Veteran's Day 2008

Consider these statistics:

• Nearly 33 percent of those who have been deployed to Iraq and Afghanistan will experience mental health issues.

• In 2007, the suicide rate among veterans who served in the US Army was at an all-time high.

• Approximately 40 percent of all homeless veterans live with mental illnesses.

• Nearly 57 percent of this aforementioned group are African American or Hispanic veterans.

•  Approximately 30 percent of veterans treated in the Veterans health system experienced depressive symptoms, two to three times the rate of the general population.

With an historic Election now behind us, Americans turn to Veterans Day on November 11 to honor all those who once served in our Armed Forces. Michelle Obama has said that, " The struggles of America's families aren't new to Barack... He also knows that when our military goes to war, their families go with them. He's a strong advocate for predictable deployments and better healthcare - including mental health - for returning service people." It is with renewed hope that we hear these words. (Read the rest here.)

Stand with NAMI and make a donation in support of better mental health care resources for veterans, active duty service members, and their families. You may even make your gift in tribute to a veteran, active duty service member, or other loved one, and include a message of support for display on the NAMI's Veterans Tribute Honor Roll.

So today let us say thank you to our veterans - including my son, whose bravery in facing the struggles of his daily life is my constant source of inspiration.

Not at my best...

It's been awhile since I've been on medication. I'm pretty par with the average consumer that I loathe the side effects of anti-depressants and I'm probably better than average at finding other ways to cope. Notice I didn't say healthier ways, just other - although as I've grown older I've tried to avoid self medicating with substances or food. sigh... key word - TRIED. Sometimes I'm pretty good at avoidance.... sometimes what I'm avoiding isn't necessarily what I should be avoiding.

I'm pretty much free falling at present - enough that I think I may have no other choice but to go to my doc and ask for meds. Again. This in and of itself, is not making me feel better.

I know that my current depression is mostly due to my reactions to some very specific current events, some of them personal and some of them the world at large. I tend to soak up the free floating anxiety that our current economy and pre-election hysteria send out to the ether; like many with depression, I feel everything personally and intensely. I just spent a full week in a training to become a WA State Certified Peer Counselor and came home pretty shook up. (Imagine a week of intensive group therapy.) Then I had someone I thought of as a friend tell me she is "done," (with me? I assume) - leading me to ruminate on how she got to "done" without me even guessing that there was a problem. ( I will think this to death. It will be my fault. Can't maintain even the most rudimentary adult relationships - just like your mother - bladdda, bladda, blah.)

The level at which I am NOT coping right now is pretty clear. Binge eating is being narrowly avoided, or not avoided depending on your point of view... I'm bingeing but on pretty low calorie fare so it hasn't left me feeling a complete failure... only a minor one. I'm avoiding social contact. I'm a complete bitch to my poor husband, because he's around me enough to catch the brunt of my misery. I haven't started drinking for relief. I cry myself to sleep after an hour or two of mindless mental activity to wear me out... or I have to take something to sleep - tylenol PM or Xanax (down to my last 6 pills and hoarding them. Don't really want to go the doc.)

Is it enough for me to say that I need help, even while I'm avoiding getting it?

Older. with Bipolar.

No sour grapes for David Zagorsky—the acronym GRAPES means something quite the opposite for this vibrant 63-year-old living in seaside Del Mar, California.

Zagorsky participated several times in a cognitive program that taught him to incorporate these words into his daily life: 'Gentle, Relaxation, Accomplishment, Pleasure, Exercise, and Social.' GRAPES, he says, are great motivation. "Just do a little of each. For example, walking to the local convenience store accomplishes both the exercise and social components."

Sometimes you'll need to dig deeper, Zagorsky admits. "When you're really down, challenge yourself, and say, 'I'm going to get up at a certain time and move on with my day. I've just got to do it.' You give in to this illness, and you're done." He knows that maturity means being able to handle what is often a full plate. "Go to work on behalf of other people to escape your own misery."

The determined and reflective Zagorsky, diagnosed with bipolar I at age 24, is a dedicated facilitator at the peer-to-peer Depression and Bipolar Support Alliance (DBSA), San Diego chapter. He relies upon his "three-legged stool"—medical management, a skilled therapist whom he trusts, and his family and friends. These friends include his DBSA group, which meets each Monday "because illness does not know vacation and it's not a walk-in-the-park illness, but one that is chronic and cyclical," he says. "You never know when it's going to sneak up on you again, so be aware of 'gradations,' those subtle changes."

