Opioids And Substance Abuse: What Can We Do?

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Opioids and other substances that alter how we feel, think and act have overtaken our culture, and have been declared a public health epidemic. We are losing our loved ones, friends, co-workers and neighbors to these substances. But we have yet to implement the solutions that will beat back this epidemic, as we have so many others, like HIV/AIDS, polio, smallpox and tobacco.

Substance use and abuse—of opioids, heroin, cannabis, stimulants, alcohol, etc.—is universal and the casualties of drug addiction affect all classes, races and regions of the U.S. These substances are too frequently used as an answer to pain, mental and physical, and have become a cure-all for people who’ve fallen on hard times. That’s why so many people use them and that’s why so many people become addicted.

Substance use disorders commonly co-occur with mental health conditions, especially serious mental illness like schizophrenia, bipolar disorder, depression, eating disorders, PTSD and other forms of trauma. People with mental illnesses often turn to drugs and alcohol to quiet their symptoms, and drugs and alcohol can adversely affect our nervous system and increase risk for mental illness.

The Solution

We are failing with this epidemic because of this country’s dogged attachment to policies and programs that have never worked for addiction. Vast sums of money continue to be wasted on campaigns of drug control and on public messages, especially for youth, that rely on scare tactics. We can and must do better. We can beat this epidemic with three public health approaches.

  1. Prevention. This includes school-based programs that provide youth with decision-making skills and methods of controlling their moods and impulses. One proven program is called the Life Skills Training. Prevention also extends to the family, such as “positive parenting,” or actively modeling and teaching children about positive behaviors. Big Brother/Big Sister programs—where an older youth of the same background takes on a younger, high-risk child—is also highly protective. These prevention programs work, and we have hardly started to apply them.
  1. Screening. Early identification of a problem means early intervention, before the substance use disorder becomes more firmly rooted. We have good screening instruments, (such as the Alcohol, Smoking and Substance Involvement Screening Test), and need to make them standard practice in schools, pediatric and family medicine offices.
  1. Treatment. Families and people affected by addiction should advocate for the strong, comprehensive treatment approach they need. Effective treatment means first detecting the presence of a co-occurring mental (or physical) condition and assuring it’s also treated. Treatment for a substance use disorder should then combine:
  • Cognitive therapy that focuses on reducing the triggers of relapse
  • 12-Step programs like Alcoholics Anonymous and Narcotics Anonymous
  • Family education and support
  • Medications

This public health epidemic that is seizing our country can be beaten. And by following these steps, we save lives, help families and restore communities.

 

Dr. Sederer is a psychiatrist, public health doctor and medical journalist. His new book is The Addiction Solution: Treating Our Dependence on Opioids and Other Drugs(Scribner, 2018). www.askdrlloyd.com.

https://www.nami.org/Blogs/NAMI-Blog/June-2018/Opioids-and-Substance-Abuse-What-Can-We-Do

You Can Be Prepared For Crises

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Each year, there are about 5 million visits to emergency departments due to mental illness. Five million people whose symptoms escalate to the point of crisis. Five million people who don’t understand what’s going on or what to do and rush to the ER.

However, this number doesn’t include the people who experience mental health crises without going to the ER—people who are scared and unsure if their situation is a “true emergency.” This number also doesn’t account for the caregivers and loved ones of those experiencing a mental health crisis, standing beside someone they care for, watching them struggle, unsure of how to help.

Mental illness is unpredictable by nature and crises can, do and will happen. Although these crises can’t always be prevented, it is possible to be prepared.

Learn As Much As You Can

The first step in being prepared is gathering any information, resources and support that is available. Start by fully understanding your loved one’s condition: What are the primary symptoms? How can you tell if symptoms are getting more severe? What can you do to support them? And the list goes on. It can be helpful to go with your loved one to see their mental health professional, so you can ask these questions and any others you may have.

Next, learn more about what a mental health crisis is and what to expect when one occurs. NAMI’s new guide: “Navigating a Mental Health Crisis: A NAMI Resource Guide for Those Experiencing a Mental Health Emergency” is a great resource. This free, downloadable guide offers practical strategies on how to deescalate a crisis, information about available resources, tips for advocating for a person in crisis and a sample crisis plan. Details like these are often critical in supporting your loved one during a crisis.

