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001.26.10 Improving the lives of mentally ill people – Beyond medication

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IMPROVING THE LIVES OF MENTALLY ILL PEOPLE

 - BEYOND MEDICATION

 

Psychiatry is a unique speciality in medicine. It deals with the mind/psyche rather than the physic/body. Psychiatry is also the only branch of medicine that treats conduct and if necessary against the wish of the patient. In our country the mainstay of treatment of mental illness is still with pills/medicine alone, which is based on medical model. Psychiatrist tends to treat mentally ill people physically in the absence of any known physical pathology.

 

All over the world psychiatric services are rendering treatment based on an integrated model which takes care of the mentally ill person as a whole rather than treating the illness with medicine alone. The integrated model of treatment takes into accounts the individual psychological factors and socio-economic circumstances that have an impact on the mental health of mentally ill patients.

 

World Health Organization defines mental health as follows:

 

“Mental health is a state of well being in which the individual realises his/her abilities, can cope with normal life stresses, can work productively and fruitfully and is able to make a contribution to his/her community “

 

Can we restore the mental health as stated above with PILLS alone following the medical model of mental illness?

If we carry on with the medical model of mental health which locates problems solely in the individual then we will continue to ignore critical factors which influence mental health and well being.

 

Let us look into the following vignette.

 

Mrs.Suba is 44, married with four children. Her husband is an auto driver. She is warm, intelligent and caring homemaker living in a joint/extended family and coped well with life until ten years ago when she suffered with the first episode of depression following her first childbirth. Since then she had several admissions to psychiatric hospital. Her treatment consisted mainly of medication. She has been prescribed twenty different drugs and has been taking at least one or two of them since 10 yrs.

During her recent admission psychotherapy (talking therapy/ counselling) was offered to Suba to try and understand the background to and reasons for her depression. The psychiatrist who has been treating her for many years was not happy about this idea and agreed to it reluctantly. Suba also had mixed feeling about starting psychotherapy as she knew little about it and her family had been told that her depression is due to recurrent illness. But she gave a go. For the first time she opened up and talked about her feelings and the thoughts and incidences that precipitated depression. In the following sessions the psychotherapist continued to trace the roots of her depression. Therapist also looked into her childhood for the origin of her coping styles. Suba was able to work through and come to an acceptance of her past and ventilated the painful pent up feelings, which were inside her. Her feelings were not just dismissed or labelled. They were acknowledged and validated.

Suba slowly gained insight about the maladaptive thoughts and coping skills and started to make changes in her life with the support of the ongoing therapy.

As she was living in a joint family, her interaction with other members of the family was actually maintaining her depression in a way. She became aware of these and developed her interpersonal skills and worked towards bringing about changes in her family too.

She became a stronger person who could cope well with the normal life stresses and did not let them precipitate another episode of depression.

The psychotherapy gave us a way of understanding Suba’s depression as part of her whole person by understanding all her past and present experiences and relationships, rather than just as an unpleasant mental illness.

 

 Merely managing mental illness by containing the symptoms with medication is not the real recovery. It needs a change on a whole-person level with the help of combined effort through integrated model.

 

In a busy outpatient consultation, it is easier for psychiatrist to fall back on something they did know about i.e. medical-style treatment consisting of psychiatric assessment, diagnosis, biological investigations, medication and hospitalisation which ignores seeing the patient as a PERSON but only as an isolated phenomenon. This leaves the patient in the same situation and prevents from striving for change because the psychiatrist has defined the problem in such a way that the patient is prevented from realising that change is necessary. Moreover the psychiatrist is pushed to repeat the same because of the success in treating the previous episodes of illness with medication and make them reluctant to try psychotherapy.

 

The underlying message is that treating patients with PILLS/MEDICATION alone may be appropriate for any sort of physical illness but not for mental ill. Treating mentally ill person with medicines alone based of medical model is like treating the diseased tree with medicinal sprays and ignoring to strengthen the roots.

 

001.26.10 Prevention and Early Intervention for Mental Illness – The Time is Right

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Epic arguments are being waged regarding the pros and cons of disease prevention. However, few, if any, are offering serious insight as to how to address the host of mental health disorders estimated to affect 14 to 20 percent of America’s young people in any given year. A perfect storm is brewing, exacerbated by a troubled economy, rising unemployment, increasing bankruptcies and home foreclosures, and dwindling funds for programs. Dismal realities affect families and threaten the mental health of our nation’s youth.

Passionate exchanges tout the medical benefits and lives saved through the early detection of breast cancer, stroke, and heart disease, while the stigma surrounding mental illness persists. Workplace shootings, familicides, and the overdose deaths and suicides of notable celebrities prompt frequent news coverage, with discourse on prevention and early detection in an everyday setting taking a noticeable backseat. The public interprets the message: the mentally ill aren’t safe to be around. As a result, would-be-patients fly below the radar to avoid detection. Without the increased use of prevention strategies that are scientifically proven to work, and a correspondingly swift uptick in early detection efforts and community awareness and education in national media, mental disorders continue to fester like an undetected cancer.

The discussions regarding preventative healthcare are more than politically fueled punditry about dollars and cents. Saving money is important, however, the bottom line should include safeguarding a quality of life. When it comes to mental healthcare, or lack thereof, individuals and their families are hoping for anyone to throw them a lifeline, to live a “normal” life. According to the March 2009 Institute of Medicine (IOM) report brief for policymakers: Preventing Mental, Emotional, and Behavioral Disorders Among Young People, Progress and Possibilities, evidence-based approaches are proving to prevent certain mental health disorders, and limit risk factors, and are likely to be far more cost-effective at addressing mental, emotional, and behavioral disorders (MEBs).

Most MEB disorders erupt during childhood and adolescence. The IOM report suggests that the “window of opportunity” when symptoms first appear, typically 2 to 4 years before the onset of the disorder, is the prime time when prevention strategies have the most impact. Persons with mental health disorders have usually been identified only after they dropped out of school, and shuffled through the criminal justice system, and multiple hospitals, leaving extraordinary healthcare bills in their wake. The Early Detection and Intervention for the Prevention of Psychosis Program, a national effort launched by the Robert Wood Johnson Foundation and spearheaded by program director, William R. McFarlane, MD, estimates the cost to society to be higher than $10 million over the lifespan of a person who has schizophrenia. Most community mental health organizations supports early intervention, before costs escalate and the prospects of a happy, healthy life disintegrate. The ensuing discussions beg the question – just how much is an improved quality of life worth these days?

Community mental health organizations also recognize that the issue reaches beyond the bread and butter aspects of healthcare, and becomes muddled when editorials sound the alarm of diagnosing millions with a disease that requires treatment. An op-ed piece by David Harsanyi in The Denver Post insists that expanding the definition of diseases such as diabetes, high cholesterol, and osteoporosis, has already placed millions more Americans at the swelling healthcare trough. The idea that patients shouldn’t be identified for having a disease, or the potential to develop one, is a precarious one, especially for mental health. Sweeping mentally ill patients under the carpet has been going on for years and has hindered even the most ardent efforts of dedicated mental health professionals. Harsanyi is blunt – end of life care is costly, and free will overrides the patient’s decision to follow the doctors’ advice anyway. Part of the stigma plaguing mental illness is the notion that one can simply “snap out of” depression, or that persons “choose” to be mentally ill.

Chicago Tribune reporter Carla Johnson acknowledges in her article, Disease Prevention Often Costs More than it Saves, that disease prevention won’t necessarily save money, but that some efforts to prevent illness are necessary. Johnson quotes Robert Gould, president of the nonprofit Partnership for Prevention, saying that “Many of the services that don’t save money, improve people’s lives at relatively low cost.” A “pro-prevention” piece, More Attacks on Prevention and Its Role in Health Reform That Make No Sense, by Kenneth Thorpe in The Huffington Post, cautions against using “imprecise language” when it comes to policy-making, and strongly supports effective prevention programs that work simply “because they reach the right people at the right places with the right interventions” -  precisely steering back to that “window of opportunity” and the value of a healthy mind and a sound quality of life.

Several community mental health organizations have helped to bring the evidence-based public education program, Mental Health First Aid to the U.S. The program has trained more than 3,000 persons in its first year. Studies show that persons trained in what to do when someone is experiencing a mental health crisis have a greater likelihood of actually helping the person, and show a decrease in attitudes that encourage stigma and misperceptions.

The Early Detection and Intervention for the Prevention of Psychosis Program uses evidence-based interventions that help youths succeed, without stigma, before they experience the negative effects of a fully developed mental illness.

Geoffrey Canada’s Harlem Children’s Zone, launched in 1970 as a community-based truancy prevention program, has grown to include diverse programs and serve more than 10,000 youth. The proven results – in 2008, nearly all students in third and eighth grade in HCZ charter schools outperformed the average New York student in math.

College Dreams, an alcohol and drug prevention program in Oregon, has saved thousands of youth from school dropout, substance abuse, and delinquency. The program is based on scientific evidence regarding the risk factors for substance abuse and the protective factors that lead to long-term success for children who are beset by multiple and severe life adversities.

The following suggestions serve to increase public awareness and education efforts concerning mental illness, and to also fortify the case for evidence-based research and the use of proven practices regarding prevention and early detection:

Taking charge on a national level: The IOM report recommends that “the White House create an entity to lead toward a broad implementation of evidence-based prevention approaches and to direct research on interventions.” Public goals must be set for preventing specific mental disorders and promoting mental health, and funding must be provided to launch and improve evidence-based programs.

Dovetail efforts: Many mental disorders have common developmental pathways. Resources must be aligned between the departments of Education, Justice, and Health and Human Services. The National Institutes of Health should develop a comprehensive 10-year plan to research ways to promote mental health and prevent mental disorders in young people. State and local agencies should coordinate efforts and foster a multi-agency approach to ensure a comprehensive developmental perspective.

Equality in research funding: At present, a great deal of research leans toward treatment. Research needs to move from laboratory settings to real world settings, and must be responsive to community socioeconomic needs, diversities, values, and goals. The IOM report also cautions that funding should not support mental health programs that lack empirical evidence, despite their popularity within communities.

Identifying children with risk factors: Mental health screenings can be a helpful tool if parents and communities are aware of the purposes and methods of screenings, and have the ability to decline if they do not want their children included. But all families can learn to be aware of warning signals for teen depression, for example, and to distinguish between signs of impending psychosis, and teenage angst that falls within the norm of behaviors prompted by the transition from children to teens to young adults.