Read the rest of the article by Stephanie Stevens here.

Anger Management

Mood specialists are careful to distinguish between occasional hot flashes of anger and the long-simmering irritability and rage—angry outbursts lasting over several days, during both manic episodes and agitated states of depression—that is symptomatic of bipolar disorder. During a manic episode, experts say, mood changes can swing from irritability to euphoria to depression—all within a 25-minute period of time.

“Instantaneous anger that lasts a few minutes and occurs twice a week is not bipolar, it’s being angry,” says David L. Dunner, MD, FACPsych, director of the Center for Anxiety and Depression in Mercer Island, Washington. “Irritability can be present during highs and lows, but irritability without elated mood makes me suspect the illness may not be bipolar.”

In other words, everybody gets angry. Just because you have a head-turning temper tantrum doesn’t mean you have bipolar disorder. Anger is a common response to both physiological illnesses like cancer and heart disease and mental illnesses such as intermittent explosive disorder, major depressive disorder and substance-induced mood disorder.

“As bipolar disorder receives more media attention, it’s easy for any type of abhorrent behavior to be attributed to it when in fact, this has to do with one’s temperament,” says Ronald A. Remick, MD, a consultant psychiatrist at St. Paul’s Hospital in Vancouver, British Columbia.
“Bipolar patients are not angry, hostile, irritable people with short fuses,” he emphasizes. “If people with bipolar illness have anger issues, they have anger issues.”

It is, however, a side of bipolar disorder that has long passed under the radar screen. Many people with bipolar say that uncontrolled anger has destroyed their marriages, families and personal relationships, ruined their careers and left them emotionally isolated...

ANGER MANAGEMENT 101

Here are some suggestions from both doctors and patients to help you get a handle on your anger.

• Ask yourself these questions when you feel yourself on the verge of anger: Is this really what I want to do? Do I want to have this conversation or explosion now? Maybe I should wait until I feel better. Answering “no” could buy you a few precious seconds to consider your next move,” says Roy Perlis, MD, MSc, medical director of the Bipolar Clinical and Research Program at Massachusetts General Hospital in Boston.
• The same goes for email. Don’t let loose too soon. Print is forever.
• If you’re prone to anger outbursts you know it by now. “For some people, this feels like a panic attack, a rush of adrenalin, heart pounding, skin flushed,” says Perlis. Have a plan in place about how you intend to RRespond—and keep to it.
• Remove yourself immediately from the situation. That’s appropriate especially if you’re a parent with a child or even a pet owner. At work, excuse yourself and go to the restroom.
• Explore relaxation techniques for managing anxiety, like visualization, listening to music, or maybe doing a task that distracts you.
• Exercise daily.
  
• Communicate with your doctor, advises Sharon Lyons. And be creative, like Jeff McDonald, who shouts the odd-sounding name of Providence Bruins hockey goalie, Finnish player, “Tuukka Rask!” Why? “It makes me laugh,” he says.

Excerpt from Stuck on the rage road in the Fall 2008 issue of bp Magazine

(I'm out of town until Oct. 18th... am attending WA State Peer Counseling Training... sort of mental health camp:)

As We Countdown to the Election

Mental Illness Awareness Week is October 5-11. That same week, our presidential candidates will hold a “town hall” debate—in which up to a quarter of the audience are likely to have experienced a mental illness.

That’s because one in four adults lives with depression, bipolar disorder, schizophrenia, post-traumatic stress disorder (PTSD) and other mental illnesses every year. That’s almost 60 million Americans.

Mental illness does not discriminate between Republicans and Democrats. It can strike anyone at any time.

Mental health is part of health care and it is essential that it be included in the nation’s health care reform debate.

Mental illness affects children. It affects people of color. Two million Americans live with schizophrenia—twice the number of those with HIV/AIDS. One in five veterans of Iraq and Afghanistan—almost 300,000 troops—will experience major depression or PTSD upon returning home. Unfortunately, two-thirds of people who live with mental illnesses do not receive treatment.

But treatment works. Recovery is possible. Between now and Election Day, every candidate needs to talk about these facts.

See how the presidential candidates responded to a NAMI survey here.

Then... VOTE.

Carrot, Egg or Coffee Bean?

A young woman went to her mother and told her about her life and how things were so hard for her. She did not know how she was going to make it and wanted to give up. She was tired of fighting and struggling. It seemed as one problem was solved, a new one arose.