Make A Crisis Plan

Creating a crisis plan should be a collaboration between your loved one and you. The best time to develop this plan is when things are going well. Take the time to ask them questions that will help build a crisis plan, like: What would be most helpful for you? What would you like to do? Who would you like to call? Waiting to ask these important questions can make it difficult to make decisions during a crisis episode.

A crisis plan should include:

  • Your loved one’s general information (date of birth, social security number, insurance information, etc.)
  • Current medications and dosages
  • Current diagnoses
  • History of suicide attempts, drug use or psychosis
  • Addresses and contact information for nearby crisis centers or emergency rooms
  • Contact information for health care professionals
  • A determined behavior/symptom that would prompt going to the hospital or calling 911

Once you create a plane, share it with family members, mental health professionals or anyone else you think should have it. Make sure to update it whenever there is a change in diagnosis, medication, treatment or provider. A crisis plan can be a life-saving resource, so keep it up-to-date and in a safe place.

Notice Behavior Changes

A person with mental illness will typically experience changes in their behavior before a crisis occurs, such as sleeplessness, mood swings or paranoia. These changes are warning signs and shouldn’t be ignored. “Psychiatric illnesses, for the most part, evolve slowly, so there’s going to be a lot of warning,” says Dr. Daniel Lieberman to U.S. News and World Report.

If you notice warning signs, talk to your loved one and encourage them to visit their treating mental health care professional or doctor. “If somebody has a relationship with an outpatient psychiatrist, that’s the first place to go,” Lieberman says.In many cases, there might be enough time to get in contact with a provider before escalating symptoms become a crisis.

Mental health crises can be frightening for everyone involved. However, being prepared can take away some of the fear and uncertainty around what to do and how to help your loved one. Your preparation and support alone can help deescalate a crisis situation—just knowing you’re there, as a stable force, can be an enormous comfort.

By Laura Greenstein

https://www.nami.org/Blogs/NAMI-Blog/June-2018/You-Can-Be-Prepared-for-Crises

Why Do We Have The Feeling That We Are Not Enough?

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Mike believed he had a good life and felt lucky for all the things he had. He was married to a loving wife, had a good job, owned a nice house and had three healthy kids.

Despite all his good fortune, Mike could not shake the nagging feeling that he wasn’t enough: “I should be more successful. I should make more money. I should be where my boss is. I should have a graduate degree. I should have a bigger house. I should have more friends.” These were some of the “shoulds” that plagued him daily.

“Could I get you curious about this part of you that feels inadequate?” I asked Mike during our first meeting. “Let yourself travel back in time. How old were you when you first felt ‘not enough?’”

He paused to reflect. “It’s definitely been with me a long time,” he said. “Maybe six or eight years old?”

Mike’s father had become extremely successful when Mike was six years old. Because of his father’s new job, his family moved to an exotic country where no one spoke English. Mike was scared and felt like a stranger. Even though he attended an international school, he had no friends for a long time.

His parents pushed him; they meant well and were trying to encourage him. But feeling scared and overwhelmed by the many changes in his life, he misinterpreted their words as disappointment that he wasn’t enough—it was the familiar feeling he still had today.

Showing Self-Compassion

We are not born feeling inadequate. Life experiences and emotions create that sense within us in a variety of ways. For example, when we were little, and we felt afraid or anxious, our mind told us something was wrong with us, not our environment. A child’s mind, not yet rational, concludes, “There must be something wrong with me if I feel so bad.” That’s why children who were abused or neglected grow up to be adults who carry so much shame. They likely spent years telling themselves: “I must be bad if I’m being treated badly.”

As adults, armed with education on emotions and how childhood adversity affects the brain, we can understand that feeling “not enough” is a byproduct of an environment that was insufficient. We are in fact enough! Yet to feel more solid, we must work to transform that “not enough” feeling.

One way to transform old beliefs is to work with them as separate parts of ourselves. With some mental energy, we can externalize ailing parts of us and then relate to them in ways that heal old wounds.

For example, I asked Mike, “Can you imagine that the 6-year-old boy inside you, who feels ‘not enough,’ is sitting on my sofa over there so we can be with him and try to help him?”

With practice, Mike learned to connect, listen and communicate with that part of himself. Offering compassion to the child inside himself helped him feel much better, even though he had struggled with the concept initially.

Since emotions are physical sensations, another way to work with wounded parts is through the body. Mike learned to recognize how “not enough” physically felt. “It’s like an emptiness—like a hole inside. I know I’ve been successful at times, and I believe my family loves me. Emotionally, it doesn’t feel that way at all. Good stuff comes in, but it goes right through me like a bucket with a hole. I’m never filled.”

