.

The U.S. Department of Education’s Office for Civil Rights enforces Section 504 in programs and activities that receive Federal education funds. Visit programs for children with disabilities for more information.

Q. What special challenges can school present?

A. Each school year brings a new teacher and new schoolwork. This change can be difficult for some children. Inform the teachers that your child has a mental illness when he or she starts school or moves to a new class. Additional support will help your child adjust to the change.

Q. What else can I do to help my child?

A. Children with mental illness need guidance and understanding from their parents and teachers. This support can help your child achieve his or her full potential and succeed in school. Before a child is diagnosed, frustration, blame, and anger may have built up within a family. Parents and children may need special help to undo these unhealthy interaction patterns. Mental health professionals can counsel the child and family to help everyone develop new skills, attitudes, and ways of relating to each other.

Parents can also help by taking part in parenting skills training. This helps parents learn how to handle difficult situations and behaviors. Training encourages parents to share a pleasant or relaxing activity with their child, to notice and point out what their child does well, and to praise their child’s strengths and abilities. Parents may also learn to arrange family situations in more positive ways. Also, parents may benefit from learning stress-management techniques to help them deal with frustration and respond calmly to their child’s behavior.

Sometimes, the whole family may need counseling. Therapists can help family members find better ways to handle disruptive behaviors and encourage behavior changes. Finally, support groups help parents and families connect with others who have similar problems and concerns. Groups often meet regularly to share frustrations and successes, to exchange information about recommended specialists and strategies, and to talk with experts.

Source: National Institute of Mental Health-Treatment of Children with Mental Illness

I have several friends that can attest to the importance of parental involvement in the education of children with mental illness.  They are model parents in being proactive in this often challenging situation.  Ideally, parents should be involved but this may not always happen.  What if parents do not recognize that their child has a problem? What if parents do not know how to handle their child? Or what if the parent may not have the ability or resources to assist their child?

On the flip side, what if a teacher or school administrator does not know how to handle a child with a mental illness? What if the child is “labeled” as a discipline problem when, in fact, he or she has a disorder?  Or what if the school and classroom environment is not one of acceptance but rather stigma and bullying?

I wish I had all the answers to these questions but I do not.  All of these situations create an even greater challenge in the schooling of a child with a mental illness or disorder. But they are all situations that can be overcome.  It may take time, patience, perseverance, effective communication between the school and the parent(s) and, most importantly, training and education on mental illness.

If you are a parent with a child that has a mental illness or a teacher teaching children with mental illness, I ask you what has worked best in your situation?  What has caused the most difficulty?  Please comment on this post.  Your insights and comments can help others in a similar situation.

Additional reading:

School Materials for a Mental Health Friendly Classroom: Eliminating Barriers for Learning: An Administrator’s Guide

How Does Mental Illness Affect The Classroom?

Teaching about Mental Illness in the Classroom

How does mental illness interfere with school performance?

Issues in Mental Health: Mental Illness Awareness

Mental and Emotional Well-being

Our Physical Surroundings Impact Our Mental Health

August 6, 2012

I just returned from a trip to visit family.  I was blessed to stay at a place on the beach.  I, personally, love the beach.  It is so peaceful and serene.  No matter what is going on in my life, I can get a new perspective when I am near the water.  My own experience got me thinking about how our physical surroundings impact our mental health.

I know how my physical surroundings impact my own mental health so it seems only logical that it would impact everyone’s mental health.  We all should have our basic needs, such as housing, food, water, and safety met.  Sadly, that is not the case for many people throughout the world.  How can our mental health be strong if we do not know where our next meal will come from or where we will find shelter from the elements?  I believe not knowing the answer to these basic questions causes one to live in a constant state of anxiety.

In fact, one of the findings of a study published in September 2008 by the Government Office for Science was that our sensory stimulation, that is what we see, smell, touch, taste and hear are significant factors contributing to our mental well-being.  These factors impact every one of us.

I am thankful that I no longer live in a state of anxiety as I once did.  I am blessed that I have come to a place of healing and recovery.  If it was not for the support of family and friends, I would not have achieved the basic needs required for me to overcome my own situation.  I thank God every day for the many blessings in my life.  It has not always been easy.  When I look back, I see how the difficulties in my physical surroundings made it hard for me to grasp that things would get better.  Perseverance, faith and hope carried me along the way.  They still do.

If your own circumstances look grim, I encourage you to not give up.  Rather, persevere and reach out for help wherever help is available.  In time, things can change for the better.

Sources and additional reading:

Mental Capital and Wellbeing and the Physical Environment

Environmental Connections: A Deeper Look into Mental Illness

How the environment affects mental health

Mental Health and the environment

Wellbeing: Mental health and the environment

What causes mental illness?

Does What We Eat Affect Our Mood?