Her mother took her to the kitchen. She filled three pots with water and placed each on a high fire. Soon the pots came to boil. In the first she placed carrots, in the second she placed eggs, and in the last she placed ground coffee beans. She let them sit and boil; without saying a word.

In about twenty minutes she turned off the burners. She fished the carrots out and placed them in a bowl. She pulled the eggs out and placed them in a bowl. Then she ladled the coffee out and placed it in a bowl. Turning to her daughter, she asked, ' Tell me what you see.'

'Carrots, eggs, and coffee,' she replied.

Her mother brought her closer and asked her to feel the carrots. She did and noted that they were soft. The mother then asked the daughter to take an egg and break it. After pulling off the shell, she observed the hard boiled egg.

Finally, the mother asked the daughter to sip the coffee. The daughter smiled as she tasted its rich aroma. The daughter then asked, 'What does it mean , mother?'

Her mother explained that each of these objects had faced the same adversity: boiling water. Each reacted differently. The carrot went in strong, hard, and unrelenting. However, after being subjected to the boiling water, it softened and became weak. The egg had been fragile. Its thin outer shell had protected its liquid interior, but after sitting through the boiling water, its inside became hardened. The ground coffee beans were unique, however. After they were in the boiling water, they had changed the water.

'Which are you?' she asked her daughter. 'When adversity knocks on your door, how do you respond? Are you a carrot, an egg or a coffee bean?

Think of this: Which am I? Am I the carrot that seems strong, but with pain and adversity do I wilt and become soft and lose my strength?

Am I the egg that starts with a malleable heart, but changes with the heat? Did I have a fluid spirit, but after a death, a breakup, a financial hardship or some other trial, have I become hardened and stiff ? Does my shell look the same, but on the inside am I bitter and tough with a stiff spirit and hardened heart?

Or am I like the coffee bean? The bean actually changes the hot water, the very circumstance that brings the pain. When the water gets hot, it releases the fragrance and flavor. If you are like the bean, when things are at their worst, you get better and change the situation around you. When the hour is the darkest and trials are their greatest do you elevate yourself to another level? How do you handle adversity? Are you a carrot, an egg or a coffee bean?

Editor's note: I'm up to my eyeballs in a new Family to Family class - 12 weeks of immersion. Bear with me and my tardy posting:)

Healthy Ideas to Manage Life's Pressures Part 3

Here is the final installment in our series on strategies to reduce the every day stress in our lives courtesy of Mental Health America. Living with mental illness is a stress in and of itself - with or without the moment to moment drama of modern life. The neurotransmitters adrenaline and epinephrine evolved to help us react quickly to an immediate threat - fight or flight - great idea if you need a speedy response to stumbling upon lions, or tigers or bears! However, we never did adapt to a steady stream of these useful chemicals - the so called 'stress response.' Long term, an overabundance of fight or flight chemicals is damaging to our health, resulting in heart disease and a host of pathological conditions. So, take a deep breath and try these ideas...

• Watch your negative self-talk. Try not to put yourself down. For example, if you don’t make it to the gym this week, don’t call yourself lazy. Instead think about the specific factor that may have kept you from going to the gym. “I wasn’t able to work out because I had to work late hours this week, but next week, I’ll make it a priority to go.” The problem is temporary and can be overcome.

• Get involved in spiritual activities. Studies have shown that religious involvement and spirituality are associated with better health outcomes, such as greater coping skills, less anxiety and a lower risk of depression. Spirituality may provide a sense of hope, meaning and purpose in life, a way to understand suffering and illness, and a connection with others. Religious and spiritual practices, such as prayer and meditation, can evoke positive emotions that can lead to better health.

• Write down three good things that happen to you each day for a week. Also write down why each good thing happened. Thinking about the good things in your life and expressing gratitude may actually help you feel happier.

And finally, deep breathing is a great way to de-stress. It actually changes your brain’s chemical balance to calm you down.

Here’s how to do it:

1. Lie down or sit on the floor or in a chair.
2. Rest your hands on your stomach.
3. Slowly count to four and inhale through your nose. Feel your stomach rise. Hold it for a second.
4. Slowly count to four while you exhale through your mouth. To control how fast you exhale, purse your lips like you’re going to whistle. Your stomach will slowly fall.
5. Do this a few times.

Check out Part 1 and Part 2 of this list for a refresher and start chillaxin!