To help patch the hole in his bucket, I helped Mike develop his capacity to hold onto good feelings by noticing them. “If you recognize and validate your accomplishments, what does that feel like inside?”

“I feel taller,” said Mike.

“Can you stay with the feeling of being taller for just ten seconds?”

Like a form of training, he built his capacity to experience positive feelings. Going slowly, we practiced noticing sensations associated with pride, love, gratitude and joy—getting used to them a little at a time.

What Else Can We Do To Help The Parts Of Us That Feel “Not Enough?”

  • We can remind ourselves again and again that our feelings of “not enough” were learned. It’s not objective fact, even when it feels so instinctually true.
  • We can connect to the part of us that feels bad and offer it compassion, like we would for our child, partner, colleague, friend or pet.
  • We can practice deeply belly breathing, five or six times in a row, to calm our nervous system.
  • We can exercise to get adrenaline flowing and create a sense of empowerment.
  • We can remember this very helpful phrase: “Compare and Despair!” When you catch yourself making comparisons to others, STOP! It only hurts, by fueling feelings and thoughts of “not enough.”

In the long run, we heal the parts of us that feel inadequate by first becoming aware of them. Once aware, we can listen to them and try to fully understand the story of how they came to believe they were “not enough.” Over time, by naming, validating and processing the associated emotions both from the past and present, “not enough” can become enough.

(Patient details are always changed to protect privacy)

https://www.nami.org/Blogs/NAMI-Blog/June-2018/Why-Do-We-Have-the-Feeling-that-We-Are-Not-Enough

Hilary Jacobs Hendel, LCSW, is the author of  It’s Not Always Depression (Random House & Penguin UK), a book which teaches both the general public and psychotherapists about emotions and how to work with them to feel better. She received her BA in biochemistry from Wesleyan University and an MSW from Fordham University. She is a certified psychoanalyst and AEDP psychotherapist and supervisor. She has published articles in The New York Times and professional journals. Hendel was also the Mental Health Consultant on AMC’s Mad Men. She lives in New York City. For more information and free resources for mental health visit: https://www.hilaryjacobshendel.com/

The 7 Thought-Habits of Highly Self-Confident People

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Are there mental habits that will increase your self-confidence?  Most definitely. You’ll read about 7 such powerful thinking habits below.

My last blog revealed the very best mental habit I know for building self-confidence: “The Daily Success Review.” This short and simple 3-minute procedure nudges you to tune into the little things you do right every day instead of over-focusing on what you think you did wrong. I have nicknamed this daily technique, “The Small-Success Review,” to counter the destructive mindset of thinking that only huge and dramatic successes and accomplishments really “count” when it comes to bolstering self-esteem.

In addition to the Small-Successes method, there are other ways to increase your self-confidence just by altering your mindset slightly.  Of course, it is also important to practice behaviors that will increase your confidence and to learn to project self-confidence to others, and those will be the topics of upcoming blogs.  This blog will spotlight the thinking activities you can do right now to build a self-esteem mindset.  Below are 7 of my favorites:

1. Don’t worry if you don’t feel confident all the time.  It sounds counter-intuitive, doesn’t it? But Dr. Alice Boyes, in her useful new book, The Healthy Mind Toolkit, describes her realization that she needs both self-confidence and self-doubt to do her best work.  A little self-doubt can keep you humble enough to realize you may need to learn more or work harder at something.  It may even give you the dogged determination to keep going and “show people what you’re made of.” Doubt, according to Boyes, “causes us to question what we’re doing, mentally prepares us to accept change, propels us to work harder or differently, and can lead to us taking more cooperative approaches in dealing with people who disagree with us.”

I love this reminder that your feelings of confidence will ebb and flow during the course of a day–or a lifetime—and that this fluctuation is normal. Not to worry!

2. Show compassion toward your Future Self.  Caring for your Future Self could involve actions as small as filling up your gas tank this afternoon because you have a busy morning tomorrow and as far-sighted as exercising now for better health as you age.  “I may not want to exercise,” you could say to yourself, “But my Future Self sure would appreciate it.”  Inthis blog(link is external), habits guru Leo Babauta points out that people who don’t procrastinate are also likely to be people who want their Future Selves to be happy.   Can you decide to be one of them?