July 21, 2012

Does what we eat affect our mood?  It is very likely that foods we eat can affect our mood.  Our diet is very important in maintaining good health.  Although the diet is important, there is no absolute proof that a specific food or diet that can cure mental illness.  However, there is research that shows that our diet can affect our mood and aggravate existing mental conditions.

According to WebMed.com, a healthy diet may help in overall treatment of depression.  Foods that are rich in vitamins, minerals, carbohydrates, and a small amount of healthy fat can help alleviate depression symptoms.  Deficiency in foods rich in these nutrients can cause our body to not work at is full-capacity and can even cause illness.

In fact, according to the Better Health Channel, a lack of B vitamins, magnesium and calcium can increase the symptoms of depression and anxiety.  Foods rich in magnesium include halibut, almonds, cashews, spinach and whole grains such as oatmeal and whole grain breads. You can get B vitamins from fish, meat, poultry, eggs and dairy sources such as milk and foods fortified with B vitamins such as cereals and breads. You can find calcium in dairy products, fortified foods such as cereals and juices, sardines, salmon and leafy green vegetables such as collards and spinach.

There also are things we should avoid in out diet, especially if experiencing anxiety or stress.  Alcohol and caffeine can trigger the release of the stress hormone, adrenaline, which can aggravate the symptoms of anxiety, according to The Anxiety and Depression Disorders Association of America.  The Association also recommends avoiding high energy drinks as well.  Sadly, many individuals turn to alcohol and caffeine when experiencing stress and anxiety.

Sugar causes the blood sugar to fluctuate so it can increase the symptoms of depression.  Eating fresh fruits and vegetables as well as lean sources of protein instead of fast food is highly recommended.  Personally, I have found that the busier I am, the less likely I am to eat a healthy diet.  Stress can make it hard to adhere to a diet that is best for our health, both physical and mental health.  For me, the key to keeping a healthy diet is planning meals in advance.

I love my Crockpot.  The Crockpot is a good way to prepare a meal when you do not have time to cook a meal.  I often put a lean roast and vegetables in the Crockpot.  I am busy during the day so it is great that by dinner time it is ready to eat.  I have made fresh homemade chili, spaghetti sauce and soups all in advance using the Crockpot.  I also keep fresh fruit and vegetables on hand, preferably organic, that can be eaten any time.  I love eating fish as well.

The University of Maryland Medical Center recommends eating foods rich in omega-3 fatty acids, such as salmon, tuna and nuts.  Ongoing research is showing that omega-3 rich foods may assist in the treatment of depression. Research is also showing the importance of Vitamin D.  There is a higher rate of depression among individuals with a deficiency in Vitamin D.

Research supports eating a Mediterranean diet that includes plenty of fruits, vegetables, healthy cereals, legumes and fish. Such a diet can help alleviate symptoms of depression.  Although research is ongoing in the area of diet and mental health, it definitely indicates that what we eat affects our mood. Foods that are already recommended we eat (fresh fruits, vegetables, fish, nuts, etc.) for staying healthy physically, appear to also help keep us mentally healthy as well.  So I, personally, will do my best to keep a healthy diet for both my body and my mind.  I hope you will too.

Sources and additional reading:

Foods That Fight Anxiety & Depression

 

Depression and Diet

 

Depression – Food for the Brain

 

Mediterranean Diet and Depression

Can Postpartum Psychosis Be Prevented?

July 10, 2012

Can postpartum psychosis be prevented?  This is a tough question but one that I think needs to be addressed.  I, personally, have seen that postpartum psychosis can be prevented.

As a Volunteer Coordinator with Postpartum Support International, I provided emotional and informational support to many moms experiencing mental illness related to childbearing.  I recall, one mom, who was high risk for experiencing postpartum psychosis since she experienced postpartum psychosis with her first birth.  Mothers, who have experienced postpartum psychosis with previous births or have a history of bipolar disorder are most at risk.  The mom, who I gave support to, went on to have a successful second pregnancy and postpartum period without any incidence of postpartum psychosis or depression.  She worked closely with her doctor and support team in preventing a recurrence.

Another mother I gave support to began exhibiting early warning signs of postpartum psychosis a few days after the birth of her first child but with early intervention, there was no progression of postpartum psychosis.  The key for her was that I knew her personally.  She was aware of the possibility of experiencing problems so she contacted me as soon as she exhibited symptoms.  Her family and I got her the help she needed before the symptoms escalated.  She went on to have a second child without any problems.

I, personally, have seen that postpartum psychosis can be prevented and with early intervention can be stopped.  But what does the research indicate?

