Stopping Schizophrenia in its Tracks (NAMI Blog Repost)

Stopping Schizophrenia in Its Tracks By Darcy Gruttadaro, Director, NAMI Child and Adolescent Action Center For those experiencing psychosis, early identification and intervention matter, a huge amount. It lessens the long-term severity and often prevents psychosis from worsening. An effective early identification and intervention program should include the following coordinated array of services and supports: Supported education and employment. Cognitive behavioral therapy. Peer support. Family support and education. Case management. Community outreach. Low dose antipsychotic medication. These services work so well because they are offered together to provide the skills and support that youth and young adults need to get better. They also take into account the context of a young person’s life and the key role that peers and families play in recovery. FEP programs reduce costly hospitalizations and put youth and young adults with psychosis on an early path to recovery. When you fund upstream interventions, you can prevent the tragedies associated with untreated mental illness: school failure, unemployment, hospitalizations, homelessness, jail and suicide. Investing in effective programs that intervene early produces far better outcomes for individuals, families and communities. There are effective strategies available, so why aren’t more young people getting help? One of the main reasons is that these services and supports are simply not available in communities. However, there has been progress made recently that to help ensure the availability of these resources in more towns and cities across the U.S. One significant event is that Congress has now required states to use 5 percent of their Mental Health Block Grant for First Episode Psychosis (FEP) programs. This means that states are obligated to set aside a certain amount of their federal funding to address the importance of early intervention. How Is NAMI Helping We recognize the urgency in expanding these programs. Our advocacy work and involvement in these programs is happening at all levels of the organization. NAMI NYC Metro is partnering with OnTrackNY, an FEP program, in providing support groups and peer support for youth and young adults experiencing early psychosis. NAMI Connecticut is offering peer-run young adult support groups located close to FEP programs to make it easy for young adults to join. NAMI Minnesota has partnered with an FEP program and is creating education and support programs for youth experiencing early psychosis and their families. Oregon was an early adopter of these services and supports, having witnessed the success of these programs in Australia. Tamara Sale, the director of the Early Assessment and Support Alliance (EASA) in Oregon and a former long-time NAMI Oregon board member, shared how their program works successfully with youth and young adults experiencing early psychosis. The EASA program recognizes that it can be difficult to engage youth and young adults experiencing early psychosis, so it uses strategic community approaches that meet young people where they are with messages of hope and relevance to their lives. They are flexible and persistent, even with youth and young adults that seem entirely uninterested in mental health care. What You Can Do FEP programs exist in a handful of communities and more must be done to spread these programs across the country. Here is how you can make sure that happens. Learn more about FEP programs. Understand why these programs are pivotal in creating better outcomes. Email or Tweet your Congressional members to thank them and to ask for their continued support of FEP programs. Connect with your NAMI Affiliate in advocating at the state and federal levels for FEP programs so that youth and young adults experiencing early psychosis can access effective services and supports. We can and must change the trajectory of people’s lives by intervening early with recovery-oriented and effective services. We simply cannot afford to wait.

Back and Forth: The Recurrence of Psychosis

Tiring as it is, it takes a lot out of you, being involved and afflicted with recurring psychosis. At one end of the spectrum, there is little to worry about, and life seems, in most regards, to move along swimmingly. Then, without warning, everyone is looking at you, watching, waiting to strike you down from their perches in trees, on top of buildings, from helicopters above and continually watching via hidden cameras planted just about everywhere. This distorted form of reality is both the trademark of those with schizophrenia, and the bane of our existence. How you handle it, how much support you have from your family and friends and the combination of medication therapy and coping strategies determine how you will fare. "...For it is the storm within that endangers him, not the storm without." And such episodes come and go, but luckily with the combination of coping strategies, family and friend's support and grit and determination to be well and whole makes me all the more strong at the end of the each day.