3. Practice compassionate and realistic self-talk.  Being able to realize when you are suffering, to comfort yourself, and to tell yourself that “tomorrow is another day,” will help you accept yourself even when you haven’t been able to handle yourself the way you would have preferred. Being supportive and kind to yourself when you have made mistakes will not only boost self-esteem; it will also boost your motivation and self-control, according to research cited by psychologist Kelly McGonigal in her book, The Willpower Instinct.

Some examples of compassionate self-talk:

  • “It’s true that you didn’t do as well as you wanted on the talk, but given that you didn’t feel well, you were a hero just to get through it.”
  • “Yes, you feel bad that you didn’t say NO to your friend’s request.  Think of what you could say next time and put it in your mental file.”
  • “You don’t have to be perfect.”
  • “Don’t let it get you down. This too shall pass.”

4. Relabel “failures” as setbacks, challenges, opportunities, or learning experiences.  Relabeling “failures” as “challenges,” for example, will immediately lower the level of stress hormones in your body.  How could you meet this latest “challenge?”  Changing one word can initiate a cascade of problem-solving thoughts. Analyzing past mistakes and setbacks may also improve your future performance, according to this research(link is external).  Strike the ugly f-word “failure” from your mental vocabulary list!  Practice enough, and you will develop a “growth mindset,” as psychologist Carol Dweck calls it.

"Idea." Image by Tumisu. Pixabay, CC0.
Source: “Idea.” Image by Tumisu. Pixabay, CC0.

5. Don’t assume that other people know what you know. Own your expertise! This reminder is also from The Healthy Mind Toolkit by Alice Boyes.  Do you know…the best places to find inexpensive clothing? Your city’s ordinances about trash, permits, and large-item pickups? The best restaurants for any occasion? Think about the times when people turn to you for information; your friends realize that you have numerous areas of expertise, both career-related and life-related.

6. Know your strengths.  Think back on compliments and positive feedback from others. Notice how much you enjoy or dislike certain kinds of tasks. Take in the way you contributed to a situation and made it better. When you’ve had a success, mentally replay it again and again.  Remembering and savoring positive feedback from others will help you internalize your strengths. Likewise, remembering other positive experiences will ingrain your special qualities into your brain. (Many readers have found this blog on “knowing yourself” a helpful way to focus on strengths.)

7. Remember your higher purpose and your meaningful values and goals.  Reminding yourself of your most important values, goals, and life mission can give you more willpower, persistence, and self-confidence, according to considerable research.  Your values keep you oriented to your “true north,” pointing to the core of who you are.

If nothing is working, and you feel prey to constant feelings of worthlessness or self-hatred, find a good therapist. Your therapist will help you challenge any deep-seated negative beliefs about yourself.  Yes, therapy involves time, money, and work, but it’s worth it to improve your self-confidence. There’s a lot of truth in this quote by Maxwell Maltz: “Low self-esteem is like driving through life with your hand-brake on.”

References

McGonigal, K. (2012). The Willpower Instinct. (NY: Avery), p. 148.

Boyes, A. (2018) The Healthy Mind Toolkit. (NY: Tarcher), p. 66, 205, 206.

Babauta, L. “Two Simple Habits of Non-Procrastinators.”

By Meg Selig

https://www.psychologytoday.com/us/blog/changepower/201805/the-7-thought-habits-highly-self-confident-people

Are You A Chronic Self-Abandoner?

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Self-abandonment is a strange concept. How can you abandon yourself when you are always with you? If you’re well-schooled in the world of self-development, you may have an educated guess at what self-abandonment is: It’s when you don’t support yourself, right? Kind of.

Essentially, self-abandonment is when you reject, suppress or ignore part of yourself in real-time. In other words, you have a need or desire you want to meet, and (often on the spot) you make the decision not to meet it.

Example A: Jen comes home from a long, exhausting work week and is looking forward to resting. A friend calls, asking if she can come over to vent about her difficult relationship. While Jen knows what she wants, she still reluctantly tells her friend to come over.

Example B: Kyle is interested in studying a particular style of art that has excited him for years. But his friends poke fun at him, saying it’s a waste of time. Kyle despondently never enrolls in art class, despite his genuine interest.

In both cases, these individuals value the needs and opinions of others more than they value their own. They have an initial trajectory they are fairly certain about, but they abandon it as soon as they are “pressured” by others.

In a self-abandoner’s mind, the belief that their needs and desires either cannot be met or should not be met is a strong one. This belief leads to a continuous process of detachment, as the self-abandoner repeatedly makes decisions to ignore, repress or condemn their personal needs. Over time, they might even forget or lose the ability to identify their own needs.