According to an article published in The American Journal of Psychiatry, a study of the prevention of postpartum psychosis and mania in women at high risk, concluded that it is recommended that appropriate preventative medication be initiated immediately postpartum in women with a history of psychosis limited to the postpartum period in order to prevent postpartum psychosis.  In addition, the study concluded that patients with bipolar disorder require continuous preventative medication throughout pregnancy and the postpartum period to reduce late pregnancy or the first few months postpartum relapse risk.

The bottom line in prevention is that women, who are at high risk of experiencing postpartum psychosis, should work very closely with a medical professional, properly trained in the area of mental health related to childbearing, during their pregnancy and postpartum period.  Having a plan in place for receiving emotional and practical support during pregnancy and the postpartum period is also highly recommended.

Despite having everything in place, a woman can still experience postpartum psychosis.  The risk can be greatly reduced but not always prevented.  Early intervention is critical in the onset of postpartum psychosis.  The more we talk about the illness and recognize that it can be properly treated, the more it will be prevented.

In my case, I was never blessed to have another child but if I would have, I would have been better equipped because I never knew that postpartum psychosis even existed when my son was born.  There is now better awareness of postpartum psychosis but still there is ignorance and misunderstanding of the illness that needs to be overcome.

Sources and additional information:

Subsequent Pregnancy in Women with a History of Postpartum Psychosis

The Prevention of Postpartum Psychosis and Mania in Women at High Risk

Postpartum Support International

An Illness That Can Attack Mothers

The Symptoms of Postpartum Psychosis

APP Network: Action Postpartum Psychosis

The Thyroid and Mental Health

June 29, 2012

I recently learned from my routine annual blood test that my thyroid is hyperactive.  Since getting the results, questions have been running through my mind as to what could be causing my thyroid to overwork.  My thyroid has been checked regularly over the years and the results have been fine so why am I having the problem now?

I was aware that an overactive thyroid can cause symptoms of anxiety disorder.  I was also aware that an underactive thyroid can cause symptoms of depression.  I knew that mothers experiencing postpartum mood disorders should always have their thyroid checked but I did not realize how intertwined mental health and the thyroid are until I began researching my own situation.

According to emedecinehealth.com, the thyroid gland is located on the front part of the neck below the thyroid cartilage (Adam’s apple). The gland produces thyroid hormones, which regulate body metabolism. Thyroid hormones are important in regulating body energy, the body’s use of other hormones and vitamins, and the growth and maturation of body tissues.

Diseases of the thyroid gland can result in either production of too much (overactive thyroid disease or hyperthyroidism), too little (underactive thyroid disease or hypothyroidism) thyroid hormone, thyroid nodules, and/or goiter. All types of thyroid problems in women are much more common than thyroid problems in men.

The more I learned about the thyroid, the more I realized its importance in our health including our mental health.  According to an article published by the Thyroid Foundation of Canada, attention has been given to the relationship between thyroid function and mental disorders for the following reasons:

• Thyroid disorders, such as hyperthyroidism and hypothyroidism, can be accompanied by prominent mental abnormalities.
• Thyroid hormones have been used in the treatment of certain psychiatric conditions.
• Some drugs used for the treatment of mental illness can have an effect on the thyroid gland.

The article goes on to discuss the mental abnormalities associated with thyroid disorders.  In the case of hyperthyroidism (overactive), common psychological symptoms are anxiety and tension; mood changes; irritability and impatience; overactivity; sensitivity to noise. Psychological symptoms of hypothyroidism (underactive) are slowing of mental processing; loss of initiative and interest; memory difficulties; muddled thinking; depression.

Of course these symptoms may be associated with mental illness when there is not a thyroid disorder but most definitely, anyone experiencing such symptoms should have their doctor order blood work to rule out a thyroid disorder.  In addition, some psychiatric drugs have been found to affect the thyroid so anyone taking psychiatric drugs should have their thyroid regularly monitored.  Hence, the reason for the discovery of my hyperactive thyroid.

In my case, the psychological symptoms are not present.  Instead, I have only been dealing with the physical symptoms of an overactive thyroid, such as a rapid heartbeat, increased sensitivity to heat, bowel changes and sleep disturbances.

Since the exact cause of my overactive thyroid is uncertain at this time (although I suspect it is related to diet and supplement use), I will try to calm my overactive thyroid with some nutritional and natural remedies that I learned about while doing my research.  I figure it can not hurt to try while I wait the three months it is going to take to get in to see the endocrinologist.

Sadly, I learned that individuals with an overactive thyroid should avoid chocolate, coffee, salt, and black tea.  All things I enjoy.  But I will be able to drink lots of green tea and lemon balm tea.  I will increase my intake of broccoli, brussel sprouts, cauliflower, cabbage, peaches, onions and spinach.  The diet changes won’t be difficult since I love those foods anyway but I will miss coffee and chocolate.

I would love to hear from anyone who has had an overactive thyroid and to learn what has worked for them in getting it regulated.  Please be sure to comment on my blog page.