Psychoactive Medication

Medication

“The ethical use of Psychotropic drugs is perhaps the single most important aspect of Psychiatric care that requires urgent attention” ~ Dr Phil Thomas

I watched the movie All that Heaven Allows with Rock Hudson and Jane Wyman (1955). There is a line in it where Jane Wyman goes to the doctor after the break up of a relationship and he says “Do you expect me to give you a prescription to cure life?”. While there are some tranquilizers that can help people short term, there is no prescription that will cure life’s emotional problems, some of which may have stemmed from trauma in a person’s past that was not properly dealt with at the time. Or more recent distress.

There has to be a better way than drugging people into oblivion or disabling a person’s cognitive abilities as part of “treatment”. There are many parts of the world that do not rely on these drugs. According to research by medical journalist Robert Whitaker some of these countries have better overall outcomes [1].

Medication can actually intensify or magnify mental health problems for some of us. I personally found that some tranquilizers can help short term, but long term these drugs held me back. While a person may need some tranquilizers if in acute distress or ‘psychosis’ (a loss of touch with ‘reality’), what they really need is someone to listen with empathy non-judgmentally, to try to understand what’s happened and set them on the right path.

Adverse effects of Prescribed Psychotropic substances

Prescribed psychotropic substances can have very damaging effects, especially when used long term. In 2005, a study funded by Eli Lilly, the maker of Zyprexa / Olanzapine, found that long term exposure to this major tranquilizer causes shrinkage of the brain, “significant reduction in brain volume that affects both gray and white matter”[2]. I first learned this from honest Psychiatrists Dr Peter Breggin and Dr Joanna Moncrieff. I was put on it at what I now consider too high a dosage (10mg) long term in 2008. I did not have informed consent about this powerful but potentially damaging drug ! There are no words to describe my shock and feeling of being let down by the medical profession on this ! The damage is there and can be felt in subtle ways. I have to remind myself to be patient and hope that neuroplasticity will help, which is the brains ability to repair some damage and injury.

When it came to the large cocktail of drugs I was on, including Olanzapine, no doctor seemed to notice the weight gain or care about that. I’m not sure if they would notice if I struggled to fit in the door. Due to adverse effects e.g. rapid weight gain and sometimes diabetes there are law suits in the US [3]. According to Robert Whitaker in Anatomy of an Epidemic 20 people died in the trial for Zyprexa (Olanzapine), a scandal in itself.


Withdrawal from prescribed psychoactive substances

It is necessary to to be cautious with Psychiatric medication. It’s easier to get on them than to get off and easier to prescribe than deprescribe.

While some people may want to stay on these drugs for life, those who would like to come off prescribed drugs should be supported & given alternatives. Stopping psychoactive drugs needs to be carefully and safely managed. Some prescribers need more up to date information on correct withdrawal methods. Supporters and family need truthful information and advice about the withdrawal process. It is important to prepare well for withdrawal in terms of talking therapy, exercise, nutrition, getting enough sleep and overall holistic work on health.

Relapse on discontinuation of psychoactive drugs can be a form of drug withdrawal state [4]. In the current biomedical system, any relapse will usually be seen as a sign of “illness” as opposed to the process of withdrawal.

When I was coming off the drugs I got NO support or correct advice. In the first 2 years I was prone to relapse, as my brain/body readjusted. I did keep some Olanzapine 5 mg on standby during that time. I am now drug free and ‘Psychosis free’ since December 2012. Sleep is an important part of the healing journey and something I struggle with since the overuse of these mind altering drugs. I never get a full nights sleep and continue to work on that. My circadian clock seems to be out of sync since these mind altering drugs.

It is very difficult to have a proper recovery in a system that revolves around the biomedical model of telling people they will be on drugs for life and calling them “non-compliant” if they try to go down an alternative route. You are basically left to your own devices in what can be a very difficult process. Coming off these drugs will usually be severely frowned upon.

Sometimes people are taken off the drugs too fast, leading to failure, but this can also take away Hope of ever becoming drug free. Withdrawal and drug reduction has to be done very slowly, under the supervision of an expert who has the most up to date honest psychopharmacological information on the withdrawal process. I’ve added a section at the very end of this blog entitled Resources to help withdraw from prescribed Psychoactive drugs.

Yearly explosion in prescribing of anti-depressants

An article in the Sunday Business Post (SBP) by Susan Mitchell in February 2018 investigated our growing dependence on prescribed painkillers and psychoactive substances. “From anti-depressants to sedatives, from painkillers to sleeping pills, the use of prescription medication is spiraling” [5]. Some of the headlines in this edition of the SBP include “We are definitely overprescribing. We’ve all seen what has happened in America, so we can’t be complacent. The figures are fairly stark”.

“In 2016, €25 million was spent on the drug (Lyrica / Pregabalin neuropathic pain drug) for medical card holders – up from €5 million in 2006” (1086% increase). “The number of prescriptions for the SSRI (antidepressant) Lexapro soared from 190,109 to 631,000 – a 232 % increase” (2006 to 2016). Sertraline prescriptions are up 252%. And Venlafaxine (Effexor) prescriptions up 107%. These are shocking increases in drug use.

The money used on the over prescription of painkillers and Psychotropic drugs could be redirected to a more humane system. But that would require a major shift in thinking from the current biomedical based model to a system that is based more on a Psycho-social and holistic approach to healing. For example, the Power Threat Meaning Framework describes an “alternative to Psychiatric classification in relation to emotional distress and troubled or troubling behaviour” [6]. One of the lead authors, clinical Psychologist Dr Lucy Johnstone, came to Dublin in May 2018 to talk about this approach, thanks to the Youth mental health charity Jigsaw. While I have been disillusioned with the approach to mental health in Ireland for the last decade, I see some glimmers of hope that we might be moving out of the dark ages when it comes to helping distressed human beings.


Do doctors give out antidepressants too easily?

In April 2013 The Right Hook (George Hook’s show on Newstalk) discussed an article in the Irish Examiner which saw journalism student Niamh Drohan approach seven GPs telling them she was suffering from stress and anxiety problems from her final year in college [7]. All of the GPs diagnosed her with a mild form of depression. All doctors prescribed her with anti depressants! She said some of the doctors failed to inform her about appropriate dosage of tablets to take.

As someone who has been damaged by these drugs I am in shock at what I heard on The Right Hook. A doctor went on the show and claimed that these drugs are not addictive and far more seriously she claimed on two occasions during the interview that anti-depressants are safe as overdose levels. Her exact words were “Not even dangerous at high levels at overdose”. Nothing could be further from the truth.

A number of years ago, in a documentary on suicide, I heard a doctor say that if someone takes an overdose of such medication they can end up alive and brain damaged. Knowing that should discourage people from taking an overdose.