This is a tough pattern that can lead in many negative directions. It can take us so far away from who we are that we find ourselves in a pattern of people-pleasing, settling or neglecting ourselves. Before long, our personal identities might even feel hazy. So, how can we move out of this pattern?

At its core, self-abandonment typically arises from a lack of self-trust. So, the fundamental solution to self-abandonment is self-trust and making a commitment to yourself. Anything that involves self-care, self-exploration or asserting yourself is a step in the right direction. Another part might be learning to handle peer pressure (yes, just like in high school!).

Here are two questions you can apply to any situation to determine if you are operating from self-abandonment:

  1. “For what reason am I making this decision?” If the answer involves guilt, shame, fear, timidity or generally negative emotions, you might be in abandonment mode.
  2. “If I were the only person on earth, would I still want to do ___?” This removes other people’s influence from your decision-making and frees you up to determine how you actually feel.

Remember: There’s no quick-and-easy solution. We don’t become self-abandoners from one decision, so we won’t change after one positive experience. Eventually, you’ll create a reservoir of experiences in which you trusted yourself and things worked out. With those in mind, you won’t default to self-abandonment. With those in mind, self-trust will come more naturally.

 

A mental health counseling grad student, Brianna runs ExistBetter.co, a blog that explores the nitty gritty of mental illness and self-development.

https://www.nami.org/Blogs/NAMI-Blog/April-2018/Are-You-a-Chronic-Self-Abandoner

Is your stress changing my brain?

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Jaideep Bains, professor in the Department of Physiology and Pharmacology, and Toni-Lee Sterley, postdoctoral fellow in Bains’ lab and the study’s lead author.
Credit: Adrian Shellard, Hotchkiss Brain Institute.

In a new study in Nature Neuroscience, Jaideep Bains, PhD, and his team at the Cumming School of Medicine’s Hotchkiss Brain Institute (HBI), at the University of Calgary have discovered that stress transmitted from others can change the brain in the same way as a real stress does. The study, in mice, also shows that the effects of stress on the brain are reversed in female mice following a social interaction. This was not true for male mice.

“Brain changes associated with stress underpin many mental illnesses including PTSD, anxiety disorders and depression,” says Bains, professor in the Department of Physiology and Pharmacology and member of the HBI. “Recent studies indicate that stress and emotions can be ‘contagious’. Whether this has lasting consequences for the brain is not known.”

The Bains research team studied the effects of stress in pairs of male or female mice. They removed one mouse from each pair and exposed it to a mild stress before returning it to its partner. They then examined the responses of a specific population of cells, specifically CRH neurons which control the brain’s response to stress, in each mouse, which revealed that networks in the brains of both the stressed mouse and naïve partner were altered in the same way.

The study’s lead author, Toni-Lee Sterley, a postdoctoral associate in Bains’ lab said, “What was remarkable was that CRH neurons from the partners, who were not themselves exposed to an actual stress, showed changes that were identical to those we measured in the stressed mice.”

Next, the team used optogenetic approaches to engineer these neurons so that they could either turn them on or off with light. When the team silenced these neurons during stress, they prevented changes in the brain that would normally take place after stress. When they silenced the neurons in the partner during its interaction with a stressed individual, the stress did not transfer to the partner. Remarkably, when they activated these neurons using light in one mouse, even in the absence of stress, the brain of the mouse receiving light and that of the partner were changed just as they would be after a real stress.

The team discovered that the activation of these CRH neurons causes the release of a chemical signal, an ‘alarm pheromone’, from the mouse that alerts the partner. The partner who detects the signal can in turn alert additional members of the group. This propagation of stress signals reveals a key mechanism for transmission of information that may be critical in the formation of social networks in various species.

Another advantage of social networks is their ability to buffer the effects of adverse events. The Bains team also found evidence for buffering of stress, but this was selective. They noticed that in females the residual effects of stress on CRH neurons were cut almost in half following time with unstressed partners. The same was not true for males.

Bains suggests that these findings may also be present in humans. “We readily communicate our stress to others, sometimes without even knowing it. There is even evidence that some symptoms of stress can persist in family and loved ones of individuals who suffer from PTSD. On the flip side, the ability to sense another’s emotional state is a key part of creating and building social bonds.”