Speak up: Programs that work need media attention to thrive. Seek out members of the media, distribute press releases, and invite the media and the public to “community education nights” that highlight prevention and early intervention efforts that build strong, healthy communities and improve the quality of life. Society can no longer afford to ignore the risk factors for and the onset of mental illnesses and substance use disorders. Ignoring prevention and early intervention is issuing a personal invitation to cut a young life drastically short.

Linda Rosenberg is the president and CEO of the National Council for Community Behavioral Healthcare. TNC specializes in lobbying for research toward the diagnosis and treatment of mental illness, including bipolar depression. Lean more at www.thenationalcouncil.org.

001.26.10 Policy Changes and Disease Management: Keys to Halting Premature Death of the Mentally Ill

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Mental illness is a mysterious condition in our world. As more information is found about mental disabilities, the more mysterious they become. Recently more research has shown worse news for those with mental illness. According to the National Council Fact Sheet, mental illness may be linked to a premature death for some. Those with serious mental illnesses such as schizophrenia, bipolar disorder and major clinical depression seem to die, on average, 25 years earlier than normal.


The cause of these premature deaths is yet unknown, but there are certain conditions that may point to an answer. For example, sixty percent of the premature deaths of those with schizophrenia involved cardiovascular conditions or pulmonary and infectious diseases. The linkage of mental illness and premature death is made worse by those with serious mental illness having less access to treatment for physical health conditions.


However, there is still work that can be done to aid with the problem of premature death of those with serious mental illnesses. Policy makers can provide assistance by creating programs that make more resources available to help give those with mental illnesses access to better physical healthcare. One example of such as policy change would be to require those providing public mental health to assess the mental and physical health of a patient.


Louisiana and Missouri have taken strides by financing the linking of mental and physical health treatment. Funding has gone to promote integrated healthcare between mental health and primary care providers in the states. Other state legislatures should follow in step by creating a link between public healthcare and mental healthcare. This would require the creation of new infrastructure in both industries.


Besides creating policy changes, the premature death of the mentally ill can be curbed through management of mental diseases. Although treatment for such diseases may not be possible, carefully monitoring may aid in catching problems leading to premature death. Typical medical care is not adequate for such instances and sometimes misses the needs of mentally ill patients.


To manage mental illnesses, planned care needs to be provided. This may require reorganizing provider roles and common practices in order to focus on new problem areas. Also, patients should be encouraged to manage their own disease. This would require careful training and easier access to those trained in monitoring mental illness.


One way to acquire the above goals is to implement a disease management program or DM program. These programs aid those with persistent medical problems and provide greater quality with lower cost. In these programs, patients are given education on self management and healthcare is coordinate across the spectrum. The adoption of DM has been encouraged by the Centers for Medicaid and Medicare Services and is currently used for asthma, diabetes, hypertension and other chronic medical conditions. The implementation of such a practice to those with mental illnesses is not a far step.


Dealing daily with a mental illness is enough of a struggle for patients and families without the addition of linking early death to mental illness. The research and prevention of this problem is crucial and hinges on changes in policy and practice. These policy changes will aid in helping researchers find the links between mental illness and premature death. The method used to find these links will not only improve the physical health of the mentally ill but will, in the case of DM programs, also give them the ability to manage the disease that plagues them daily.

The author is the Director of Marketing and Communications at The National Council. The National Council for Community Behavioral Healthcare is a not-for-profit 501(c)(3) association. For more information, visit http://www.thenationalcouncil.org.

001.26.10 Beyond the Open Door — Challenges in Housing for People with Mental Illness

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Housing for people with mental illness is as much a place as it is an ongoing process to engage and promote their recovery. Helping consumers easily access and maintain stable housing must remain at the heart of any service system.

The suitability of certain types of housing for people with mental illness is a discussion as relevant today as it was thirty years ago. Recently, a New York State judge made a landmark decision regarding the rights of people with mental illness residing in adult homes in New York City (Disability Advocates, Inc. vs. NYS Governor David A. Paterson et al, 2009). He ruled that the adult homes provide little opportunity for people with mental illness to integrate within the community. The judge also noted that keeping them in adult homes is more expensive by several thousand dollars per person per year than providing these individuals with supported housing and community services. The court ordered the state to create a plan to transition these residents from adult homes into supported housing or smaller group residences.

This decision, though right now limited to New York City, could set a nationwide precedent,particularly in states that rely heavily on board and care homes, as well as nursing homes, to house people with mental illness. Given the potential changes ahead, it is vital we understand the questions and issues posed by supported housing. What follows is a brief discussion of four critical questions that every mental health and housing provider must consider in order to create stable housing and successful community inclusion for people with mental illness.

What works best for different people?

The Housing First model has had an undeniable positive impact on how we approach housing for people with mental illness. This model unconditionally offers consumers an apartment of their own and then crafts personalized supports for them that range from flexible case management to community-based mobile treatment in the form of Assertive Community Treatment. Since not everyone wants to live in his or her own apartment, a range of options that includes small congregate housing programs and other alternatives with flexible supports is necessary and appropriate.

What clinical supports do clients need in communities and how best can these be provided?

A recent article in the New York Times (For Families of Mentally Ill, Mixed Feelings Over Push Away From Adult Homes, October 8, 2009) voiced concerns pertaining to the court’s ruling on adult homes. Relatives of people living in adult homes fear that their loved ones do not have the skills to survive in their own apartments and have previously failed in similar circumstances.

Supported housing that provides small studio apartments within congregate buildings might address those concerns. This type of congregate model has been shown to be very cost-effective and programmatically responsive for clients who otherwise might not be successful in a scatter-site apartment arrangement. These buildings generally consist of approximately 40 studio apartments and, while congregate, are small enough to foster a sense of community inclusion and privacy and maintain a very high retention rate. People who live in these small buildings typically have access to a front desk attendant round the clock.

How can supported housing and its necessary supports best be financed, especially in a recessionary economy?

Wrapping in appropriate supports for people with serious mental illness living in communities can be expensive — but by no means more expensive than the alternative. Most state budgets are strained and the largest single cost escalator is Medicaid, especially for people with serious mental illness. Medicaid costs are ballooning for people with mental illness because of the heavy utilization of hospital emergency rooms and subsequent hospitalizations due to avoidable medical and psychiatric emergencies.

In an effort to stabilize medical care received by people with mental illness in the community and reduce emergency costs, there is a national movement to create “medical homes.” Medical homes provide continuous and consistent medical care to people with mental illness. However, stable consumer housing is a necessary precursor to the implementation of an effective “medical home” intervention.

Supported housing is less expensive than all costs associated with adult home care. However, there needs to be a means of aggregating all available funding into a single payer silo and allocating a fair share to supported housing. Otherwise, it will be difficult to make supported housing universally available. One major barrier is that Medicaid defines eligible costs as those that are medically necessary, thereby limiting Medicaid participation to an illness model. It would be more productive and cost-effective to permit Medicaid’s participation in prevention planning and implementation. Additionally, supported congregate housing, in contrast to the general housing market, requires a capital investment to finance the building of efficiency unit-housing facilities and a long-term commitment to support affordable rents despite market escalations.

What types of risk management approaches most effectively respond to legitimate community safety issues?

It only takes one or two well-publicized allegations of crime to further ingrain the stigma against people with mental illness. Widespread use of supported housing will force community-based agencies to train case management staff differently and develop clinical support tools to assist in consumer risk assessment and monitoring. Additionally, for parents with mental illness raising their children in supported housing, case managers with family development skills will be required to ensure child safety within the context of supporting the whole family.

Many of the lessons we at the Institute for Community Living have learned about community-based housing were gained through our work with the people we serve. One of the most important design elements is to enlist consumer participation in housing decisions. It is the hope of all mental health care providers that an ongoing conversation surrounding these topics will raise more questions than provide answers, thereby fueling the national dialogue on how to help people with mental illness — an incredibly diverse population — best integrate within the community.

Linda Rosenberg is the president and CEO of the National Council for Community Behavioral Healthcare. TNC specializes in lobbying for research toward the diagnosis and treatment of mental illnesses. Lean more at www.thenationalcouncil.org.

001.26.10 The Role of Histamine in Mental Illness and its Attenuation with Vitamin C – Part I

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A Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy

Clayton College of Natural Health    

 Birmingham, Alabama     2005

 

Abstract

The prevalence of mental illness in America is increasingly becoming recognized as an epidemic. There are a number of conventional methods to deal with mental illness, including psychotherapy and pharmaceutical medications. However, both of these types of treatments have their limitations, and pharmaceutical drugs can have many dangerous side effects. Natural therapies have much less side effects than conventional medications, although they have traditionally been used to treat specific mental illnesses. Vitamin C is nontoxic, easily tolerated, and in theory will help the vast majority of mental illnesses. Vitamin C has both mild stimulant and potent antihistamine properties. High histamine levels are associated with both anxiety and depression, and high histamine levels have been shown to be significantly lowered with megadoses of vitamin C. Indeed, vitamin C has been shown to act as both a mild antidepressant and anxiolytic. Its mild stimulant property is due to its boosting of cyclic adenosine monophosphate (cAMP) via inhibition of the enzyme that degrades cAMP, phosphodiesterase. Vitamin C also is involved in the production of the hormone norepinephrine, which is necessary for mental health.

Vitamin C is known to be a key nutrient for proper brain function. Besides keeping histamine levels in check, vitamin C also modulates dopamine levels; high dopamine levels are associated with psychosis. Vitamin C also boosts oxytocin levels, which is involved in pleasure and well-being. Vitamin C protects against neuronal damage, usually via its antioxidant property. Vitamin C inhibits release of the stress hormone cortisol, chronically high levels of which are associated with depression. High blood levels of vitamin C are associated with a significant reduction in death rate. There is no reliable evidence for vitamin C causing DNA mutations, rebound scurvy, iron overload, vitamin B-12 deficiency, or uric acid buildup. The vast majority of animals synthesize their own vitamin C, and animals weighing the equivalent of a human produce roughly a dozen grams of vitamin C daily. This fact adds weight to the theory that humans should megadose with vitamin C, especially if they have mental illness.