In Ireland in 2009 there was the very tragic Shane Clancy case, which involved an overdose of the drug Citalopram. The tragedy happened 17 days after starting the anti-depressant SSRI drug Citalopram. Thankfully Shane Clancy’s mother Leonie Fennell and Psychiatrist and Psychopharmacologist Prof David Healy got to speak on the show shortly after that. I had complained to Newstalk about the original interview with a celebrity doctor which gave incorrect and potentially damaging information on the safety of overdose levels and let Leonie Fennell know about this reckless interview.


Evidence Based Medicine (EBM)

I’ve included a presentation by Prof David Healy [8]. 6 minutes into the presentation you will see that the negative trials on SSRIs anti-depressants have been hidden. Not forgetting ghost written articles.

Evidence Based Medicine is broken is an article from the British Medical Journal (2014) written by Scottish GP Des Spence [9] ~

“Now doctors can prescribe a pill for every ill. The billion prescriptions a year in England in 2012, up 66% in one decade, do not reflect a true increased burden of illness nor an ageing population, just polypharmacy supposedly based on evidence… How many people care that the research pond is polluted with fraud, sham diagnosis, short term data, poor regulation, surrogate ends, questionnaires that can’t be validated, and statistically significant but clinically irrelevant outcomes? Medical experts who should be providing oversight are on the take…the current incarnation of EBM (Evidence Based Medicine) is corrupted, let down by academics and regulators alike. What do we do? We must first recognise that we have a problem.”

Quote from Psychiatrist Dr Allen Frances (chair of the taskforce that wrote the DSM-IV) “It’s been many years since I have trusted anything I read in a medical or psychiatric journal. There is an enterprise-wide positive bias; findings never seem to replicate; benefits are hyped; harms are hidden… In 1962, it took a year or two from the time of a drug’s launch to recognize its major hazards. It now takes decades” [10].

Placebo

“The difference between the effect of a placebo and the effect of an antidepressant is minimal for most people” Harvard Professor, Irving Kirsch

The placebo effect is a genuine therapeutic mind-body effect. It can be triggered by a range of different phenomena in medicine and healthcare. The branding, the expensiveness, the colouration of pills, the number of times you have to take them per day, even experiencing side effects to medication can increase the placebo effect …

Kirsch and his colleagues discovered that antidepressants are not more effective than placebos for mild to moderate depression. They did find some research that antidepressants outperformed placebos for individuals with severe depression (in these cases, there is a small but clinically significant difference)”, article by Charlotte Blease [11].

DSM (Diagnostic and Statistics Manual)

Mental health is an area where there are powerful vested interests. The pharmaceutical industry is a multi billion dollar industry. This has a major impact on the approach taken in treating people & the fact that the biomedical model is still dominant.

DSM stands for Diagnostic and Statistics manual and is now at revision 5. When you have 69 % of the DSM-5 taskforce with financial links to the pharmaceutical industry this leads to vast amounts of over diagnosis and over prescribing of drugs. These drugs can delay recovery and cause disability leading to a huge burden on the social welfare system. This burden could be reduced with more ethical prescribing and more honesty about the drugs.

The biomedical model may be the dominate approach being used but it is the one that costs the individual and society a lot more in the long run. It is possible to get people through recovery and back to being a productive member of their community faster. This is not always possible if the person is on high doses of strong tranquilizers which can affect their ability to function e.g. in a work environment.

It would help if the Psychiatrists read the advice in the DSM when a person is on anti-depressants before saddling them with a heavy label and pumping them with a cocktail of drugs long term!

DSM-IV-TR (2000) ~ fourth edition, text revision

emphasizes that a diagnosis of Mania or Bipolar Disorder should not be made when the hypomania or mania first appears while the individual is taking a medication that can cause these symptoms” Dr Peter Breggin [12].

Conflicts of Interest

“Doctors, consultants and other medical practitioners will be obliged to declare gifts or donations from pharmaceutical and healthcare companies under new legislation introduced in the Dáil” [13].

THE PHARMACEUTICAL INDUSTRY made payments worth €6.8 million to Irish doctors and €10.7 million to Irish healthcare institutions in 2015″ [14].

“The HSE wants pharmaceutical companies to name those in receipt of payments for travel, sponsorship, medical education, grants and other activities” [15].

It’s frustrating to attend a public lecture in 2013 in a top medical college in Ireland and listen to a mainstream Psychiatrist speak without declaring his conflicts of interest at the start. It can potentially result in the public been misinformed about the serious risks that go with certain drugs. That’s also relevant when doctors / Psychiatrists go to the High Court with their “expert” advice which influences the judge.

In academic research its important to know who funded the research and if there was any pharmaceutical company linked to it.


GP training in mental health

“Medical knowledge should be open to public scrutiny” Dr Terry Lynch

Most GPs in Ireland do not have specific training in mental health. In the sample of GPs questioned in the SWAHB survey, 68% indicated they had no specific training in mental health; the remaining 32% had training consisting of between three and nine months’ clinical placement and/or during their hospital rotation” ‘Vision for Change’ policy document, pg 67 [16].

That is a staggering statistic. Hopefully it has improved since this document was written, but I personally feel that GPs should have more training in mental health. That is where a lot of emotional issues are dealt with. A prescription for pills rarely solves anything long term and can sometimes cause more harm than good. While doctors can be supportive, they work under time pressure in busy surgeries. Inadequate training can lead to damage to the patient and long term trauma.


The Power of the Sub-conscious mind

I have learned a lot about the power of the sub-conscious mind from a book by Dr Joseph Murphy [17]. “Whatever you impress upon your subconscious mind is expressed … as conditions, experiences, and events. Therefore, you should carefully watch all ideas and thoughts entertained in your conscious mind”. “You can interfere with the normal rhythm of your heart, lungs, and other organs by worry, anxiety and fear. Feed your sub-conscious with thoughts of harmony, health and peace and all the functions of your body will become normal again”.

Bernheim “was one of the first to explain how a physician’s suggestion to the patient took effect because of the force of the subconscious mind”. I was initially told by a doctor that I would need to be on the “anti-depressant” Citalopram for the rest of my life due to anxiety and panic attacks. When this drug triggered off mania/psychosis I was then taken off this drug ‘cold turkey’ by someone in the mental health system and saddled with the label Manic Depression / Bipolar.

The medical profession had broken my spirit and had me on a cocktail of very powerful, sedating drugs. Due to their training in the biomedical model, when I had no energy and didn’t want to get out of bed until 2 or 3 pm I had been sub-consciously conditioned into believing I had a serious brain disease / illness so I put the lethargy and lack of motivation etc down to “my illness”. Also when I went into a three month high in 2010 I assumed this was “my illness”. Luckily, through some miraculous intervention I managed to get past this and eventually started to realise that it was the drugs that were fueling the extreme lows and lethargy and also the highs, as well as the psychosis. Becoming aware of this was a major turning point in my healing journey.