Robin Williams Suicide and Understanding Why It Makes a Huge Impact

August 12, 2014 **Update: Robin's widow has stated that he suffered from the early states of Parkinson's, shedding more light on his death. In addition, the actor's friend, Peter Coyote, who is a Zen Buddhist priest, posted the following remembrance for him, which I would like to leave as the most important share surrounding Robin William's suicide: "Robin William’s Last Gift Robin and I were friends. Not intimate, because he was very shy when he was not performing. Still, I spent many birthdays and holidays at his home with Marsha and the children, and he showed up at my 70th birthday to say “Hello” and wound up mesmerizing my relatives with a fifteen minute set that pulverized the audience. When I heard that he had died, I put my own sorrow aside for a later time. I’m a Zen Buddhist priest and my vows instruct me to try to help others. So this little letter is meant in that spirit. Normally when you are gifted with a huge talent of some kind, it’s like having a magnificent bicep. People will say, “Wow, that’s fantastic” and they tell you, truthfully, that it can change your life, take you to unimaginable realms. It can and often does. The Zen perspective is a little different. We might say, “Well, that’s a great bicep, you don’t have to do anything to it. Let’s work at bringing the rest of your body up to that level.” Robin’s gift could be likened to fastest thoroughbred race-horse on earth. It had unbeatable endurance, nimbleness, and a huge heart. However, it had never been fully trained. Sometimes Robin would ride it like a kayaker tearing down white-water, skimming on the edge of control. We would marvel at his courage, his daring, and his brilliance. But at other times, the horse went where he wanted, and Robin could only hang on for dear life. In the final analysis, what failed Robin was his greatest gift---his imagination. Clutching the horse he could no longer think of a single thing to do to change his life or make himself feel better, and he stepped off the edge of the saddle. Had the horse been trained, it might have reminded him that there is always something we can do. We can take a walk until the feeling passes. We can find someone else suffering and help them, taking the attention off our own. Or, finally, we can learn to muster our courage and simply sit still with what we are thinking are insoluble problems, becoming as intimate with them as we can, facing them until we get over our fear. They may even be insoluble, but that does not mean that there is nothing we can do. Our great-hearted friend will be back as the rain, as the cry of a Raven as the wind. He, you and I have never for one moment not been a part of all it. But we would be doing his life and memory a dis-service if we did not extract some wisdom from his choice, which, if we ponder deeply enough, will turn out to be his last gift. He would beg us to pay attention if he could." News of Robin William's suicide on Monday put a dent of grief into the nonstop broadcasts of war and other violence, and the gap of grief has expanded into days. With it, there has been talk on the Internet, and some of it has been so good that I felt it would benefit to share: "I remember having Mork suspenders and crying when I watched Dead Poet's Society. I feel much like I did when Phillip Seymour Hoffman died - like a light went out. That's the thing about so many artists, they make you feel more connected to the world. They give you this gift of depth and connection, all the while battling isolation and pain. We have all been filled with despair so big that it takes our breath away but pain, even the deep and relentless kind, has an end if only we can hold on long enough. Everyone tells people to reach out when they're hurting but I think that sort of pain is paralyzing and unfathomable. Before anyone needs to reach out - tell people how much they matter. Don't just tell your parents or your children or spouse. Tell your third grade teacher, the author of a book that changed your life or the guy that makes your morning coffee. When you tell someone they matter you express your gratitude for someone's presence and gifts. What you're really saying is, "I am so grateful you are alive and the world is made better by your presence." Don't wait to tell the world how wonderful someone is at a funeral. Look someone in the eye today and tell them that their example made you a better man or woman, tell them that they gave you hope and helped you to live your best life. Don't be stingy with love and praise and kindness. They are FREE! There is no such thing as too much love. And yes, it may not save anyone, but maybe it will, and if it doesn't then at least they will know that they were deeply loved and you will know that you said it out loud and they heard you. Dear Robin may you rest in peace. I know your soul must have been so tired. Thank you for making be laugh and cry and bringing so much humanity to your work. You will be missed." - Anna Marie Houghtailing When lights of Robin's stature go out, especially by their own hand, it does something to the whole world of people who have been moved by that individual. It's like a call to attention. The grief, the loss, it forces us to appreciate what we no longer have. Could it be prevented by having appreciated the person more fully in their lives? It's not a sure bet, but it can't hurt. One thing is certain - when someone chooses to take their own life, (s)he feels out of options. The pain has become intolerable. The peace of death is the only solace that remains in their estimation. It's a very serious decision, and a completely personal one that we are not free to judge. ...I felt compelled to write this article because like any mental illness-related accident or death, there by the grace of God go I. And it’s not only in poor taste to deride a man who by all accounts, was going though severe depression at the time of his death, it’s also just plain wrong. Suicide isn’t “giving up” or “giving in.” Suicide is a terrible decision made by someone whose pain is so great that they can no longer hold it, and feel they have no other option in life but to end it. It’s a decision you can’t take back, and a decision that will affect your friends and family forever. It is not taken lightly. Losing a person to suicide may feel like a waste. And I think it’s fair to react to it that way, especially in the first hard days of grief. For someone looking in, it does seem like a waste—especially in the case of Williams, who was a brilliantly funny man and a talented actor. But imagine, if you will, feeling so desperate, so desolate, so incredibly sad and hurt that you honestly cannot see a way out. The feelings leading to suicide are the darkest a human mind can fathom. It’s like being shut into a dark tunnel with no point of light to guide your way. You can hear voices on the outside, but the walls are too thick to get in. And feeling like it’s closing in, like there’s no way out—well, suicide, for that person, is a blessed release. Life, however, is never wasted. Williams did things in his life that touched people to their core. It is a sad, sad loss, but it is not a waste. "Suicide is not a weak decision. It is a decision that takes an incredible amount of strength to make, actually. Someone isn’t weak if they end their life. They are desperate. There is a difference. It’s okay to feel angry at the person for dying. It’s okay to question, to rail against the forces that caused this. But it isn’t weakness. Mental illness isn’t weakness. It’s a disease, a pervasive, sometimes awful disease. The person doesn’t deserve anger and skepticism forever. They deserve compassion. Their family deserves compassion. Ending a life is incredibly, incredibly tragic. It represents a lost battle with mental illness. In that, it is no different than cancer, or diabetes, or a heart attack. Where it is different is that suicide is a choice. Whether it is the right or wrong choice for that person is solely the business of that person who commits suicide. But for the family left behind, it is devastating. Don’t rail against Robin Williams, or anyone else, for committing suicide (if indeed, that is the cause of his death). Instead, reach out. Let people know you’re there for them. Find a crisis line in your area to call if you are feeling desperate and like you want to do something you can’t take back. Support the family and friends left behind in the best way you can. Let the people you love know that you love them and that you are thinking about them. Let them know that they are not alone." - Elizabeth Hawksworth "What Depression Isn't" Reverend Coyote, Ms. Hawksworth, and Ms. Houghtailing said it so well that I'd just be imitating them. Then we have this, from a Jungian expert: "That is where I would praise him, for what he has managed to do for six+ decades; handle fire, while being made of parchment."- DR. Clarissa Pinkola Estes, Managing Editor of TMV, and Columnist I always saw the pain and sensitivity in Robin Williams, because I know that pain and sensitivity too. I am grateful that he held the darkness at bey for so long, and that he succeeded in shedding as much love, light, joy, and heart as he did. He was a giant who shone for us, for decades. Thank you, Mr. Williams. It was an unforgettable lifetime, and you will live on forever in all those whom you touched. Our numbers are vast. The image accompanying this article has a number for a suicide hotline. Please don't wait to reach out. You are important, you matter, and the world needs you. And if you sense someone in need, reach out. Sometimes a phone call can save a life.