Table of Contents

Chapter 1: Introduction to the Problem or Issue………………………………………..2

Statement of the Problem or Issue…………………………………………………………….2

Background and History……………………………………………………………………………..5

Research Questions…………………………………………………………………………………..8

Hypothesis………………………………………………………………………………………………….9

The Significance of the Study……………………………………………………………………..9

Definition of Terms……………………………………………………………………………………..9

Summary…………………………………………………………………………………………………..12

 

Chapter 2: Review of Related Literature and Research…………………………..14

Introduction……………………………………………………………………………………………….14

Literature Review………………………………………………………………………………………29

Summary…………………………………………………………………………………………………..41

 

Chapter 4: Results and Findings……………………………………………………………..45

Introduction……………………………………………………………………………………………….45

Findings……………………………………………………………………………………………………45

Summary………………………………………………………………………………………………….48

 

Chapter 5: Conclusions, Implications

and Recommendations for Further Research…………………………………………52

Conclusions and Implications…………………………………………………………………52

Recommendations for Further Research………………………………………………..55

Summary………………………………………………………………………………………………….58

 

References Cited……………………………………………………………………………………..61

 

List of Tables, Illustrations and Other Graphics

Abbreviations and Definitions………………………………………………………………….10

 

Chapter 1: Introduction to the Problem or Issue

Statement of the Problem or Issue:

The general purpose of this dissertation is to determine if high intake of Vitamin C alone can help resolve mental illness in general, especially in atopic (allergic) people. Mental illness is a significant problem in today’s society, and a growing body of evidence indicates that nutritional therapies may partially or completely resolve this issue. Many nutrients affect both mental health and the immune system, and it is now well-known that the central nervous system (CNS) and the immune system are intimately linked. The immune system plays a role in regulating feeding behavior, sleep, body temperature, and brain activity (Steinman, 2004). As will be discussed later, histamine is involved in all of the above activities.

A group of peptide hormones called interleukins are prime examples of CNS/immune system interactions. For example, when the immune hormone “IL-2 is given to normal individuals, it produces schizophrenia-like symptoms” (Heleniak & O’ Desky, 1999, p.40). Release of the immune hormone Interleukin-1 beta (IL-1b) can result in depression, learned helplessness, and pain-related behavior (Hurwitz & Morgenstern, 2001). Interleukins are a sub-class of immune hormones termed cytokines. Cytokines can act to create a loss of appetite, malaise, increased sleep, drowsiness, and fatigue (Martin, 1997). A group of cytokines called the interferons (IFNs) are often administered for serious viral infections or cancer. IFN use is associated with depression, insomnia, delirium, and even suicide (McDonald, Mann, & Thomas, 1987). Also, several studies have found that normal white blood cell response to growth factors is impaired in depression, as is natural killer (NK) cell activity (Kagaya & Yamawaki, 1998).  

In order to understand the links between mental health and the immune system, a brief explanation of hormones is needed. There are three main types of hormones: steroid hormones, which are derived from cholesterol, peptide hormones, derived from protein synthesis, and amino-acid derived hormones. The seven major amino-acid derived hormones include: serotonin, norepinephrine (also called noradrenaline), epinephrine (also called adrenaline), dopamine, acetylcholine, gamma-amino butyric acid (GABA), and histamine. The last of these seven amino-acid derived hormones, histamine, will be the primary focus of this dissertation. The reason for this is that histamine is unique among amino-acid derived hormones because it plays prominent roles in both mental status and immune status. Epinephrine and norepinephrine do play certain roles in immune function, but unlike histamine, their roles are generally positive in normal subjects. However, depressed people tend to have higher levels of epinephrine, norepinephrine, and the steroid hormone cortisol (Martin, 1997). This phenomenon will be described in greater detail later. The other four amino-acid derived hormones play only minor roles, if any, in immune status.

Histamine has myriad effects on the body, ranging from subtle to lethal. These effects will be described in detail throughout this dissertation. The complex effects of histamine are due to both its positive and negative effects, depending on the cell type that released it. As mentioned above, histamine is both a neurotransmitter and an immune modulator. Neurotransmitter cells that release histamine are called neurons, and immune modulator cells that release histamine are most often mast cells, although a few other immune cell types also store histamine. Both neurotransmitter histamine and mast cell histamine are found in the brain. Neurotransmitter-released histamine can perform both positive and negative functions, while mast cell-released histamine generally performs negative (morbid/mortal) functions.

It has been discovered that in rat brains, mast cells release histamine during stress (Arrigo-Reina & Chiechio, 1998). Released brain histamine may play a role in both physical dependence and tolerance to morphine (Glick & Crane, 1978). Further evidence of this phenomenon is provided by a combination antihistamine / opioid therapy as a heroin substitute (Galosi et al., 2001). Another intriguing finding is that neurotransmitter histamine tends to decrease with age, while mast cell brain histamine tends to increase with age (Fernandez-Novoa & Cacabelos, 2001). Normal histamine levels play useful physiological roles, but high histamine levels are considered pathological (Subramanian, Nandi, Majumber, & Chatterjee, 1974). Excessive blood histamine levels may raise the overall death rate by 24% (Johnston, 1996).

Elevated brain histamine levels inhibit reward-related behavior (Galosi et al., 2001). This lack of motivation may lead to apathy and depression. Another of the many functions of brain histamine is memory modulation. Local administration of histamine into animal forebrain reinforced fear memory (Blandina et al., 2004). However, histamine can both facilitate and inhibit memory (Blandina et al., 2004). More specifically, histamine usually improves short-term memory (Prast, Argyriou, & Philippu, 1996), while possibly impairing long-term memory. Interestingly, histamine facilitated memory retrieval in old rats (Kamei & Tasaka, 1993).

It is well-known that histamine is involved in allergic and inflammatory reactions (Haas, 1992). A detailed explanation of this effect is in the Introduction section of Chapter 2. There is strong evidence to suggest a link between mental illness and allergies. “Studies of depressed and chronically fatigued patients found that up to 70 percent suffered from allergies—as compared to 2 percent of healthy controls” (Firshein, 1996, p. 160). Another study found that “85% of depressed patients had allergies” (Ossofsky, 1976, p.335). Histamine can cause behavioral depression, and this can be reversed by the antihistamine effects of tricyclic antidepressants (Arrigo-Reina & Chiechio, 1998). Tricyclics have many other actions on neurotransmission as well.

It is well-known that allergies and asthma are strongly linked. An important study found that children with severe asthma have significantly more behavioral problems (Bussing, Halforn, Benjamin, Wells, 1995). Children with early onset asthma, before the age of four, tend to have fearfulness, insomnia, and depressed mood (Mrazek, Schuman, & Klinnert, 1998). Conversely, psychosocial stressors can precipitate asthma (Kilpelainen, Koskenvuo, Helenius, & Terho, 2002), creating a vicious cycle. Intriguingly, behavior problems tend to precede asthma in children (Stevenson et al., 2003). The link between allergies/asthma and behavioral problems can begin as early as age three (Calam et al., 2003).

Background and History:

The application of nutritional therapies to mental illness began in the latter half of the 20th Century, with Drs. Abram Hoffer and Carl Pfeiffer. They recognized that blood histamine levels were low in around 50% of schizophrenic patients, and subsequently designed nutritional therapies for them (Petrie & Ban, 1985). However, many schizophrenics have raised histamine levels. The standard orthomolecular therapy for high histamine levels is calcium, magnesium, methionine, and zinc. It has been known for some time that vitamin C detoxifies excess histamine by cleavage of the imidazole group (Subramanian, 1977). Unfortunately, vitamin C is not one of the main treatments for high histamine levels, and the recommended therapeutic dose is relatively low, at 2000 mg/day. In fact, low histamine levels were treated with higher vitamin C doses (Edelman, 1998).

Histamine’s actions have been studied in both humans and animals. Histamine injected into animal brains caused a variety of behavioral symptoms, including irritability, teeth chattering, grooming, facial tremors, chewing, head shakes, yawning, writhing, and salivation (Glick & Crane, 1978). As mentioned in the previous section, tricyclic antidepressants have been used in the past to reverse histamine-induced depression via their common antihistamine actions. Classical antihistamines are known to decrease anxiety, in that “H1 receptor antagonists and H3 receptor antagonists decrease the anxiety state” (Ito, 2000, p.263). Furthermore, tricyclic antidepressants may lower anxiety (most tricylics have a strong antihistamine effect).

Unfortunately, tricyclic antidepressants have a plethora of side effects, some of which are lethal (Wilson, Shannon, & Stang, 2000). The tricyclic antidepressants can be informally categorized under the ‘first-generation’ of antihistamines, which cross the blood-brain barrier. Side effects of these first-generation antihistamines include dry mouth, drowsiness, restlessness, and sleepiness (Edelman, 1997). One of the most notorious side effects of first-generation antihistamines is weight gain (Tuomisto, 1994). Chronic use of first-generation antihistamines may cause memory loss (Mark & Mark, 1989). Other first-generation antihistamines besides tricyclics have also been used to treat mental illness, specifically anxiety disorders.

The most commonly used antihistamine used in the past for anxiety was Hydroxyzine (Atarax); drowsiness was the most commonly reported side effect (Lader & Scotto, 1998). Over-the-counter first-generation antihistamines have been abused for a variety of reasons, including hallucinations, anxiety-lowering effects, and/or euphoric sensations (Halpert, Olmstead, & Beninger, 2002). The antihistamine diphenhydramine (Nytol, Benadryl) has reportedly been abused by pre-teens (Dinndorf, McCabe, & Frierdich, 1998).

Due to the above problems with the older antihistamines, pharmaceutical companies attempted to design next-generation antihistamines that do not cross the blood-brain barrier, and thus presumably would not have any CNS or brain side effects. In the late 1980’s the first prototype second-generation antihistamines were synthesized. Since the structure of the second-generation antihistamines was more hydrophilic than the older antihistamines, the second-generation antihistamines did not cross the fatty blood-brain barrier to a significant extent, and thus did not cause sedation in most people. They also do not share the anticholinergic effects of the older antihistamines, which can cause dry mouth and thickening of mucus secretions (Wray, 1998; Fried, 1999).