One day I went to see my doctor and had stopped Lithium briefly due to a physical medical issue. The Psychiatrist had advised this. I also refused to move to 200 mg of Seroquel as I felt that I became angry on it. When I told the doctor this he called me “non-compliant” and wrote a letter to the Psychiatrist to this effect ! The same doctor is the only one that wrote anything positive about me in my notes so I thank him for that part. One of these days soon I will have a burning ceremony for the same biomedical based, fictional notes which I accessed under Freedom of Information. I don’t recommend accessing your notes unless you have a good support network around you as doing so can be traumatic.

In 2011 I had managed to get off the drugs but because I didn’t have good advice or support from those around me, including doctors, I would have come off the drugs too fast. So I went to a GP to ask for some of the medication. He said, in a disapproving tone, “These drugs are not made for a’la carte people like you!”. That particular day was a major turning point and I can thank him now for his sarcastic but valuable one liner. That was the day I knew I wanted to get off these drugs for sure. I was going to show him that I can do this. At the same time, without support from doctors and family, it has been a bumpy ride.

I have to remember that the massive amount of prescribed tranquilizers I was put on for over 3 years, while it appeared to be the correct treatment from a DSM / Psychiatric point of view, was in fact a cunning way of not admitting that anti-depressants were the cause of my serious symptoms initially. It was in effect a cover up. But a very elaborate one, that will be difficult for the public to understand, due to the brainwashing that goes on in the field of mental health. But the majority of doctors are also brainwashed due to the influence the pharma industry has over medical schools and perks they receive.

So for those of us saddled with heavy labels my way towards healing involved blood, sweat and tears to break free from the flawed biomedical approach. I feel I am coming out the other side, but it’s taken a decade of my life! With the help of some great people and also through connecting to other Psychiatric survivors. I could still be living the “illness” and “disorder” model of mental health but decided to break free from that. Even though I have self-sabotaged throughout the years and tried to numb out some of the feelings, I perservered, while dealing with a lot of emotional distress.

“It is foolish to believe in sickness or in anything that will hurt or harm you. Believe in perfect health, prosperity, peace, wealth and divine guidance” Dr Joseph Murphy (PhD as opposed to MD).

References

[1] Anatomy of an Epidemic by Robert Whitaker, 2010 ~
https://www.amazon.com/Anatomy-Epidemic-Bullets-Psychiatric-Astonishing/dp/1491513217

[2] “The Influence of Chronic Exposure to Antipsychotic Medications”, 2005 ~ http://www.nature.com/npp/journal/v30/n9/full/1300710a.html

[3] Lilly Settles With 18,000 Over Zyprexa / Olanzapine ~

www.nytimes.com/2007/01/05/business/05drug.html

[4] Psychiatry in Context : Experience, Meaning & Communities by Dr Philip Thomas, 2015 ~

https://www.amazon.com/Psychiatry-Context-Experience-Meaning-Communities/dp/1906254729

[5] Hooked: Ireland’s hidden addiction to prescription drugs

Sunday Business Post, Susan Mitchell, Feb 2018 ~
https://www.businesspost.ie/health-social/hooked-irelands-hidden-addiction-prescription-drugs-408128

[6] The Power Threat Meaning Framework overview ~ Lead authors Dr Lucy Johnstone (clinical Psychologist) and Prof Mary Boyle, 2018

https://www1.bps.org.uk/system/files/user-files/Division%20of%20Clinical%20Psychology/public/INF299%20PTM%20overview%20web.pdf

Also video presentation on PTM Framework ~
https://vimeo.com/267401691

[7] “Depressing truth about treating depression in the young” Niamh Drohan ~

www.irishexaminer.com/ireland/depressing-truth-about-anxiety-and-doctors-227126.html

[8] A talk by Prof David Healy at Cardiff University (Nov 2012)

“Time to abandon evidence based medicine?” http://www.youtube.com/watch?v=A3YB59EKMKw

[9] Evidence based medicine is broken, GP Des Spence, 2014 ~
http://www.bmj.com/content/348/bmj.g22?ijkey=nedZMe934zzz5bC&keytype=ref

[10] The Crisis of Confidence in Medical Research, Dr Allen Frances, 2015 ~
https://www.huffingtonpost.com/allen-frances/the-crisis-of-confidence-_b_6432236.html


[11] “Research on the placebo effect is a bitter pill for pharmaceutical firms to swallow” Dr Charlotte Blease, 2015
www.herald.ie/lifestyle/research-on-the-placebo-effect-is-a-bitter-pill-for-pharmaceutical-firms-to-swallow-31219408.html

[12] Suicidality, violence and mania caused by SSRIs: A review and analysis ~

http://breggin.com/wp-content/uploads/2005/01/31-49.pdf

[13] Bill will require doctors to declare gifts from pharma firms

Healthcare companies gave €30 million to hospitals, medical staff in 2016, says Minister ~
https://www.irishtimes.com/news/politics/oireachtas/bill-will-require-doctors-to-declare-gifts-from-pharma-firms-1.3263608

[14] Pharmaceutical industry paid Irish doctors €3.7 million for “undisclosed” reasons in 2015

http://www.thejournal.ie/big-pharma-ireland-3068146-Nov2016/

[14] “The HSE wants pharmaceutical companies to name those in receipt of payments for travel, sponsorship, medical education, grants and other activities”
https://www.businesspost.ie/health-social/hse-warns-pharma-firms-payments-doctors-392431


[16] Vision for Change (Report of the expert group on Mental Health Policy), 2006 ~

www.hse.ie/eng/services/publications/Mentalhealth/Mental_Health_-_A_Vision_for_Change.pdf

[17] The Power of Your Subconscious Mind, Dr Joseph Murphy, 2011 (Originally published 1963).

https://www.amazon.com/Power-Your-Subconscious-Mind/dp/1614270198

Other Relevant Resources

* Study 329 – where the hell is the outrage? by Dr Malcolm Kendrick ~

www.drmalcolmkendrick.org/2015/10/01/study-329-where-the-hell-is-the-outrage/

* Teen girl in care of HSE to continue anti-psychotic medication despite her mother’s objection ~www.irishtimes.com/news/crime-and-law/teen-girl-in-care-of-hse-to-continue-anti-psychotic-medication-despite-her-mother-s-objection-1.1370237

* ‘I was unaware of potential adverse effects to my prescribed antidepressants’ ~

www.independent.ie/life/health-wellbeing/mental-health/aines-story-i-was-unaware-of-potential-adverse-effects-to-my-prescribed-antidepressants-31218347.html

* One woman’s account of suffering from Psychosis ~

www.todayfm.com/One-womans-account-of-sufferinbg-from-psychosis


*
John Rengen Virapen ~ Pharma whistleblower ~ www.youtube.com/watch?v=pmnOni0xlM4


* Dr. Allen Frances on the Risks of DSM-5 (Diagnostic and Statistics Manual) – The Lens Report ~

www.youtube.com/watch?v=-AMvrcBvYWk

* Danish doctor Peter Gøtzsche is co-founder of the respected Cochrane Collaboration.