This research from the Bains lab indicates that stress and social interactions are intricately linked. The consequences of these interactions can be long-lasting and may influence behaviours at a later time.

Story Source:

Materials provided by University of Calgary. Note: Content may be edited for style and length.

Journal Reference:

  1. Toni-Lee Sterley, Dinara Baimoukhametova, Tamás Füzesi, Agnieszka A. Zurek, Nuria Daviu, Neilen P. Rasiah, David Rosenegger, Jaideep S. Bains. Social transmission and buffering of synaptic changes after stress. Nature Neuroscience, 2018; DOI: 10.1038/s41593-017-0044-6

https://www.sciencedaily.com/releases/2018/03/180308143212.htm

Recovery and St. Patrick’s Day

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Most often, when people in recovery from alcohol and drug dependence think about getting through the Holidays and staying sober, they think about Thanksgiving, Christmas, and New Years. These Holidays are sometimes referred to as the Bermuda Triangle of relapse. March 17th is often forgotten in the mix of holidays, despite its association with pubs, drinking, and parades. The hazards of relapse are all there for the individual who has years of ingrained patterns of using when celebrating this occasion.

These triggers are similar to those associated with the other holidays. Memories of music, the smells of traditional foods, and even the color green can all trigger the positive memories from the past, while the blinders of denial shield the mind from the negative consequences experienced in years gone by. As with other holidays, liquor may appear in places one was not expecting. Proprietors and friends may offer a red solo cup of beer, or a shot of Irish whiskey for your coffee, in a local business. Caught off guard, in a moment of awkwardness, one may be inclined to accept that “wee drop” while others, who can drink without impunity, are enjoying their beverages all around.

The plan, and the principles applied, is the same as any other plan for early recovery. First, avoid people, places, and things associated with past drinking/using rituals. Remember, this is not a life sentence. Many people in recovery enjoy going to parties and other places where liquor are served, but only after they have developed a firm foundation in recovery! The time this may take varies, but most people in recovery will advise that anyone with less than a year sobriety should avoid being around parties and alcohol like they would the plague. If you have to ask yourself if being around alcohol is a good idea, it probably isn’t.

Next, plan your day. Begin by getting your head on straight. An early morning AA/NA meeting is an excellent start. If one is spiritually inclined, one can follow the true Irish tradition of attending mass on Saint Patrick’s. If one is going to party, party with people that are in recovery also. After work one could attend a meeting when everyone else is off to the pub. In Ireland, Saint Patrick’s Day is traditionally celebrated by attending mass, and then spending the holiday with family and a traditional Irish meal (which is not corned beef and cabbage, by the way). This could be Shepherd’s Pie or salmon served with mashed potatoes. And of course you can’t leave out the Irish Soda Bread, which is a simple to make recipe and delicious served warm with butter.

The key for a successful life in recovery is to replace old drinking/drugging rituals with new rituals, preferably shared with a non-using social support network. So don’t be gloomy on this special holiday dwelling on the old days. Begin a new life centered on new enjoyable activities with clean and sober friends and many years ahead of memorable Saint Patrick’s Days!

By Thomas Finnerty, MHS, LCADC, HS-BCP

Recovery and St. Patrick’s Day

The Messy Truth About Obsessive-Compulsive Disorder

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I hear comments all the time:

“My place is so perfect. I’m so OCD.”
“No, it has to be neat and clean. I’m so OCD.”
“You should see how I organized my Star Wars collection. I’m so OCD.”

I was born with Obsessive-Compulsive Disorder (OCD). I struggled throughout my childhood, through multiple high schools and left college after just one semester—consumed by my obsessive thoughts. I barely made it through my twenties. In my early thirties, I hit rock bottom. I was bedridden in my parent’s guest bedroom, paralyzed by OCD.

One year included three psychiatric hospitals; intensive outpatient therapy; two months at the OCD Institute at McLean Hospital in Boston; being kicked out of said OCD Institute; and living on the streets of Boston in the middle of winter with little money, no transportation, no job and severe OCD and separation anxiety.

It took hitting rock bottom to get the help I needed. After eight scary therapeutic months, I was “reborn” and moved to Los Angeles a healthy, happy and thriving member of society. I finally understand the point of the therapy my loved ones had desperately been trying to get me into.

Why do most people believe the myth that OCD is just about a hyper-organized desk or color-coordinated closet? The reality is that most of the 3 million people with OCD in this country struggle just to function on a daily basis. They’re not bragging about the “benefits” of OCD.