Even the second-generation antihistamines have their share of side effects, which include: drowsiness, sedation, headache, depression, fatigue, nausea, anxiety, hypotension, hypertension, palpitations, tachycardia, vomiting, blurred vision, and rash (Wilson, Shannon, & Stang, 2000). Second-generation antihistamines also can produce altered brain activity that can approach convulsions (Fernandez-Novoa & Cacabelos, 2001). The second-generation antihistamine Fexofenadine (Allegra) can cause life-threatening arrythmias and fibrillation, and “has been withdrawn from the market in several countries” (Taglialatela, Timmerman, & Annunziato, 2000, p.53). Second-generation antihistamines Cetirizine (Zyrtec) and Loratadine (Claritin) have both been shown to cause memory loss (Nishiga, Fujii, Konishi, Hossen, & Chiaki, 2003). Both first- and second-generation antihistamines can cause seizures (Taglialatela, Timmerman, & Annunziato, 2000).

Research Questions:   

The major discrepancy noted above in the beginning of the Background and History section (using vitamin C to treat low histamine levels) may be unique to treating schizophrenia, but unfortunately the historical research has shown that no other form of mental illness has been given the nutritional attention that schizophrenia has. Contemporary research has studied vitamin C from a relatively theoretical level, and it has been determined that vitamin C affects many different aspects of behavior and mental health. It is the goal of this dissertation to suggest various applications for vitamin C in improvement of various mental health issues based on both new information and reevaluation of historical research.

Hypothesis:

Large doses of vitamin C can reduce or reverse most mental illnesses, especially when they are allergy-linked.

Significance of the Study:

Treatment of mental illness with pharmaceutical drugs can be dangerous to the patient. Over half of the main prescription drugs used to treat anxiety and depression have potentially lethal side effects (Jensen, 2002). Pharmaceutical antihistamines have many side effects, some of which were described in the Background and History section of Chapter 1. It would be an accomplishment of major significance if one or more nutrients were safely and successfully used to help most forms of mental illness, and if this information were to be accepted by mainstream health care. Possible impacts of this study include using vitamin C as an adjunct therapy along with other nutrients, or alone as a holistic therapy for various mental illnesses. Potential benefits of the above use of vitamin C could result in a significant decline in morbidity and mortality of prescription drug users, and possibly even resolution of mental symptoms.

Definition of Terms:

The variables in this study include various forms of mental illness, although this study will attempt to take a holistic approach to the treatment of mental illness, and will only mention specific diagnoses if they are essential to understanding the greater issue at hand. There will be many uncommon terms used in the proposed study. Vitamin C will be the term used to describe the molecule ascorbate. If ascorbic acid, sodium or calcium ascorbate, or dehydroascorbate is specifically mentioned or recommended, then those terms will be used instead of vitamin C. There will be many different hormones and proteins named in the study, often with their abbreviations. If a hormone or protein is to be abbreviated throughout the dissertation, it will be introduced initially with its full name, then with its abbreviation from then on. A list of common abbreviations and definitions is provided below.

 

AA                                           Arachidonic Acid (precursor to prostaglandins)

ACTH                                     Adrenocorticotropic Hormone

ADD                                       Attention Deficit Disorder

ADHD                                    Attention Deficit-Hyperactivity Disorder

Allergen                                Antigen

Antagonist                            Receptor blocker

Axon                                       Presynaptic nerve terminal

BDNF                                     Brain-Derived Neurotrophic Factor

Ca2+                                      Calcium ion

CaM                                        Calmodulin

CAM K’s                                 Calmodulin kinases

cAMP                                       cyclic Adenosine Monophosphate

CNS                                        Central Nervous System

CREB                                      cAMP Response Element Binding Protein

CRH                                        Corticotropin-Releasing Hormone

Cu2+                                       Copper ion

Cytosol                                    The intracellular fluid of a cell and the vast majority of a typical cell’s volume

DAG                                         Diacylglycerol

Dehydroascorbate                Fully oxidized vitamin C

Dendrite                                  Postsynaptic nerve terminal

DGLA                                       Dihomo-Gamma Linoleic Acid

DNA                                         Deoxyribonucleic Acid

GABA                                       Gamma-aminobutyric acid

5-HT                                         5-hydroxytryptamine; serotonin

H                                               Histamine

Histaminemia                        Elevated histamine blood and/or tissue levels

HPA axis                                  Hypothalamic-Pituitary-Adrenal axis

IFN’s                                         Interferons

IgE                                            Immunoglobulin E (anti-allergen antibody)

IL-1b                                         Interleukin -1 Beta

IP3                                            Inositol triphosphate

Kinase                                     A protein that transfers a phosphate group to another protein or small molecule

Lipid                                         Fat

LTD                                           Long-term Depression (of neural activity)

LTP                                           Long-term Potentiation (of neural activity)

MAP2                                        Microtubule-associated Protein 2

mRNA                                      messenger Ribonucleic Acid

NK cells                                   Natural Killer cells

NMDA                                       N-Methyl-D-aspartate

Paracrine                                 Local hormone action

PLC                                          Phospholipase C

PGE1                                       Prostaglandin E1

PGF2a                                     Prostaglandin GF2a

PIP2                                         Phosphatidylinositol 4,5-bisphosphate

PKA                                          Protein Kinase A

PKC                                         Protein Kinase C

PRL                                          Prolactin

SAMe                                       S-Adenosylmethionine

Synapse                                  Intracellular space between neurons

Th1                                           T-helper 1 immune response; the classical immune response against microbes

Th2                                           T-helper 2 immune response; the classical ‘allergic’ IgE-mediated immune response against allergens

Transcription                           RNA is made from a DNA template

Translation                              Expression of protein from mRNA

Vitamin C                                 Ascorbic acid, ascorbate

 

Summary:

The main issue in this dissertation is whether or not vitamin C can significantly attenuate histamine-related mental illness. Many different nutritional supplements have been successfully used in resolving mental illness (Edelman, 1998). However, the literature does not show vitamin C ever being used as a main-line nutritional therapy for any kind of mental illness. The antihistamine effect of vitamin C has not been effectively utilized in the past by the vast majority of either conventional or alternative practitioners. Conversely, the fact that relatively small amounts of vitamin C can release histamine has been used as a therapy in schizophrenic patients that have abnormally low histamine levels. Unfortunately, the practitioners that used this therapy did not use high-dose vitamin C therapy for schizophrenics with high histamine levels. Presumably this is because they believed that the extra doses of vitamin C may release even more histamine, and they also may not have been aware of vitamin C’s antihistamine effects at doses of several grams/day.

There is much evidence to support numerous interactions between the brain and the immune system. Abnormal amounts of immune hormones can cause schizophrenia and/or depression (Heleniak and & O’Desky, 1999; Hurwitz & Morgenstern, 2001). Of the amino-acid derived hormones that are both neurotransmitters and immunomodulators, histamine is by far the most important. It has been hypothesized that histamine is involved in mental illness (Pfeiffer, 1987), and it has long been proven that histamine is a major instigator of immune abnormalities/overreactions (Haas, 1992). In congruence with previous data suggesting a genetic basis for schizophrenia, there appears to be a genetic basis for some histamine-related schizophrenia (Brown, Stevens, & Haas, 2001). One theory of schizophrenia is that the blood-brain barrier is compromised, allowing unwanted molecules into the brain. Histamine has been shown to disrupt the blood-brain barrier (Greenwood, 1991). In the past decade, much research has been conducted into the classic stress-related ‘fight-or-flight’ response. Histamine has been found to be an important promoter of this morbid response (Johnston, Retrum, & Srilaskshmi, 1992).

Histamine can cause a variety of behavioral abnormalities in both humans and animals, and some of these abnormalities can be reversed by pharmaceutical antihistamines (Lader & Scotto, 1998). Unfortunately, pharmaceutical antihistamines have several side effects, and the more dangerous ones can be lethal (Wilson, Shannon, & Stang, 2000). Even the relatively safer second-generation pharmaceutical antihistamines have their share of side effects (Wilson, Shannon, & Stang, 2000). Since the second-generation antihistamines do not cross the blood-brain barrier to an appreciable extent, they cannot be used to treat mental illness. Vitamin C has potent antihistamine effects, does cross the blood-brain barrier, and has very mild side effects, if any. There is also both anecdotal and epidemiological evidence that vitamin C supplementation improves mental health (Mark & Mark, 1989; Balch & Balch, 1997; Brody, 2002). It would seem from the above information that vitamin C supplementation should be included in every mental illness therapy regimen.

Dr. Jensen is both a consultant and author in the BioMedical and Nutrition fields. He has previously written a book on both topics, The Failures of American Medicine, published in 2002. Dr. Jensen has also written a doctoral dissertation on how Vitamin C can reduce stress and allergies via its antihistamine effect. He has worked in a broad range of BioMedical fields, such as gene regulation, cancer research, and HIV vaccine development. However, Dr. Jensen eventually decided that helping people more directly would be more rewarding for everyone involved. He has since helped clients with dozens of different ailments. Dr. Jensen is a practitioner in the field of Metabolic Typing, which characterizes different biochemistries among people based on certain physical and behavioral traits they have.

You can contact Dr. Jensen at 1-800-390-5365, or mail him at drjensen@individualizednutrition.com.

001.26.10 Every Mental Illness is a Chronic Disease: Including Depression

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Misconceptions about mental illness have existed for centuries. Accused of everything from moral failings to demonic possession, people with mental illness had been forced to hide their suffering. The Surgeon General of the United States reported in 1999 that stigma was the single largest barrier to the recovery of people with mental illness, making it harder for people to get treatment as well as find housing, jobs, and friends. Nearly two-thirds of people with mental illness do not get the help they need.

Today we understand that mental illness is not only treatable, but that it is a chronic disease like asthma or diabetes. Classifying mental illness as a chronic disease may seem surprising, but consider the statistics. Nearly one in five Americans has a mental disorder, and mental illness is the leading cause of workplace absenteeism. Depression, one of the most common mental illnesses, is harder on people’s health than long-term illnesses like angina, arthritis, asthma, and diabetes. A new study by the Centers for Disease Control and Prevention finds that depression and anxiety are two major causes of health problems and chronic illnesses, including asthma, diabetes, and cardiovascular disease.

Emergency rooms are overcrowded with people with mental illness. According to the Agency for Healthcare Research and Quality, almost one-fourth of all stays in U.S. community hospitals-7.6 million of nearly 32 million stays-involved depression, bipolar disorder, schizophrenia, and other mental health disorders or addiction disorders. Our contemporary response to mental illness has been to treat mental illness as an acute illness-with a hospital stay followed by a referral to a doctor or clinic in the community.