Interview ~ www.youtube.com/watch?v=VIIQVll7DYY

* Does long term use of psychiatric drugs cause more harm than good? ~

www.bmj.com/content/350/bmj.h2435

* Mary Maddock: a survivor of ECT and decades of Psychiatric drugging ~

www.vimeo.com/87711795

* AstraZeneca Settles Most Seroquel Suits ~
https://prescriptions.blogs.nytimes.com/2011/07/28/astrazeneca-settles-most-seroquel-suits/


* SPECIAL REPORT: The anti-depressant generation ~
www.irishexaminer.com/ireland/special-report-the-anti-depressant-generation-319128.html

* Our €40m drug problem ~

www.irishexaminer.com/viewpoints/analysis/special-report-our-euro40m-drug-problem-319134.html

* Recording from The International Society for Ethical Psychology & Psychiatry (ISEPP) Conference. A mother (nurse) speaks of how difficult it was for her son to come off Paxil (Seroxat).

www.youtube.com/watch?v=R8ReARNiAHI


* Yolande Lucire ~ Adverse reactions to Psychiatric drugs:

www.youtube.com/watch?v=IEoSs6Yo0DA&feature=youtu.be


* New study concludes psychiatric drug treatments haven’t resulted in an improvement

in the long-term outcome of patients with “mood disorders”:

www.ncbi.nlm.nih.gov/m/pubmed/24285565/

* Deadly Medicines and Organised Crime: How big pharma has corrupted healthcare by

Peter Gøtzsche, 2013 ~

www.radcliffehealth.com/shop/deadly-medicines-and-organised-crime-how-big-pharma-has-corrupted-healthcare

* Deadly Psychiatry and Organised Denial by Peter Gøtzsche, 2015 ~
https://www.amazon.com/Deadly-Psychiatry-Organised-Denial-Gotzsche-ebook/dp/B014SO7GHS

* DEPRESSION DELUSION: The Myth of the Brain Chemical Imbalance, 2015 ~

www.amazon.com/DEPRESSION-DELUSION-Volume-One-Imbalance/dp/1908561017

* The Emperor’s New Drugs: Exploding the Antidepressant Myth, Irving Kirsch, 2009 ~

www.amazon.com/The-Emperors-New-Drugs-Antidepressant/dp/0465022006

* “The Myth of the Chemical Cure ~ A critique of Psychiatric drug treatment” by Dr. Joanna Moncrieff ~ www.amazon.com/Mans-Search-Meaning-Viktor-Frankl/dp/080701429X

* A Straight Talking Introduction to Psychiatric Diagnosis by Lucy Johnstone
www.amazon.co.uk/Straight-Introduction-Psychiatric-Diagnosis-Introductions/dp/1906254664

* Anna Byrne. The Anti-depressants Seroxat and Sertraline are mentioned in this article ~

www.independent.ie/national-news/courts/open-verdict-at-inquest-into-death-of-anna-byrne-3300290.html

* Deaths in the UK potentially of people on antidepressants ~ www.antidepaware.co.uk

* Psychiatrist / Psychopharmacologist Prof David Healy ~ www.davidhealy.org

* “A lecture by Prof David Healy from the Institute of Psychological Medicine and Clinical Neurosciences at Cardiff University on the over 100 drugs that can cause violence” (2013)

www.vimeo.com/67245935

* Peter Lehmann “Recovery from Psychosis and Depression by Taking Psychiatric Drugs versus Recovery by Coming off Psychiatric Drugs”

www.peter-lehmann-publishing.com/articles/lehmann/pdf/recovery-from.pdf

* Will Self ~ Psychiatrists: the drug pushers ~

www.theguardian.com/society/2013/aug/03/will-self-psychiatrist-drug-medication

* My review of Psychiatry in Context ~ www.goodreads.com/user/show/46943899-anne

This review was published in the Journal of Critical Psychology, Counselling and Psychotherapy (Volume 16, Number 1, March 2016)

* Youth mental health charity Jigsaw ~
https://www.jigsaw.ie/

Resources to help withdraw from prescribed Psychoactive drugs


* Psychiatric Drug Withdrawal A Guide for Prescribers, Therapists, Patients and their Families

www.breggin.com/index.php?option=com_content&task=view&id=296

* Website which aims to give you up to date information about psychiatric medication, how it functions and the withdrawal process ~
www.comingoff.com

* how to stop anti-depressants ~

https://rxisk.org/guide-stopping-antidepressants/

* Drug safety website ~

www.rxisk.org

* Harm Reduction Guide to Coming Off Psychiatric Drugs ~
http://www.comingoff.com/harm.php

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Irish Mental Health Service

“Our prime purpose in life is to help others. And if you can’t help them at least don’t hurt them” Dalai Lama

From the end of Prof Ivor Browne’s chapter “The Frozen Present”, regarding the bureaucratic mental health service in Ireland “In my experience the administrators of a health board are not primarily interested in the therapeutic outcome and welfare of the patients. Rather, they are concerned with running a service that is financially economical and causes them as little trouble and disruption as possible” [1].

The Mental Health Commission (MHC)

The Mental Health Commission inspects Psychiatric units and write inspection reports. This is from their website The Commission is an independent body that was set up in 2002. Our functions are set out in the Mental Health Act 2001. Our main functions are to promote, encourage and foster high standards and good practices in the delivery of mental health services and to protect the interests of patients who are involuntarily admitted” [2].

In my hospital notes it says that I was “voluntary” but if I insisted on leaving the hospital I should be detained and regraded to involuntary! So I basically was involuntary with none of the rights that goes with that e.g. the Mental Health Commission should have been informed and there is a whole process that goes with involuntary status.

Once locked into the building, which caused me unimaginable stress and trauma, despite my adverse drug reaction to an antidepressant that resulted in my incarceration in the first place, I had a lot more “insight” than they realised. I quickly learned about the Mental Health Act [3], the MHC and my basic human rights. I had contacted the Mental Health Commission. At some stage they came and went and did an inspection but I was not informed. The report from the time said they asked to speak to ALL service users and we ALL declined. “All service users were offered the opportunity to speak to the Inspectorate team individually but they all declined” [4].

I was never informed they were in the building and was probably resting in bed at the time. That evening a nurse slyly told me they had come and gone. As if to say we will show you who has the power and control ! Not forgetting that most of the patients at the time were more than likely unaware of who the MHC are.