Well, Hollywood’s general portrayal and perspective of OCD is limited. Movies and TV present OCD as quirky or fun. Characters often use their symptoms to their advantage, almost like a skill or superpower. Hollywood has created the belief that OCD is just double-checking, hand washing or a strong dislike of germs. Hollywood and the media rarely address the reality of this serious condition—it simply seems funny to watch, and not too difficult to live with. So, many individuals with OCD continue to struggle in silence, afraid to seek help.

OCD typically looks nothing like what you see on television. I didn’t wash my hands; I didn’t check, organize or clean; I wasn’t afraid of germs. My OCD was based in my fear of losing control. OCD is complicated like that; it preys on your unique fears and anxieties that have no basis in reality. For some people that’s germs, for others (like me) it’s extremely taboo topics, like self-harm.

To you, these fears and anxieties seem irrational and easy to brush aside, but the actual experience of having OCD is losing that rational perspective. Your brain can’t shrug off these fears. It’s a constant battle between uncertainty and truth inside your brain. That’s why the disorder is a far cry from: “I love when my kitchen is put away perfectly. I’m a little OCD.”

 

Ethan S. Smith currently lives in the Los Angeles area working as a successful writer/director/producer/author and OCD Advocate. Ethan was born with OCD and struggled most of his life until receiving life-changing treatment in 2010. Ethan was the keynote speaker at the 2014 annual OCD conference in Los Angeles and is the current International OCD Foundation’s National Ambassador.

https://www.nami.org/Blogs/NAMI-Blog/March-2018/The-Messy-Truth-About-Obsessive-Compulsive-Disorde

Why Don’t More Olympians Talk About Mental Illness?

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Many Olympians have talked about various health issues they’ve overcome, but so few have opened up about living with a mental health condition. This is surprising due to the immense mental component of being an Olympic athlete.

Many Olympians have commented that the mental aspect of the game far exceeds the physical. So, coping with symptoms of mental illness would make competing even more challenging, just as a physical injury would. But even if it does make competing more challenging, a mental health condition wouldn’t prohibit someone from being able to compete—or win.

Olympians who have told the world they experience mental illness seem to do so after their career as an Olympian has ended. Of course, there are exceptions, such as bronze-medalist figure skater Gracie Gold who isn’t competing in this year’s Winter Olympics due to her struggles with mental health. She bravely shared that she needed to put skating on hold, due to mental health treatment.

“I am still undergoing treatment for depression, anxiety and an eating disorder,” Gold explained. “It pains me to not compete in this Olympic season, but I know it’s for the best.”

Statistically speaking, Gold is not the lone Olympian in this year’s Pyeongchang’s games living with a mental health condition. There are 244 athletes competing in the 2018 Winter Olympics on Team USA. Since 1 in 5 adults live with a mental health condition, approximately 49 of these athletes live with a mental health condition. Yet only a handful have spoken out.

So why don’t Olympians talk freely about mental illness, if they have it? Probably stigma. Athletes want to be viewed as strong and empowered, and rightly so. They don’t want the public shaming them for any issue or condition, especially one that is so heavily stigmatized in our society.

But the simple truth is: Olympians can prove having mental illness doesn’t mean you’re weak. Being able to manage symptoms well enough to handle the highest-pressure competition in the world proves that mental illness doesn’t have to hold you back. And that some of the strongest, most motivated individuals in the world have these struggles as well.

We need to encourage athletes to open up about their mental health. It could alter society’s perception of what someone living with a mental health condition is capable of achieving. We need to break the stigma that is keeping these world class athletes silent. Join NAMI’s movement to stop stigma on mental illness. Go to www.nami.org/stigmafree and take the pledge to be StigmaFree.

By Laura Greenstein

https://www.nami.org/Blogs/NAMI-Blog/February-2018/Why-Don-t-More-Olympians-Talk-About-Mental-Illness

Pets Help People Manage The Pain Of Serious Mental Illness

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https://www.youtube.com/watch?v=GTwIK-vEEKw

(Check out this short compilation of baby goats! https://www.youtube.com/watch?v=GTwIK-vEEKw)

Mental illness can be isolating, making the companionship of pets even more precious.

Any pet owner will tell you that their animal companions comfort and sustain them when life gets rough. This may be especially true for people with serious mental illness, a study finds. When people with schizophrenia or bipolar disorder were asked who or what helped them manage the condition, many said it was pets that helped the most.