Unfortunately, the outcome is often relapse and repeated cycles of high-cost hospital stays. The coverage for treatment of mental illness contrasts sharply with its chronic nature. Only an estimated one-fifth of U.S. workers with employer sponsored health insurance are covered by strong parity laws that mandate mental health benefits, prohibit limits on outpatient visits and inpatient days, and limit the extent to which enrollees are burdened with higher cost sharing for mental health services.

Managing the Disease

With adequate treatment and support, people can learn to manage their mental illness and can recover sufficiently to have full, productive lives even if they are not cured. In fact, recovery rates for mental illnesses like depression, anxiety, schizophrenia, and bipolar disorder surpass the treatment success rates for many physical disorders such as heart disease.

But there are major challenges to the well being of people with mental illness. Contributing to the complexity of successful treatment is poor employment status and resulting poverty; high levels of substance use and physical illnesses; and difficulty with adherence to treatment regimens.

The same kind of care-management approaches effective in treating physical conditions such as diabetes or asthma-approaches that offer continuity, coordination and comprehensiveness-can also work for mental illness. The millions of Americans who are living with mental illness need the confidence and skills to manage their condition; the most appropriate treatments for optimal disease control and prevention of complications; a mutually understood care plan that includes coordination among all physicians and support-service providers; and careful, continuous follow up.

People with mental illnesses are no different than people living with arthritis, diabetes, and other chronic diseases. They need to be evaluated, insured, and treated. They need continued care and monitoring.

Ending Insurance Discrimination

Adequate care requires adequate dollars. Public insurance pays for at least 75 percent of treatment services for people with chronic and serious mental illnesses in community settings. Despite its discriminatory approach, it is the only option for millions of poor, unemployed, homeless, incarcerated, and other vulnerable populations with mental illness. So we must act to end the discrimination. We must eliminate ongoing and threatened cuts to Medicaid. And Medicare must stop requiring higher copays from people with mental illness, while strengthening its sadly inadequate mental health benefits package.

Private insurance also discriminates against people with mental illness. Currently, only an estimated one-fifth of U.S. workers with employer sponsored health insurance are covered by strong parity laws that mandate mental health benefits, prohibit limits on outpatient visits and inpatient days, and limit the extent to which enrollees are burdened with higher cost sharing for mental health services.

The recent House passage of the parity bill-the Paul Wellstone Mental Health and Addiction Equity Act-offers hope, taking us closer to ending discriminatory private health insurance policies that deny or restrict access to treatment for people who are suffering from mental illnesses and addiction disorders. If it becomes law, the bill will require health insurers to offer mental health benefits equal in cost and scope to medical and surgical benefits. It will prevent insurers from requiring larger copayments or imposing lower reimbursement ceilings for mental illnesses and addictions.

We have indeed come a long way in how we perceive and treat mental illnesses. But more needs to be done to meet the needs and manage the costs of this chronically ill population. Now is the time to put mental illnesses on an equal footing with other chronic diseases. The sooner that mental illnesses achieve parity, the sooner millions of Americans can get on the road to recovery.

Linda Rosenberg is the president and CEO of the National Council for Community Behavioral Healthcare. TNC specializes in the treatment of mental illness, including depression, while also promoting public policy for emotional and behavioral disorders. Lean more at www.thenationalcouncil.org.

001.26.10 Mental Illness Caused Through Work Stress

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Every year a substantial number of people are diagnosed mental illness brought on by stress at work. The effects can be devastating. The causes can vary a great deal, but might include:

· Excessive workloads,

· Excessive working hours,

· Bullying in the workplace, or

· Exposure to particular traumatic circumstances.

These issues could frequently be prevented by employers taking appropriate action as soon as they become aware of a problem. Many employers will wait until after the damage to their employees has become apparent before they provide counselling, or even begin to tackle the cause of the problem.

Employers owe their workforce a duty to combat work related stress when it is made known to them. However, many employers provide no support at all, while others take inadequate measures that fail to prevent further injury.

Compensation for these injuries could be worth as much as £10,000 or more. An award could be made for wages lost as a result of mental illness. Further sums can be recovered if the illness has affected a claimant’s future employability.

A claim against an employer or a former employer can be vitally important – not just in order to recover compensation, but as a means of making employers accountable. A successful work claim could force an employer to take action to prevent these injuries being suffered by others in future.

There are a number of state benefits available to victims and their carers. A specialist Solicitor can not only pursue compensation claims for sufferers on a true No Win, No Fee* basis, but also provide advice and assistance with applications in order to maximise benefit entitlement.

Andrew Bowen is the Managing Director of CityView Media who own and run a number of online websites including National Injury Claims and Claim King Accident Compensation.

001.25.10 Can Severe Debt Problems Lead to Mental Illness?

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Personal debt is a growing problem in the UK, but is an even greater problem for those that suffer mental illness for a variety of reasons. In many cases it is the anxiety over the amount of debt they have that has contributed to the mental health issue, but others have got into debt while already suffering from the illness.

Even now, as would-be lenders become ultra-cautious about to whom they lend, credit is still readily available. Advertising regularly espouses the “buy now, pay later” culture, into which many of us have been drawn. It now appears impossible to enjoy an everyday life without incurring some element of debt along the way, as many struggle to get onto the housing ladder or afford their drastically increased mortgage payments.

But, while most manage to just keep their head above water, financially, many more are drowning in debt, and dealing with that throws up many emotional problems. The classification of ‘over-indebtedness’ by the Citizens Advice Bureau includes someone who is “unable to pay their current credit repayments and meet their other commitments without reducing other expenditure below normal minimal levels.” Many of the people who fall into that classification will suffer more readily from depression and ill-health, and that includes mental illness, as well as being more likely to incur even more debt.

The department of health and the environment at the Wales Centre for Health is conducting research into the link between ill health and debt. Director Susan Malby said:

“Most of us are in debt of some kind, but we prefer to call it credit, a much more socially acceptable way of describing debt. However, over-indebtedness isn’t linked uniquely with poor debt management or low-income families. Events such as birth of a child, sudden unemployment, the death of someone close, long-term illness or disability; all significantly increase the chances of falling into severe debt.”

The study has found that many who fall into debt suffer health problems because they can no longer afford to eat properly or heat their home. That adds to the anxiety they are already feeling and that’s when people can slip into the spiral of hopelessness that in-turn leads to lack of self-esteem at best, or can manifest itself as mental illness in worst case scenarios.

To prevent that Malby recommends that anyone in the situation where they need help finding appropriate debt solutions, should immediately contact the Citizens Advice Bureau in the first instance, and get back on the road to financial and emotional well-being.

Elisha Burberry is an online, freelance journalist and keen traveller and watersports enthusiast. Originally from Scotland, she now resides in London.

001.25.10 The Prevalence of Mental Health Disorders, Emotional and Behavioral Disorders and Mental Illness in Children

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Mental health disorders and mental illnesses affect a greater number of children and juveniles than many people are aware of. These emotional and behavioral disorders can have profound negative effects on the growth and development of children, especially when they go unnoticed and untreated. A greater proportion of children and youth in the child welfare and juvenile justice systems have mental health problems than children and youth in the general population.

-50% of children and youth in the child welfare system have mental health problems.
-67% to 70% of youth in the juvenile justice system have a diagnosable mental health disorder.

Prevalence Estimates of Mental, Emotional and Behavioral Disorders In Young People

DISORDER                                            PERCENTAGE OF YOUNG PEOPLE AFFECTED

Learning D/O:                                                                5%
Substance use / addiction disorder:                                  10.3%
CD:                                                                              3.5%
ODD:                                                                            2.8%
ADHD:                                                                           4.5%
Anxiety Disorders (various):                                             8%
Unipolar Disorder:                                                           5.2%
One or more disorders:                                                   17%

(D/O = Disorder; CD = Conduct Disorder; ODD = Oppositional Defiant Disorder; ADHD = Attention Deficit Hyperactivity Disorder Source: Preventing Mental, Emotional and Behavioral Disorders Among Young People, 2009. National Research Council and Institute of Medicine, of the National Academies.)

Early Detection and Intervention are Critical

The onset of major mental illness may occur as early as 7 to 11 years old.
-Research supported by the National Institute of Mental Health indicates that half of adults with MEB disorders were first diagnosed by age 14 and three fourths were diagnosed by age 24.  
-Factors that predict mental health problems can be identified in the early years, with children and youth from low-income  households at increased risk for mental health problems.  

Age at Onset of First Symptom of Full Psychiatric Disorder, by Age 21

DISORDER                        AVG. AGE OF FIRST SYMPTOM            AVG. AGE OF FIRST DIAGNOSIS

ADHD:                                            Age 5                                                 Age 5
ODD:                                              Age 5                                                 Age 10
CD:                                                Age 6                                                 Age 11
Anxiety Disorders (Various):              Age 7                                                 Age 8
Depression:                                     Age 12                                               Age 15
Substance Abuse:                             Age 14                                               Age 15
Substance Dependence:                    Age 16                                               Age 17
Any Psychiatric Diagnosis:                  Age 9                                                 Age 11

(Source: Preventing Mental, Emotional and Behavioral Disorders Among Young People, 2009. National Research Council and Institute of Medicine, of the National Academies)

Obstacles to Access and Quality in Mental Healthcare

Several federal commissions and workgroups federal task forces have documented the need for improved and expanded mental health services for children and youth.

-It is estimated that less than 1 in 5 of these children receive the appropriate needed treatment  
-Only 15% of youths who had difficulties had parents that actively talked to a health care provider or school staff about their child?s emotional or behavioral difficulties.  

There is not adequate financial support for quality services to prevent and treat mental health problems of children and youth. Many child mental health services are not covered by managed care payers. In 2007, 3.1 million youths, (12.5 percent of 12 to 17 year olds) received treatment or counseling for problems with behavior or emotional disturbances in specialty mental health settings (which include inpatient and outpatient care).