I was basically imprisoned with no rights or no solicitor appointed, other than a relative I contacted in that profession. Seemingly the Mental Health Commission was unaware of me, despite having visited the Unit at the time! I was treated like a criminal even though I hadn’t committed a crime. And I did not feel protected by the Mental Health Act of 2001.

Human Rights

“The Psychiatric system in this country is inhumane and too reliant on drugs” Jeremy Irons

Despite being classified as a ‘voluntary’ patient I was not allowed to freely go into the garden, as it was not enclosed. I was not allowed out the front door. While the ward was generally calm, one day a fight broke out between a patient and a staff member (which I feel may have been triggered by the member of staff as opposed to the patient!). There were drips of blood on the floor. I found the experience frightening. I packed my stuff and said I was leaving. I was told I could not go.

I asked to go into the town with a friend for an hour. I was told NO. After a week I realised my job was in danger so I asked to get out to speak to my boss. I was told NO. I assumed I would have basic human rights to try and protect my job, which was temporary, but no one seemed to care about that or the long term consequences or helped me deal with this! The day I realised my job was gone was extremely traumatic and upsetting, as well as damaging to my emotional and mental well being. It turned out to be the ending of a career I had worked so hard to get into. I had only recently qualified 3 years earlier as a Primary teacher and did well as a Learning Support / Resource teacher, helping numerous children who had Dyslexia and other needs.

Qualifying as a teacher had cost me up to €10,000 and involved taking out a loan. I also invested a great deal of time and effort into the course and graduated with an Honours Degree, as part of the first group of people to qualify with Hibernia College. I held down a job at the same time. So there I was in 2008 working for the State and then became the victim of a dysfunctional part of our State i.e. our mental ‘health’ system, after an adverse reaction to a doctor prescribed drug that I was put on by doctors for anxiety (Citalopram).

Article 23 of the Universal Declaration of Human Rights [5] states that “Everyone has the right to work, to free choice of employment, to just and favourable conditions of work and to protection against unemployment”. When I was locked into a building for 3 weeks, pumped full of a cocktail of damaging and sedating drugs for 3 years, spent years withdrawing from these drugs with no support or guidance and feeling the damage done, this had a detrimental affect on my career and job prospects.

I am currently working with a Job coach trying to put together some of the shattered pieces, as well as deal with a number of health issues. She looked at my Curriculum Vitae which is impressive up until 2008 when this disaster happened with the mental health system and said “You are wasted!”. Of course I’m wasted. I spent years in college studying for an Honours Degree and Masters in Computer Science (1993), A HDip in Primary Teaching (graduated with Honours, 2005) etc etc While I was never particularly happy working in computer software, I did enjoy Primary teaching and working as a Massage therapist. I now look back and wonder why did I bother ? What was it all for ? When a damaging, legalised drug dealing system can help take it all away.

By the way the State would have helped fund my Primary Degree in Computer Science ! So they invested in me as a 17 year old, after I went through the State school system. I went on to have high salaries in that field. They then helped pull the rug from under me at 38, due to a dysfunctional approach to mental health. How many others has this happened to ? How can we stop it from happening to others in the future ? While some may claim to have been helped by such a system, many of us have been harmed by it.

I directed a lot of my emotions, pain and whatever energy was left into Activism. Trying to raise awareness, attending conferences, writing an article in a national newspaper, speaking on radio etc While dealing with my own recovery and distress. Activism has a role in insuring our voices are being heard e.g. I participated in an Advance Directive study [6]. It’s important to have an Advance Directive in place, even if it’s not a legal document. I have covered this in the blog Hope of Recovery and Healing.

Amnesty International and Colm O’Gorman organised a number of good conferences including the Capacity Law conference (Dublin 2012) and Mental Health Law Reform conferences(NUI Galway, 2012 and Dublin, 2013). I added some recordings below under Other Relevant Resources.

Opportunities arose to become involved in Mental health policy and delivery of local services e.g. via ARI (Advancing Recovery in Ireland), the Recovery College initiative, Mental Health Alliance and the forming of Consumer panels. Or so I thought. But when I become involved in some of these initiatives and went to several meetings in my local mental health region, including becoming involved in the co-production of a module called “Recovery and the Family”, I felt that my input was mainly ignored and squashed. And replaced with pharma influenced information links. I had hoped that people in my area would gain some knowledge about Open Dialogue via my input but that was not to be ! So I saw no choice but to leave this behind me. The work was unpaid and you usually had to travel to meetings at your own expense. At one stage I was in a group with my former Psychiatrist who seemed to be a silent watcher when I think back.

Informed Consent

A doctor is “under a duty to take reasonable care to ensure that the patient is aware of any material risks involved in any recommended treatments”. A doctor’s advisory role includes dialogue with the patient about risks. Due to the hiding of negative trials on drugs people do not get to hear the truth and hence do not have informed consent about drugs. Putting their health and lives at risk. And even when risks are known. For instance with the major tranquilizer Olanzapine, people are not informed of all the risks. I was even once told not to be reading the PILS (Patient Information Leaflet that comes with the drug)!

Andrew Herxheimer, spent most of his career teaching clinical pharmacology. Anyone who plans on going on prescribed drugs, be it a psychoactive drug or others should watch this discussion [6]. It includes anti-depressants at 21 mins but discusses the pharma industry in general. The longer a drug is on the market the more that is known about it. Due to the hiding of negative trials on drugs, the public are the real clinical trial. So it is up to the public to educate themselves and research any drug that they are about to start from reputable sources outside the pharma marketing brochures e.g. the database on rxisk.org [7].

Pat Bracken

In my experience, very few of the many Psychiatrists I met seem to pay attention to understanding the person’s life story or psychosocial factors that have resulted in the person experiencing emotional distress or specific symptoms. There are a few exceptions. I have written about Prof Ivor Browne in a number of my blogs and he has been very helpful in my own healing journey.

Psychiatrist Pat Bracken is another example. With his help Open Dialogue was implemented in West Cork / Bantry. He has since retired from the Irish health service / HSE. In West Cork Iseult Twamley is Open Dialogue Clinical Lead and Senior Clinical Psychologist with the HSE. Adrienne Adams is an advanced nurse practitioner implementing Open Dialogue.

The following are quotes from an article entitled Psychiatry beyond the current paradigm that Dr Bracken co-wrote with Philip Thomas, Sami Timimi and others [9].

”…there is ample evidence that anti-stigma campaigns based on biogenetic models of serious mental illness have been counterproductive…”.

”…the increasing focus on Neuroscience has meant that other important developments in the provision of care and support for people with mental health problems over the course of the past century have been neglected…”.

When it comes to recovery from mental health issues ”…Research has pointed to the importance of the therapeutic alliance in determining outcomes. Others have pointed to the importance of self-esteem and an ‘internal locus of control’. It seems that creating a therapeutic context that promotes empowerment and connectedness and that helps rebuild a positive self-identity is of great significance…”. Therapeutic alliance is the quality of the relationship between a therapist and the human being they are working with.