“When I’m feeling really low they are wonderful because they won’t leave my side for two days,” one study participant with two dogs and two cats, “They just stay with me until I am ready to come out of it.”

Another person said of their pet birds: “If I didn’t have my pets I think I would be on my own. You know what I mean, so it’s — it’s nice to come home and, you know, listen to the birds singing and that, you know.”

Many people with serious mental illness live at home and have limited contact with the health care system, says Helen Brooks, a mental health researcher at University of Manchester in the United Kingdom and the lead author on the study, which was published Friday in the journal BMC Psychiatry. So they’re doing a lot of the work of managing their conditions.

Brooks says, “Many felt deep emotional connections with their pet that weren’t available from friends and family.”

Brooks and her colleagues interviewed 54 people with serious long-term mental illnesses. Twenty-five of them considered their pets to be a part of their social network. The scientists asked who they went to when they needed help or advice, where they gained emotional support and encouragement and how they spent their days.

The participants were then given a diagram with three consecutive circles radiating out from a square representing the participant. They were asked to write the people, places and things that gave them support into the circles, with the circles closest to the center being the most important.

Sixty percent of the people who considered pets to be a part of their social networks placed them in the central, most important circle — the same place many people put close family and social workers. 20 percent placed pets in the second circle.

This study participant had a limited social network, so he placed his birds in the closest social circle in his life, along with his social worker and gardening group.

Helen Brooks/University of Manchester

The interviews with participants are poignant, and reveal the struggle and isolation that can come with mental illness.

“I think it’s really hard when you haven’t had a mental illness to know what the actual experience is [like],” said one participant. “There’s like a chasm, deep chasm between us … [Other people are] on one side of it, and we’re on the other side of it. We’re sending smoke signals to each other to try and understand each other but we don’t always — we don’t always understand.”

People with mental illnesses often see their social groups shrink and find themselves alienated from their friends. For many of these people, says Brooks, animals can break through the isolation. They give affection without needing to understand the disorder.

“[Pets] don’t look at the scars on your arms,” one participant said. “They don’t question where you’ve been.”

The pets provided more than just emotional support and companionship, participants said. The animals also could distract them from their illness, even from severe psychosis.

One study participant placed birds in his closest social circle. When he was hearing voices, he said that they “help me in the sense, you know, I’m not thinking about the voices, I’m just thinking of when I hear the birds singing.”

Another participant said that merely seeing a hamster climbing the bars on the cage and acting cute helped with some difficult situations.

And having to take care of pets keeps people from withdrawing from the world. “They force me, the cats force me to sort of still be involved,” said one participant.

Another said that walking the dog helped them get out of the house and with people. “That surprised me, you know, the amount of people that stop and talk to him, and that, yeah, it cheers me up with him. I haven’t got much in my life, but he’s quite good, yeah.”

“The routine these pets provide is really important for people,” says Brooks. “Getting up in the morning to feed them and groom them and walk them, giving them structure and a sense of purpose that they won’t otherwise have.”

Many of the study participants are unemployed because of their illness, she notes. Having a pet that was well taken care of was a source of pride for them.

Mark Longsjo, the program director of adult services at McLean Southeast, an inpatient mental facility in Middleborough, Mass., says that the interviews in the study reflect his professional experiences. “We have so many patients come through, and we always ask them about their support system. Sometimes its family members, sometimes its friends, but it’s very common to hear about pets.”

When he does patient intake surveys, Longsjo says that he includes pets in their risk assessments. Patients with pets often say the animals help keep them from following through on suicidal thinking, because they know their pets depend on them.

The social workers at McLean also incorporate pets into their aftercare planning, encouraging patients to make walking and grooming their pets a part of their routine. “I think there’s significant value in considering the common everyday pet to be as important as the relationships one has with one’s family in the course of their treatment,” says Longsjo. He feels this study is important because, although there’s a lot of work looking at the benefits of trained therapy animals, they can be expensive and out of the reach of many patients.

Brooks hopes that more health workers will consider incorporating pets into care plans for people with mental illness. Many of her participants said that sometimes it felt like their pets could sense when they needed help the most, and were able to provide it — just like the owners took care of them.

As one person in the study said, “When he comes up and sits beside you on a night, it’s different, you know. It’s just, like, he needs me as much as I need him.”

By Erin Ross

https://www.npr.org/sections/health-shots/2016/12/09/504971146/pets-help-people-manage-life-with-serious-mental-illness