Effective Treatment and Prevention Exists

Clear windows of opportunity are available to prevent MEB disorders and related problems before they occur. An intervention before a disorder manifests itself is possible and offers the best opportunity to protect young people. Effective prevention includes strengthening families by targeting problems, strengthening individuals by building resilience and skills, preventing specific disorders by screening individuals at risk, promoting mental health in schools and promoting mental health through health care and community programs. The key to most approaches is to identify risks (biological, psychological and social factors) that may increase a child?s risk of MEB disorders.

Linda Rosenberg is the president and CEO of the National Council for Community Behavioral Healthcare. TNC specializes in the treatment of mental illnesses and addiction disorders while also promoting public policy for emotional and behavioral disorders in children. Lean more at http://www.thenationalcouncil.org/.

001.25.10 Malingering Brain Damage And Mental Illness

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Malingering of brain injury or damage, and malingering of mental illness are common concerns that must be considered in all litigation involving mental health professionals. Malingering in a forensic mental health context is a word which usually refers to deception intended to fake or exaggerate symptoms of a genuine mental illness, brain injury, or brain damage. That is the basic meaning, but in actual practice it is more complicated than that. Malingering is actually an inference made about someone’s motivation when there is an indication the information they are providing is not reliable or consistent with what is known about them and the condition.

The possibility of malingering must be considered in every forensic mental health evaluation because there is always the potential for a person to try and “beat the system” by attempting to exaggerate their symptoms, or present with symptoms of a condition that they do not actually suffer. The process of assessment of malingering has come a very long way since the time of professionals just going on their “gut feelings” and their clinical experience. In current forensic mental health practice there are a wide variety of techniques available to mental health professionals to assess the issues related to possible malingering.

The issue of possible malingering of mental illness or brain damage is present in both criminal and civil proceedings. In criminal proceedings it is most often seen in competency to proceed and mental status at the time of the offense issues. In civil proceedings the possibility of malingering brain damage is often seen in personal injury cases involving accidents and malpractice which may have resulted in brain damage. Malingering of other types of mental illness in civil proceedings are also common concerns in claims of post traumatic stress disorder and other conditions which may arise out of traumatic events or loss of independence.

The frequency of malingering found in the available literature indicates that it is neither prevalent nor particularly rare. There is considerable variation from one setting to another, but overall the frequency of malingering mental illness or brain injury in legal proceedings is probably between 15-18 % of cases. Most people involved in litigation do not exaggerate or fabricate their conditions, but the problem is common enough that it cannot be ignored.

Attorneys on both sides of any case involving mental health issues should be aware of the issues associated with malingering, and be certain that any mental health expert they use understands and considers such issues in the context of giving a professional opinion in legal proceedings. It almost goes without saying that mental health professionals, such as forensic psychologists and psychiatrists, should be familiar with the issues associated with possible malingering, and be prepared to answer questions about how they addressed the possibility of malingering.

Eric Mings Ph.D. is a clinical psychologist specializing in forensic psychology. Malingering is an area of special interest to him and additional information is available at Malingering.Info .

001.25.10 How To Deal With Your Job When You Have Mentall Illness

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We all know that the bills don’t stop even when you become ill. That includes mental illness. No matter what we are dealing with in life, we still have to work to pay our bills. The good thing is that mental illnesses rarely incapacitate you physically from doing your job. There are a lot of things you can do to give yourself the emotional and mental capabilities to continue working while you are dealing with your illness as well.

Keep things orderly.


Having too many things to do at once can cause a lot of stress and aggravate mental illness. Break down tasks into small, easily handled projects.

Delegate responsibility if you can.


If you are in a position to accept other’s help on projects, do it. Shouldering too much responsibility can make things more difficult for you. It is not necessary to accomplish everything by yourself. You are only human.

Stay positive.


It is easy to have a negative outlook on things. No matter what the issue is, if it is personal, or work related, look at things in a positive way and always try to find the good or even humorous side of a situation. The saying ‘laughter is the best medicine’ was invented for just that reason. You have to be able to laugh at circumstances. It helps all of us get through the days.


Know who you are

As simple as that sounds, it is an important aspect of dealing with mental illness, especially in the face of what others may think. You know who you are. Have confidence in your abilities, and who you are as a person and others will pick up on that and see you for who you are, not for your illness, too.


Know that you are human

Everyone has bad days, and everyone has something to deal with physically or emotionally. The problems you face on account of your illness may make you feel like you are different, that can lead to a desire to isolate yourself from the world. It just isn’t true. You are not different. You have a disease, and that disease causes a lot of problems for you but most people have problems of one sort or another. So that just makes you human.


Some of the symptoms of mental illness are just exaggerated forms of what everybody faces daily. If you give yourself the allowance to be human, and know that these are genuine human concerns, you will be able to feel better about yourself. That will give you the ability to cope with situations your illness brings on, and handle them better.


Evaluate situations

When you are put in a position at work to do a job you feel is beyond your scope. Don’t be afraid to say so. Putting yourself under too much pressure to succeed in a task will only lead to frustration and heightened symptoms. Asking for help in completing a project will make sure it is accomplished and you can feel good about having handled it.


Remember that others will treat you the way you expect to be treated. They will see you as you see yourself. If you need to, tell yourself in the mirror every morning that you are a good person. You deserve to be treated well, and with respect as a fellow human being. Most important, tell yourself you can handle what comes your way. Give yourself the pep talk you need to walk out and face the day and all of the challenges with resolve, and don’t forget the sense of humor.

Ronen David is the chairman of “Malam” (an Israeli organization supporting and representing those dealing with mental disabilities). He is the author of the “How to Cope With Psychosis & Schizophrenia Self Help Handbook”.
Visit his web site and learn Dealing With Mental Illness

001.25.10 Mental Illness: Disease or Choice?

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Is it true that Dr. William Glasser’s Choice Theory doesn’t believe in mental illness? Of course not! However, that is what many believe and some don’t give his ideas credence because they think he is wrong about that. This article is my humble attempt to explain exactly what Dr. Glasser means when he says he believes in mental health, not mental illness. This article should be particularly helpful to those of you who work in the helping professions or those of you with family members who have been diagnosed with any type of mental disorder.

I’m asking you to take a journey with me into the realm of possibility. What if what we believe about mental illness is wrong in much the same way people in Columbus’ day believed the world was flat? And if it’s possible our conceptualization about mental illness is wrong, then it logically follows that perhaps we need to look at treatment differently.

My goal in this issue is not to change your mind about what you think and believe, but merely to present another possibility. Take a journey with me into an alternative explanation and see where it takes us . . .

Choice theory has two concepts that are central to this discussion. One is the concept of total behavior and the other is our creative system. I’ll start with total behavior. Glasser says all behavior is total, meaning it consists of four inseparable components-your actions, your thinking, your feelings and your body’s physiology. All of these components occur simultaneously, even when you are more aware of one of them.

You only have direct control over two of these components. No matter how hard you try, you will not be able to change your feelings or your body’s physiology without first changing your actions or your thinking. You may not believe you have control over your thinking because sometimes certain thoughts enter our minds unbidden. However, once you learn how, you can direct your thoughts from unwanted topics to healthier ones.

When we want something we don’t have, we are driven to create a behavior designed to get us what we want. Sometimes, we rely on behaviors we’ve used in the past that were effective. Other times we create a new behavior. Whatever our choice, we are choosing the best behavior available to us at the time to get what we want.

When it comes to mental health symptoms, many believe that an imbalance in our body’s chemistry causes the unusual behavior or thinking. But what if the “crazy” behavior and thinking over an extended period of time actually causes the chemical imbalance instead? Isn’t it at least possible? Isn’t it exercising that releases endorphins into our blood? It’s not the endorphins that make us exercise. Isn’t it thoughts of bodily harm that releases the chemical adrenaline into our blood stream when we are scared? It’s not the adrenaline that makes us scared, is it?

And what about those diagnoses that don’t have a known chemical imbalance? What about Post Traumatic Stress Disorder or Dissociative Identity Disorder. These are groups of symptoms that develop during a serious crisis that serve us in that moment. In Choice Theory, Glasser would say they become organized behavior. In neurology, it might be said that neurons that fire together wire together. This means that once we produce a behavior and repeat it over time, it basically becomes the path of least resistance and when confronted with similar circumstances, we will default to our typical way of handling it.

So, if someone has developed a behavior that works for them to get something they want, then they are more likely to choose that behavior in the future. It is difficult to think of mental health symptoms as having any positive benefit to them. Why would someone choose such thoughts and behaviors?

Currently, there is a concept I hear more and more in psychology called secondary gain. Mental health professionals are recognizing that there often is some pay off for mental health clients in their symptomotology. It might get the client attention. It may abdicate them of daily responsibility. It might get them SSI benefits. They may be able to avoid unpleasant situations and keep undesirables at arm’s length. The list goes on and on. Couldn’t it at least be possible that these are not actually secondary gains, but rather the reason the symptoms developed in the first place?

Couldn’t it be that a person learned that being sad got them attention so they developed the behavior of depression? Couldn’t it be that a person learns anxiety gets them out of doing certain undesirable things? Once we experience a benefit, the behavior is more likely to become hard wired and therefore repeated, even long after it stops being effective.

Once of the criticisms of Glasser’s theory is that no one would actively choose to be neurotic or psychotic or personality disordered. Glasser never said it was a conscious choice. Most people suffering with mental health disorders are truly suffering, unaware there is any choice in the matter. Our current approach to treatment basically reinforces this image of mental health clients as victims.

I don’t know about you, but I want my clients to know there is a choice. They didn’t know it before. But if they understand now how symptoms can develop out of satisfying some need the had, then treatment becomes a matter of teaching them more responsible ways of getting those needs met.

http://www.Kimolver.com>Kim Olver is a life and relationship coach. She has consulted on training, leadership development, diversity, treatment programs and management styles. She is an internationally recognized speaker, having worked in Australia, Europe, Africa, Canada and the United States. She is the author of Leveraging Diversity at Work and the creator of the new, revolutionary process called, http://www.insideoutempowerment.com>Inside Out Empowerment.

001.25.10 How To Deal With Mental Illness Successfully

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The most difficult thing to deal with when you have been diagnosed with mental illness may be the stigma attached to it. Learning how to cope and deal with other people’s perceptions of you, may make you feel like hiding your problems. This can make life even more stressful than it already is because of your illness.


The first thing to realize that will help you cope with your problem is that it is, in fact, an illness. It is not something you made up. It is not something you can control, or choose. It is not, and probably the most common misconception others may have surrounding mental illness, a matter of you feeling sorry for yourself.