Slate.com Article Repost. Violence is not a product of mental illness

In the 1980s, around the time of the massive deinstitutionalization of the mentally ill, I was working toward my degree in clinical psychology by training at a psychiatric hospital in Washington, D.C. One sweet, diminutive, elderly patient sometimes wandered the halls. She had been committed to the hospital after she stabbed someone in a supermarket. She was what is sometimes referred to as a revolving-door patient: She was schizophrenic and heard frightening voices in her head, and when she became psychotic enough, she would be hospitalized, stabilized on medication, and then released back to the community. There she would soon go off her medication, become psychotic, be rehospitalized, stabilized again on medication, released, etc. At her commitment hearing, she testified that she had become extremely upset in the grocery store before repeatedly stabbing the man in front of her in the checkout line. The hearing officer, aware of her history and sympathetic to this woman with such a sweet demeanor, asked helpfully if she had been hearing voices at the time. Yes, she replied, she had. “And what were the voices telling you?” the officer inquired supportively. She explained that the voices were telling her not to hurt the man, but he had gotten in the express checkout lane with more than 10 items, and that made her so mad that she couldn’t stop herself. In addition to being a valuable cautionary tale about grocery etiquette, the story illustrates an important truth about violence and mental health: Violence is not a product of mental illness; violence is a product of anger. When we cannot modulate anger, it will control our behavior. In the wake of a string of horrific mass shootings by people who in many cases had emotional problems, it has become fashionable to blame mental illness for violent crimes. It has even been suggested that these crimes justify not only banning people with a history of mental illness from buying weapons but also arming those without such diagnoses so that they may protect themselves from the dangerous mentally ill. This fundamentally misrepresents where the danger lies. Violence is not a product of mental illness. Nor is violence generally the action of ordinary, stable individuals who suddenly “break” and commit crimes of passion. Violent crimes are committed by violent people, those who do not have the skills to manage their anger. Most homicides are committed by people with a history of violence. Murderers are rarely ordinary, law-abiding citizens, and they are also rarely mentally ill. Violence is a product of compromised anger management skills. We are a culture awash in anger. In a summary of studies on murder and prior record of violence, Don Kates and Gary Mauser found that 80 to 90 percent of murderers had prior police records, in contrast to 15 percent of American adults overall. In a study of domestic murderers, 46 percent of the perpetrators had had a restraining order against them at some time. Family murders are preceded by prior domestic violence more than 90 percent of the time. Violent crimes are committed by people who lack the skills to modulate anger, express it constructively, and move beyond it. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, the reference book used by mental health professionals to assign diagnoses of mental illness, does very little to address anger. The one relevant diagnosis is intermittent explosive disorder, a disorder of anger management. People with IED tend to come from backgrounds in which they have been exposed to patterns of IED behavior, often from parents whose own anger is out of control. But the DSM does not provide a diagnostic category helpful for explaining how someone can, with careful advance planning, come to enter an elementary school, nursing home, theater, or government facility and indiscriminately begin to kill. Lt. Gen. Mark Milley, Fort Hood's commanding general, speaks during a press conference on April 2, 2014, about the shooting that occurred there earlier in the day. Lt. Gen. Mark Milley, Fort Hood's commanding general, speaks during a press conference on April 2, 2014, about the shooting that occurred there earlier in the day. Photo by Drew Anthony Smith/Getty Images Violent crimes committed by people with severe mental illnesses get a lot of attention, but such attacks are relatively rare. Paolo del Vecchio of the federal Substance Abuse and Mental Health Services Administration has said, “Violence by those with mental illness is so small that even if you could somehow cure it all, 95 percent of violent crime would still exist.” A 2009 study by Seena Fazel found a slightly higher rate of violent crime in schizophrenics—but it was almost entirely accounted for by alcohol and drug abuse. Likewise, the MacArthur Violence Risk Assessment Study found that mentally ill people who did not have a substance abuse problem were no more violent than other people in their neighborhoods. With no clear explanation of the causes of violent crime from the mental health field, and with significant encouragement from the gun lobby, the public has begun to seize on the wrong explanation for tragic, violent events. They focus not on the IED-diagnosed patients but on those with other diagnoses, schizophrenia in particular, ignoring the fact that what the perpetrators have in common in every single one of these cases is a loss of control of their anger.