Conclusion

Psychiatry have taken the work voluntary and reinvented it for their own purposes. The MHC include Psychiatrists inspecting Psychiatrists. Can we really have faith in such a system ?

”…All forms of suffering involve layers of personal history, embedded in a nexus of meaningful relationships that are, in turn, embedded in cultural and political systems…” [9]. The current Minister for Mental Health is Jim Daly (since June 2017). The time has come for real change at a political and cultural level.

There is a lot of talk in media about mental health awareness but at the same time the system itself is slow to change and many are suffering unneccesarily. A person should not go looking for help in a mental health system and end up far worse than they started, as happened in my case ! Or sometimes dead. As I think of great women like retired nurse Teresa Mullaney from Sligo. The system and its powerful but potentially damaging drugs failed her. You can read more about her tragic story in Leonie Fennell’s blog [10]. Rest in Peace to Teresa and others who have lost their life.
Including our Youth which I have previously written about.


Even though the world was told a fable for 105 years about the sinking of the Titanic, it was a lot more than an iceberg that sank it, killing over 1,500 people. There was a fire on board before it even left Belfast ! Most of us are unaware of this. It was uncovered around 2017 thanks to Senan Malony and others and their work has been made into a very good Channel4 documentary [11]. When I do my activism in mental health I’m aware of the cover up and fire that rages within the system, potentially helping some but injuring and killing Titanic loads of people. Many that we never hear about publicly.

The United Nations Convention on the Rights of Persons with Disabilities has been ratified. “Ireland is the last of the 27 European Union states to ratify the convention, which was adopted by the UN in 2006” [12]. There is a certain amount of overlap between the field of mental health and that of disabilities. In my experience when it comes to basic human rights and treating people in distress with respect and dignity we have a long way to go to reform an outdated system.

{ Important Do not stop or change prescribed psychoactive drugs without consulting your prescriber, due to the dangers of withdrawal. Any changes need to take place under the supervision of an expert. What I discuss in part of this blog is my own experience and is not medical advice. We all have our own unique journey. Samaritans 116 123 }

References

[1] Music and Madness, Ivor Browne, 2009 ~
http://www.corkuniversitypress.com/Ivor-Browne-Music-and-Madness-p/9780955226182.htm

[2] Mental Health Commssion website ~ http://www.mhcirl.ie/

[3] Your Guide to the Mental Health Act 2001 ~ http://www.mhcirl.ie/File/SUI_EnglishV2009.pdf

[4] Report of the Inspector of Mental Health Services 2008 ~ Roscommon 2008 ~
http://www.mhcirl.ie/File/IRs/DOP_Roscomm_IR2008.pdf

[5] The Universal Declaration of Human Rights ~ www.un.org/en/documents/udhr/

[6] The introduction of a legal framework for advance directives in the UN CRPD era: The views of Irish service users and consultant psychiatrists, Dr Fiona Morrissey, 2015 ~
https://www.sciencedirect.com/science/article/pii/S2352552515001048

[7] Adverse Psychiatric side effects of medicines: what’s our responsibility ~
Andrew Herxheimer Talk & Panel Discussion with Professor David Healy, chaired by Dr Joanna Moncrieff ~ https://vimeo.com/16363571

[8] Drug safety website ~ www.rxisk.org

[9] Psychiatry beyond the current paradigm ~
https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/psychiatry-beyond-the-current-paradigm/0EF061925997CA565C223DFE22BC3BEA/core-reader

[10] Inquest of Teresa Mullaney ~
https://leoniesblog.com/2014/02/28/teresa-mullaney-dr-desmond-moran-effexor-zeprexa-death/

[11] Channel 4 -Titanic : The New Evidence ~
https://vimeo.com/198568091

[12] “UN convention on disability rights passed by Dáil” ~
https://www.rte.ie/news/ireland/2018/0307/945705-disability-rights/


Other Relevant Resources

* Mental health system too drug-related, says Irons as he launches farm project ~

https://www.irishexaminer.com/ireland/mental-health-system-too-drug-related-says-irons-as-he-launches-farm-project-231819.html

* A better way to mental health ~ Joan Hamilton and Slí Eile project in Cork ~
https://www.irishtimes.com/news/health/a-better-way-to-mental-health-1.657880

http://www.slieile.ie/

* Dr. Lucy Johnstone: The Power Threat Meaning Framework ~
https://www.madinamerica.com/2018/03/dr-lucy-johnstone-power-threat-meaning-framework/

* Healthcare Update: Assisted Decision-Making Capacity Act and Proposed Irish Mental Health Law Reform ~ https://www.mhc.ie/latest/insights/healthcare-update-assisted-decision-making-capacity-act-update-and-proposed-irish-mental-health-law-reform


* Government to begin ratifying UN convention on disability rights ~
https://www.irishtimes.com/news/social-affairs/government-to-begin-ratifying-un-convention-on-disability-rights-1.3418273

* What is the UN CRPD (Convention on the Rights of Persons with Disabilities)?
https://www.disability-federation.ie/news/latest/2017/03/11/what-is-the-un-crpd/

* Advancing Recovery in Ireland (ARI) ~
https://www.hse.ie/eng/services/list/4/mental-health-services/advancingrecoveryireland/


* “Phil Fennell, Professor of Law at Cardiff University, looks at mental health legislation
in Britain and elsewhere, and draws lessons for reform of Ireland’s Mental Health Act 2001. Phil was speaking at an Amnesty International Ireland conference on mental health law reform in March 2013″ ~ www.youtube.com/watch?v=rDvah16UtaU

* George Szmukler, Professor of Psychiatry & Society at King’s College London at an Amnesty International Ireland conference in March 2013 on reviewing the Mental Health Act 2001 ~
https://www.youtube.com/watch?v=oq3WA5LnHd4

* Report of the Expert Group Review of the Mental Health Act, 2001 ~
https://health.gov.ie/blog/publications/report-of-the-expert-group-review-of-the-mental-health-act-2001/

* Reform of mental health law should put patient’s voice to the fore ~
https://www.irishtimes.com/opinion/reform-of-mental-health-law-should-put-patient-s-voice-to-the-fore-1.3156755

Articles on Open Dialogue pilot project in Bantry, West Cork

Note : Open Dialogue is a concept that originated in Finland and has been around since the 1980s. I have covered it in an earlier blog.