You have an illness. The good news is it is a treatable illness. Once you yourself come to grips with the truths surrounding your mental illness, truths regarding the misconceptions that you also have had ingrained from birth by society, you will be able to face others with the self confidence and assurance that will give them pause to realize you are not defined by an illness.


Treat your illness as something that is a matter of fact, when talking about it with others. Hiding it won’t make it go away, and will only make you seem evasive and untrustworthy. Not making a huge issue of it, and yet accepting and explaining the realities of it calmly allow it to be simply a statement of your physical well being rather than a scary unknown emotional instability.


The realities of mental illness are things you can help to control along with medications that soothe the physical triggers of mental illness. You know what triggers your own bouts of mental illness whether it’s manic or depression, or any of the other mental illnesses. Everyone has different triggers so knowing what works for you may not work for the guy next to you even if he has exactly the same illness.

Some things tend to go along with all forms of mental illness. The need for stability in routine is a very common factor in patients with mental illness.


Feeling overwhelmed often accompanies something as simple as a task that is too large or broad to be easily defined so it is easy to get too scattered in your approach to it, and it leaves you feeling like you can’t do it.


Order your days and any situations you face in small groups of things to do in order to accomplish each goal. That will help you feel a sense of accomplishment while also giving you the assurance that you are in control of the situation, and it is not too big to handle.


Give yourself credit for being human. While a lot of issues you face are compounded by your illness, the fact is most of those things that are so highlighted by your disease that they seem out of proportion, or make you feel singled out, are really things that happen to everybody and not something to get upset over.


Keep yourself busy. Staying active and involved in both social activities and hobbies goes a long way to helping those with mental illnesses cope on a daily basis. There is a tendency to draw back from others because you may feel insecure about how they will react to you. Give them a chance and you may be surprised at how open your friends and others will treat you. If people drawback, then shrug it off. It is there loss. That happens to anybody not just you, and you can’t help how someone else is going to react.


Keep yourself healthy. Regular exercise is a great way to keep yourself feeling good both physically and mentally. Regulate your alcohol consumption as it can aggravate mental illnesses and make things worse.

Above all else, enjoy your life and have a positive attitude. You can live a healthy, happy life while learning to control your mental illness.

Ronen David is the chairman of “Malam” (an Israeli organization supporting and representing those dealing with mental disabilities). He is the author of the “How to Cope With Psychosis & Schizophrenia Self Help Handbook”.
Visit his web site and learn Dealing With Schizophrenia

001.25.10 Some Mental Illness Symptoms You Should Be Aware Of

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Millions of people throughout the world suffer from all sorts of mental illnesses. These mental disorders and illnesses range from very mild mood disorders to extreme manic depressive illnesses. Even though mental illnesses are very serious in nature, there are plenty of actions that one can take to deal with them. There are some mental illness symptoms you should be aware of if you wish to manage such conditions effectively.

Some of the most noticeable symptoms of mental illnesses, especially severe ones like Manic Depression, include those that can be observed through physical changes. Someone who is beginning to show signs of or is currently suffering from a mental disorder or mental illness may have a dazed look, or lose concentration easily when carrying out regular daily activities. Granted, being able to recognize the physical symptoms of a mental patient may be difficult at first, but once one sees that their friend or family member is making such physical changes, he or she will find it gradually easier to recognize such conditions.

Having a withdrawn behavior and “lonely” attitude are some of the more important mental illness symptoms that need to be looked out for by family members and friends. Withdrawing from family life and social activities that had been previously enjoyed by the individual is one such symptom. It is almost always exhibited by individuals who are feeling depressed, have mood disorders, suffer from schizophrenia, social anxiety disorders, and many other types of mental illnesses.

Some other common symptoms of mental illnesses are irritability and unprovoked anger. If you are living with a family member that has a mental disorder, or believe that you may be suffering from one yourself, then you may have already experienced such behavior. Someone who is suffering from a mental disorder may be easily angered, yell for no apparent reason, and appear more irritable in general.

It is important to identify and monitor the above mentioned mental illness symptoms in order to obtain good professional help. Contacting a mental health center or a psychiatrist is a great way to get help because they can prescribe various treatment options for the specific mental illness that one is suffering from. For example, prescription medications like anti-depressant medications may be required, and those medications can be combined with counseling and behavior modification therapy. In addition, mental health professionals often extend their services to family members who live with the individual suffering from a severe mental disorder. These services often include family therapy and counseling that benefits all. Multiple solutions and coping mechanisms can be shared and used through such counseling and psychotherapy.

All things considered, dealing with a mental illness definitely is not easy as it requires a lot of patience and perseverance. However, by using the proper treatment for the diagnosed mental disorder and seeking help from the professionals, the symptoms of these major mental illnesses can be treated effectively. Thus, understanding these mental illness symptoms well will enable you and your loved ones to be in better control when facing with such situations.

Ian Spencer is an expert in solving anxiety and stress problems at http://www.Mental-Health-Counselor.org . Where he provides anxiety help advice to treat panic attacks and severe anxiety. Click Here to get your FREE anxiety analysis done online today.

001.25.10 Three Myths About Mental Illness

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In my practice, I have met many misconceptions about mental illness from patients and their relatives. I can’t blame them. Mental illness has not been understood for a while. In fact, it has created a stigma that people dismiss its importance and its impact in their lives. Some even hide their emotional difficulties from the scrutiny of their close friends and loved ones.

Failure to recognize and address the illness though has staggering consequences. People have lost their families, their jobs, their sources of security and comfort, their present and future. Unfortunately, some even lose their lives.

In my office, I have several extra chairs intended for my patients’ relatives. With my patients’ consent, I educate their loved ones about the illness and treatment choices. Only through truthful understanding that mental illness can be resolved and treated.

Sad but true. Mental illness should be seen in a different light, and has to be understood using a different lens. It has to be explored with compassion and humanity, with openness and tolerance.

Myth 1: “Bad nerves” is bad

Having “bad nerves” is not necessarily being bad or that possessing it is in itself bad. It has nothing to do with your past sins, failures, or mistakes. When you have mental illness, you have a medical disorder that happens in the brain. Like any medical condition — flu, high blood pressure, or asthma — it also has physical manifestations such as poor energy or appetite loss.

Mental illness can be compared to a stroke — both affect the brain and both have harmful outcomes to the afflicted individuals and their families.

Unlike stroke however, mental illness may not easily be detected by unsuspecting eye and doesn’t show weakness or paralysis in only one part of the body. It can however paralyze one’s life.

Myth 2: Mental illness means being a “weak person”

Mental illness simply means having an illness in the brain. It doesn’t have anything to do with your worth as a person, with your importance and place in society. It has nothing to do with your family’s socio-economic status.

In fact some successful, well-known personalities — millionaires, politicians, celebrities, professionals, artists, physicians — have suffered from this illness.

Mental illness doesn’t have any monopoly. It doesn’t spare anyone — rich and poor, educated and uneducated, young and old, single and married, employed and unemployed, famous and notorious.

Everyone is vulnerable.

Myth 3: You can easily “snap out of it”

If you can easily shake off sadness or anxiety, it means that you’re still experiencing normal emotions. Mental illness however may not easily be shaken off even when the condition is mild. It lasts for several days, weeks, or months often associated with distress and difficulty performing normal activities.

Once it worsens, it has far-reaching results such as frequent fights with loved ones, inability to hold a job, failure to function at home, and difficulty relating with others.

Some even become a threat to themselves or others; and some develop their own version of reality. At this stage, it’s more difficult to control without professional help or without the use of talk therapy or medication.

In the mental health realm, myths abound propelled by lack of knowledge and information. It’s about time to face mental illness as it is, not as a misfortune created by our own biases and inadequacies.

Mental illness can’t be ignored or dismissed as simply part of human frailties. Like any medical problem, it should be seriously recognized and addressed.

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001.25.10 How To Be Independent When Having Mental Illness

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No one wants to be a burden on their families, or others. We all want to leave independent and productive lives. Just because you have been diagnosed with a mental illness does not change that for you, and it is possible. You can live your own life and have independence if you plan well and take care of yourself.


Plan out your days.

It will be important to hold down a job in order to maintain your independence unless you are collecting government benefits. It is possible for many sufferers of mental illnesses to continue to work and hold down jobs if they are very careful to acknowledge the difficulties and plan for them.

Whether it is at work, or at home, careful planning will help to alleviate the stress and worry of the unknown and provide the needed comfort of having a detailed plan set out to accomplish your daily tasks. The day will not seem as insurmountable if you have a list of smaller items that add up to a successful day. As you complete each smaller task you can feel good about having made it through it and will begin to develop self-esteem for having accomplished each one.


Knowing that finishing each item on the list will give you a full and happy day is a great feeling. This is a helpful tip for anyone whether they have a mental illness or not.


Keep your stress to a minimum

One of the biggest triggers for many sufferers of mental illness is stress and anxiety. Learn to know what types of events are likely to trigger such emotions and avoid them at all costs. When things begin to feel overwhelming, stop, relax, and take a deep breath. If necessary take a walk to clear your mind, or take a nap. Sleep is a great way to reduce stress. This is not to be confused with the trouble sign of too much sleeping. Deciding to take a nap to relax isn’t the same thing as not being able to get out of bed. Beware of trouble signs, but at the same time don’t allow yourself to become too run down.


Take care of your body

Physical activities are wonderful ways to reduce stress, help your body stay in shape, and feel better about yourself. Get moving. If you feel upset or depressed, take a nice long walk. Set a regular schedule to work out in a gym, or at home with some simple exercise equipment, or sign up for an aerobics class. Yoga is another great class to take. It is very relaxing while working the body at the same time.


Know the signs of relapse

Know what to look for and contact your health care professional immediately if you experience any of the signs of crisis such as depression, difficulty eating or sleeping, increased appetite, or too much sleep, difficulty making decisions, or scattered thoughts, or the general feeling of being over-burdened. Keeping an eye out for trouble before it becomes too serious can make dealing with it easier. Usually a quick trip to your doctor can stop the trouble from escalating and interfering with your life and ability to handle your own affairs.