A prolonged, non-drug induced and horrific psychosis

To the ones who don't believe that mental illness is real, I say this: have you ever had to suffer a pervasive, prolonged and non-drug induced "bad trip?" In fact, I never do drugs, yet this evening, I felt as if I were having a bad acid trip, mixed with a heroin overdose. None of these things would be possible were it not for schizophrenia, the dreaded disease of the brain that affects nearly 1 per cent of the population worldwide on any given day. To make matters worse, I was solely responsible for the well being of two sons, one 7 years old and one 3 years of age. There is nothing more humbling than that of having to care for a child while under the mental illness knife, that cuts deeper than a scalpel in an operating room. To the voices, I say, leave this old hat alone- he has weathered enough storms. To the paranoia, I plead, let the peace of mind wash away your caustic inky blackness. And to the delusions and over-stimulation, well, let's not add insult to injury. Wellness begins at home. It takes time. This too shall pass.

A Reblog from Americamanifesto

americanifesto in Kuta Lombok I went to town to look around and took in many things: I saw one cow – don’t ask me how – and one bird with brown wings. It sang a song both loud and strong to flee its cage it sought, wreathed in a cloud of burning trash – sad things mankind has wrought. The ride this morn was swift and fleet we slept perhaps three winks, in captain’s berth we sampled mirth, the ferry did not sink. Now through this cabin we explored while sleep into our brain-pans bored, we looked in cubby; cranny; nook; as wave and sea the vessel shook. There was the book by Chairman Mao – his lesson, guide, and rule – three fancy shirts, a dead cockroach, some bits of foam, a toilet brush, the AC vented cool. Then through the hills and sopping fields our caravan did wander, in search of places rich in surf from here to there and yonder. We quarter in a spartan room, the basics they are present, my company is quick to laugh – indeed she is quite pleasant. The waters glint with pla stic junk, so much it can’t be counted; now off to rest, to try this bed, with consciousness dismounted.

When everyone else goes to bed each night, I lament the days' wasted truths--that all I get to celebrate is being a pauper (albiet with a beautiful family) and someone who suffers with major mental illness. Schizophrenia is not a joke. There are some good times, yes--but moreover there are struggles and disappointments that go along with it, each and every day. That is why I am a Trustee of the local NAMI chapter--so that I can help others the way people have helped me through some deep, dark times in my life. Although there'll never be a cure, each day, I look forward to my medication management as well as my coping strategies and support system to help me get better. X

On hearing voices while at Elementary School to pick up my son

The paranoia had returned, and it had brought with it overstimulation. I was at the elementary school of my son, who was in second grade, my three year old younger brother and son in tow. It had come onto me on the ride to the school, and I had attempted to stave off the symptoms with a bit of seroquel in the car as well. It was the worst 15 minutes of my day, to be sure, waiting for Tyler to come from Art Club and sign him out. The art teacher, usually not talkative after the club let out, decided to ask me about my younger son today. I answered curtly that he was my youngest, as any schizophrenic who just wanted out would do. The time had come to go home, and I knew a ride from hell awaited me. No matter, soon I would be home, in the confines of my safe house, I could rest up and let the demons pass. -Everything2show4