* Open Dialogue is a new way of dealing with mental health ~
https://www.irishexaminer.com/lifestyle/features/open-dialogue-is-a-new-way-of-dealing-with-mental-health-458828.html

* Mental health pilot focus of Finnish film ‘Open Dialogue’ ~
https://www.irishexaminer.com/ireland/mental-health-pilot-focus-of-finnish-film-open-dialogue-393492.html

* Radical mental health initiative invites patients’ families into care scheme ~
https://www.irishexaminer.com/ireland/radical-mental-health-initiative-invites-patients-families-into-care-scheme-420494.html

* A fresh approach to mental health ~
https://www.irishexaminer.com/lifestyle/features/a-fresh-approach-to-mental-health-396031.html

Factors that can affect emotional health and what can help

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“Be the silent watcher of your thoughts and behaviour. You are beneath the thinker. You are the stillness beneath the mental noise. You are the love and joy beneath the pain” Eckhart Tolle

There are many factors which can affect our emotional well-being including stress, difficulties in relationships, rumination and bullying.

Stress

If a person is under a lot of stress in their lives this can affect both their physical and mental health. Some stress is good in a person’s life but it can be a problem if it is excessive and unmanaged. Hormones such as adrenaline and cortisol are produced as part of the “fight or flight” response.

Adrenaline increases your heart rate and raise your blood pressure. Cortisol triggers the release of glucose into the bloodstream. Stress can play a role in anxiety, panic attacks and Depression. It can affect relationships as the person may become more irritable and find it hard to relax.

Some tools that may be used in stress management, depending on the person, include Yoga, meditation, mindfulness, watch diet / alcohol / caffeine, exercise, learning to breath properly,

cutting back on responsibilities if possible or delegation, self-awareness and keeping a journal. Mental / physical health requires daily work. For some more than others. It’s important not to develop unhelpful or damaging ‘coping mechanisms’ e.g. using alcohol to excess. It may also be important to learn about time management.

Difficulties in relationships

“Between stimulus and response, there is a space, In that space lies our freedom and power to choose our response. In our response lies our growth and our happiness” Viktor Frankl

Having difficulties in relationships with others can affect mental health. Our early relationships with our caregivers are important. To flourish people need safe and secure attachments in the early years.

Human beings are social creatures and their experience and interactions with others is an important part of everyday living. When someone or people you trust let you down badly this can affect your future relationships. Isolation from others can affect mental health.

Difficulties in relationships should be addressed sooner rather than later. Good communication is key. Sometimes a mediator may be necessary. A person can work on their interpersonal skills. It’s important to show respect when communicating with others e.g. not to resort to name calling

or abuse. Be “the best possible version of yourself” while not allowing others to take advantage of you. Learn how to use positive influencing tactics with others as opposed to forceful or nagging ones e.g. nudge theory.

Rumination

“Most of the shadows in this life are caused by standing in one’s own sunshine” Ralph Waldo Emerson

Rumination involves going over things repeatedly in your mind, sometimes in an obsessive way. If we overthink negative experiences or are hard on ourselves, blame ourselves and feel guilty, this leaves less time for enjoyment of life. This can lead to increased levels of anxiety and affect mood.

Over thinking doesn’t change what happened in the past. There is some overlap between techniques used in Stress Management and what can help rumination. Useful tips in coping with rumination include

  • Identify the thought or fear

  • Think about the worse case scenario

  • Let go of what you can’t control

  • Look at mistakes as learning opportunities

  • Schedule a worry break

  • Mindfulness

  • Exercise

  • For more deep seated long term issues Psychotherapy may be helpful [1].

CBT (Cognitive Behaviour Therapy) might also help [2] and keeping a journal.

It is important to wind down in the evening and avoid over-stimulation e.g. Stepping away from social media and being disciplined around that. For some social media can be addictive. The light emitted by screens can affect sleep. Sleep is an important part of physical / emotional well being.

Bullying

“Bullying is defined by the Department of Education and Skills guidelines as unwanted negative behaviour, verbal, psychological or physical, conducted by an individual or group against another person (or persons) and which is repeated over time. Placing a once-off offensive or hurtful public message, image or statement on a social network site or other public forum where that message, image or statement can be viewed and/or repeated by other people is also regarded as bullying behaviour. Bullying can occur at any age, in any environment, and can be long or short-term” [3].

These tips are taken from “How can I help my teenager respond to bullying”, a Barnardo’s document on positive parenting [4] ~

  • Demonstrate Assertive Behaviour

  • Saying No is Acceptable

  • Encourage your teen to express feelings positively

  • Show courtesy and respect for others

  • Encourage your teen to ignore situations if appropriate ~ showing little reaction or response can be a useful tool

  • Encourage your teenager to make new friends

  • Acknowledge when your teenager is doing well

  • Help your teen to identify situations where discrimination, aggression or unkind behaviour is happening

  • Listen to your teenager

  • Ask your teenager how you can help.

The document also includes advice on what not to do.

Exercises that can help improve our emotional well being

“Make a list of the areas in your life that feel like a struggle. Use this writing time to let it all out; write until you feel complete. After journaling take a moment to feel all of the sensations in your body, mind, and heart associated with your writing. Take a deep breath in, using your breath to send gentle love and light to any place within that feels tense, uneasy, heavy, or conflicted. Visualize all feelings of struggle being released as you exhale” ~ From Oprah Winfrey / Deepak Chopra 21 day meditations in 2013 [5].

“Write yourself a self-care plan for this week. How can you take good care of yourself? What things can you plan to incorporate into your week that nourish and fuel you?” From Oprah / Deepak Chopra 21 day meditations, 2013.

Vision Board

A Vision Board is a useful tool that can be used to create a picture of what type of future a person would like to work towards. It is a collage of images, pictures and affirmations of dreams and desires. It can help bring to light goals in a creative way. There are plenty of online resources that describe Vision Boards in more detail. The picture at the top of this blog is one I created a while back. It includes aspects of my past, present and future and what I consider to be some of my priorities on my Life journey.

Having structure in life and managing time

Dr. Daniel Siegel looked at how we can use our time so that it supports our well-being and inner growth. He list seven ways to spend time [6]:

  • Sleep time – Getting a full night’s restful sleep

  • Physical time – Taking time to move and let your body be active

  • Focus time – Being alone for a while to concentrate on what matters to you

  • Time in – Taking time for meditation, prayer, or self-reflection

  • Downtime – Setting aside time to simply to be here

  • Play time – to have fun and enjoy yourself

  • Connecting time – between you and those you love and care for

If the person gets the balance right between minding themselves but also challenging themselves, they are more likely to enjoy life and experience peace of mind.

Bibliotherapy

Bibliotherapy, the therapeutic aspect that sometimes comes from reading, is a useful aspect of recovery if the person enjoys reading or would like to get into reading. There are a lot of great authors out there eg Wayne Dyer, Louise Hay, Stephen Covey and Sadhguru. Some of these authors/motivational speakers can help a person understand how to live more in the present and how to overcome any negative thinking patterns. Recovery can involve learned habits that need to be unlearned.