Accept the love of your family and friends

No matter how much we all need to feel independent, we also all need a shoulder now and then. Don’t push away your family and friends when they want to help, or listen to your troubles. Accept their love and support with the knowledge that they are not trying to hold you down, they are trying to bolster you up. Let them help, and know that you are doing all that you can possibly do to live a long, happy, healthy life, and you will be on your way to greater independence in your life.

Ronen David is the chairman of “Malam” (an Israeli organization supporting and representing those dealing with mental disabilities). He is the author of the “How to Cope With Psychosis & Schizophrenia Self Help Handbook”.
Visit his web site and learn Coping With Mental Illness

001.25.10 Do you Care About Someone With Mental Illness?

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My big brother, Tom, has challenges beyond my understanding. He struggles with schizoaffective disorder. Although I’ve never looked up his “diagnosis” in the official record of mental illnesses, the DSM, I know he has problems. I know this by his fixations on seemingly benign things that happened 20 years ago. Or the threats he might make from time to time to family members who love him.

Tom goes through cycles, ups and downs, which is typical for people suffering some types of mental dis-ease like schizoaffective or bi polar disorder. Despite his struggles, my parents have always required Tom to work and forge ahead as best he can. I lost track of the jobs he’s had, mainly because there have been so many! Over the years my siblings and I have taken on various roles in his life. Most of us have simply drifted away from him ignoring his desire to spend time with each of us. My hunch is that many “affected others” ignore and stay away because they don’t understand the illness or they feel compelled to “do” something to make “it” better. It can be very challenging and frustrating for the caregiver/ or affected other to interact with the person without feeling overwhelmed.

There are ways to stay connected to or participate in the life of someone struggling with mental dis-ease. My top 5 list includes:

1. Make a list of things you can offer the person. Maybe you enjoy the movies and will commit to taking him/her every 2 months or so. My commitment to Tom is to have him come stay with me for 4 days every 2 months. The important thing here is consistency and follow through. Try not to take on more than you can reasonably do. Remember, for someone who might have a small social circle, this date with you can be critically important to the person.

2. Try to let go of all wishes and desires for certain behaviors for the person. Simply meet them where they are and “be” with them instead of “doing” anything that you feel might “help” them or “heal” them. Now there are exceptions to this. One might be if you are trying to encourage better dress habits. Tom, for example hates wearing socks and underwear. If he is coming somewhere with me I make it a requriement that he at least put socks on!

3. Always check with the person before giving them something that you think they might want. I have found that many times we “think” the person would like something when in fact they don’t. Don’t be offended or try to encourage it, simply let it go and honor the answer you are given.

4. Have a solid set of boundaries for dealing with the person. If you are not able to give something,tell them. Don’t treat them differently from how you might treat someone else. It takes too much energy and, quite frankly, it’s unnecessary. Treating all people with respect and honesty is generally a good policy.

5. Send the person a card or make a quick phone call just to say “HI, I was thinking about you…”. Nothing more, nothing less. Just a small but significant thing.

In the end, all relationships with people struggling with mental dis-ease can be a challenge. But caring for yourself and taking appropriate steps to protect your life will, in the end, help you to keep on giving.

Mary Logan is a personal coach and business woman. Her enthusiasm around helping others set boundaries with those around them is at the heart of her business. Take her free “Are You an Effective Caregiver?” survey and other tips at http://www.fromsurvivetothrive.com

001.25.10 Do you Hide in the Closet and Then Wonder Why Mental Illness Has you in a Tizzy?

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If you are a family member who deals with another’s mental illness, chances are your life can get very full and often confusing. I hope this article about healthy boundaries helps.

OK, so your life has changed. Things are a bit different after the diagnosis of a family member’s illness. It could be a daughter with bi-polar, a husband with clinical depression or your own sudden experiences with panic disorder. These circumstances happen every year to millions of Americans and family members — the “affected others” — need to adjust and compensate for this new situation.

Presumably, if you are an affected other, you have the professional medical support you need to help your loved one. But you’re realizing that still things do not work as smoothly as they did before. This is hard! Learning how to implement boundaries and raising your personal standards are good ways of “surviving” another’s mental illness. Some things that used to be OK in your life suddenly are just too much. This is to be expected — but not tolerated. Let’s consider a typical problem that most people face at some time in their life: people who drop by your home without notice.

Some people don’t mind drop-in traffic. However, at some point you may feel overwhelmed by this prospect since you are now dealing with the new challenges of a family member’s mental illness. If you used to be fine with drop-in guests but now find them overwhelming, you may want to implement a new “boundary” to improve your life and reduce your stress.

Without boundaries, you’re constantly tiptoeing around hoping your friend Suzy doesn’t suddenly pop in to “dump” all her woes on you. Caring for and worrying about your own family member can be a 24/7 preoccupation

Mary Logan, MA is a personal coach who works with family members dealing with mental illness. Mary Logan focuses on wellness issues facing her clients as they enter a new role of caring for a family member with mental illness. You can sign up for her free 7-part e-course on staying well with boundaries at http://www.ucanthrive.com

001.25.10 Taking Care Of Mentally Ill Seniors – Best Activities For Mental Stimulation

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The role of a caregiver can be very stressful and coping with the emotional drain is a difficult challenge. At times, it is a challenge even to look after the best interests of the elderly in your care, especially if the person is mentally ill. A mentally ill senior will require additional care and efforts on the part of the caregiver. However, keeping a mentally ill senior occupied with some activity will take the load off your mind to a small extent.

It is essential that the mentally ill seniors keep their minds occupied with simple activities. Arranging for simple, fun activities suitable to their capabilities will provide a welcome break from the daily routine for both of you. A specific amount of time can be set aside for mentally stimulating activities during the week. For the senior this is something they begin to look forward to as it means a break in the routine. They are responding to the stimulus of the activity as a light at the end of a dark tunnel.

Elderly persons suffering from Alzheimer’s disease, Dementia or Parkinson’s disease must exercise their minds as much as possible. The caregiver has the task of finding the right ways to do this, but it is a difficult goal to achieve unless he has some help or advice in the matter. Therefore, the caregiver has to rely on medical advice or research that may help in achieving this goal.

Medical research shows that some forms of stimuli are better than others because of the way the mind responds to them. For instance, bright colors used in any activity get a better response and playing with brightly colored balls has worked wonders with mentally ill elders. They are able to concentrate better with bright colors around them.
However, these are just fun activities and do not serve a purpose beyond raising their spirits. Brightly colored games and puzzles can help them to sharpen their minds a little. For example, large piece jigsaw puzzles can be used to stimulate the thought processes in the elderly person’s mind. They can be asked to place the pieces to complete the puzzle, with some help from the caregiver.

Outdoor activities involving animals can be suited to the mentally disabled elders. Walking a dog can be very therapeutic, bringing a sense of responsibility that was absent earlier. The task of looking after another living creature can help to lift their spirits and brighten up their life to some extent. Dogs are very loving animals and ideally suited for this purpose, because they provide an affectionate and warm response to the fuss and attention they receive. Activities such as these should be undertaken under close supervision to ensure the safety of all concerned.

As a caregiver, you must ensure that the elderly in your care remains in the best of health as much as is possible. The activities mentioned earlier can be very stimulating and beneficial to mentally ill elders and since these are done together, it is beneficial to the caregiver, too. One you start these activities and meet with success be sure to introduce some more activities to keep the elderly occupied. It helps you do your job that much better!

Abhishek successfully runs an Old Age Home and he has got some great Eldercare Secrets up his sleeves! Download his FREE 80 Pages Ebook, “How To Take Great Care Of Elders” from his website http://www.Senior-Guides.com/560/index.htm . Only limited Free Copies available.

001.25.10 How To Date With Mental Illness

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For people suffering with mental illnesses the world can be a lonely place. The feeling of isolation can complicate many of the issues and symptoms of mental illness. When a person suffering with mental illnesses is single the feeling of being alone can be even more overwhelming. Dating and relationships are stressful enough in normal situations, and that stress can make it nearly impossible for a person suffering mental illness to feel they will ever be able to find a partner.


It doesn’t have to be that way. There are many ways to find new relationships and make them work even if you suffer a mental illness. There are even dating services specifically designed for people with mental illnesses. Such services can be helpful as they reduce the stress and anxiety of worrying over explaining your situation to strangers.


Whether you meet someone at a party, at work, at a dating service, or on the street making a first date is an anxious situation for anyone. Realizing that you’re not alone in that fear is a big step to overcoming the anxiety. It is helpful if the person you are approaching knows who you are and understand your condition. That’s why some of the dating services that specialize in helping people with mental illnesses meet others are so helpful. But if the person you are poaching doesn’t know about your condition it’s still okay. Don’t make a huge issue of it. While it is important to disclose these issues to people who are potentially going to be involved with you, it’s as much a part of you as the type of closure wearing for your choice of hair style but it is no bigger and the issue either.

It’s a part of what makes us who we are, and that’s not good or bad, it’s just a fact. Be an active part of your social life. Don’t be afraid to get out there and meet people. Don’t let the feeling of being ashamed or the fear of being teased stop you from finding a loving relationship. Realizing that everybody has these fears can help alleviate some of the tension.


Just like everybody else you have to realize you’re going to be rejected occasionally. This can happen for a number of reasons not just mental illnesses. However, when you have a mental illness it’s easy to focus on that as a source of their rejection. You’ve heard the expression you have to squeeze a lot of lemons to make lemonade; the same can be said for dating mental illness or not.


Once you’ve found Mrs. or Mr. Right, knowing your own limitations is an important part of dealing with the stress of a new relationship. The feeling of being rushed can add to stress and anxiety. So if you feel a relationship is moving faster than is comfortable for you don’t be afraid to slow it down.

Once you’ve decided to take that first step toward finding someone to share your life with your realize it’s not as daunting as it first seems. All the trials and tribulations of any normal relationship are the same the difference is you’re being able to handle them. Knowing yourself and your abilities will go a long way in handling the anxieties to come along with all baiting situations. Finding true love is worth all of them. Be honest an up-front and you will find the person perfect for you. You don’t have to go through life alone. You can find a partner to share your life with and experience the joys and happiness of the solid relationship while dealing with your mental illness.

Ronen David is the chairman of “Malam” (an Israeli organization supporting and representing those dealing with mental disabilities). He is the author of the “How to Cope With Psychosis & Schizophrenia Self Help Handbook”.
Visit his web site and learn Coping With Mental Illness

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