Meditation

Meditation is the only intentional, systematic human activity which at bottom is about not trying to improve yourself or get anywhere else, but simply to realize where you already are.” Jon Kabat-Zinn.

Meditation can be practiced at night and in the morning or whenever suits the person. There are lots of useful resources out there that can help a person learn more about this [7].

Mindfulness

Mindfulness is the Psychological process of bringing one’s attention to experiences occurring in the present moment, which can be developed through the practice of meditation and other training.” (Definition on Wikipedia).

Some of the experts in this field include Eckhart Tolle (author of The Power of Now), Thich Nhat Hanh and Jon Kabat-Zinn. See Other Useful Resources below.

Exercise

As physical and mental health are very much connected, it is good to set some goals for fitness or at least to make exercise a part of a daily and weekly routine. Sometimes medication may have led to weight gain so it may be necessary to set targets for weight loss and possibly join a gym or a weight loss class. In my own routine I like to take a few minutes in the morning to do some Yoga stretches, sometimes with a video [8].

Social Inclusion

People with mental health difficulties sometimes end up feeling socially excluded. A person who has been through emotional distress may need help with this. Some people may need support in recognising patterns of behaviour that may lead to exclusion and to work on improving that area of their life e.g. where there are addiction issues.

Integration into community life is a goal in recovery, as isolation and withdrawal from society can hinder progress. So, goals can be set and time frames that will assist the person in participating in and becoming a productive member of society. Local sports activities, clubs and events could be looked into depending on the interests of the person e.g. drama groups, dance classes, a cycling or walking club. That would enable the person to meet new people and possibly establish friendships, thus broadening their social circle. It would also help them build up their self-confidence. When someone has been through trauma and distress, their self confidence can be low and sometimes their trust in other people. This may need to be rebuilt.

Depending on the person and what they would like to achieve, some voluntary work could be looked into e.g. working to help raise money for those who are experiencing homelessness.

There are various organisations that run courses. In the Midlands in Ireland the Dr. Steven’s Centre provide QQI courses in computer skills, Personal Development, Communication skills, Customer Service, work experience etc Through courses people get to meet others, develop their skills and sometimes get back into the work force.

Motivation

“As you reflect on your heart’s deepest desires know that it is inspiration paired with action that activates the path to making your dreams come to life” Deepak Chopra

A golden rule is “Action leads to Motivation” [2]. A diary can help and small goals each day. For longer term goals a Life Coach may be useful. Writing in a journal can assist a person in organising their thoughts and feelings.

If a person is lacking energy and motivation the drugs they are on may need to be reduced slowly under the supervision of a doctor, as some prescribed psychoactive drugs can have a very tranquilizing effect.

As part of daily work on my physical / mental health I try to get the day off to a good start with a few Yoga stretches first thing, reading some meditation and a healthy breakfast and make that a habit.

Social media

Social media e.g. Facebook and Twitter allowed me to connect to other survivors of Psychiatric abuse or the relatives of those killed by drugs. I also connected to professionals (honest Psychiatrists and Psychologists), to gain knowledge, network, educate myself, learn about WRAP, build back confidence and try to help others have informed consent. Something I never had. It was a life saver on some level. In the loneliness of the “real world”. After what happened to me.

On the downside, social media is used by some who benefit from the “illness model” to encourage people to claim they are “mentally ill” when they may just be going through emotional distress, effects of the drugs etc. People should not take on the “mental illness” label lightly as it has many implications for a person’s life

Unless you are self-disciplined about being on social media it can take up a lot of time and become an addiction in itself. 

Conclusion

When you find yourself getting caught up in the twists and turns of life, become aware of what brings you back into balance. For me it is important to breath correctly, not to catastrophise and think the worst, Yoga, mindfulness, meditation, to get outdoor light, to be solution focused and to be kind to myself. Nutrition and Sleep are very important. Also for life to have some purpose or meaning and to be able to spend time with friends or family without conflict. Downtime can become harder with access to the internet. That is where self-discipline comes in.

See other blogs e.g. Nutrition, Hope of Recovery and Healing and Youth Mental Health discusses WRAP (Wellness Recovery Action Plan).

References

[1] 8 Tips to Help Stop Ruminating by Lauren Feiner ~

https://psychcentral.com/blog/8-tips-to-help-stop-ruminating/

[2] “The Feeling Good Handbook” by David D. Burns (CBT) ~

www.amazon.com/Feeling-Good-Handbook-David-Burns/dp/0452281326

[3] Bullying in Schools ~ http://www.citizensinformation.ie/en/education/primary_and_post_primary_education/attendance_and_discipline_in_schools/bullying_in_schools_in_ireland.html

[4] Parenting Positively ~ Helping Teenagers to Cope with Bullying ~

https://www.barnardos.ie/assets/files/publications/free/Teenagers%20and%20Bullying_web.pdf

[5] Oprah and Deepak 21 Day meditation experience ~
https://chopracentermeditation.com (Register and they provide free 21 day meditations every few months).

[6] Dr Dan Siegel ~ The Healthy Mind Platter ~
http://www.drdansiegel.com/resources/healthy_mind_platter/

[7] Back To Basics Guided Meditation: For beginners & returning meditation users ~

by Jason Stephenson ~ https://www.youtube.com/watch?v=IzV6J4WCwRM

[8] Flexibility and Range of Motion, Beginner Yoga With Tara Stiles ~
https://www.youtube.com/watch?v=4PgIfOOHwH8

Other useful Resources

* Dr Chatterjee ~ Episode 11: Good Sleep Habits & Sleep Misconceptions with Dr Guy Meadows ~
https://drchatterjee.com/guymeadows/

* A Pragmatic Guide to the Power of the Now by Eckhart Tolle Animated ~
https://www.youtube.com/watch?v=ykmwCyHlDXM

* Eckhart Tolle’s Top 10 Rules For Success ~ https://www.youtube.com/watch?v=f1Zc7EYXdds

* Thich Nhat Hanh ~
https://plumvillage.org/about/thich-nhat-hanh/

* Thich Nhat Hanh interview with Oprah Winfrey on compassionate listening. Can help with difficult relationships ~ http://www.oprah.com/own-super-soul-sunday/thich-nhat-hanh-on-compassionate-listening-video

* Jon Kabat Zinn Breathscape And Bodyscape guided meditation, mindfulness 20 mins ~
https://www.youtube.com/watch?v=NbXUAg5tA0s

* Full Catastrophe Living (Revised Edition): Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness, Jon Kabat-Zinn, 2013 ~
https://www.amazon.com/Full-Catastrophe-Living-Revised-Illness/dp/0345536932

* 3 Definitions of Mindfulness That Might Surprise You ~
https://www.psychologytoday.com/us/blog/what-matters-most/201711/3-definitions-mindfulness-might-surprise-you

* Anti-bullying Procedures for Primary and Post-Primary schools ~
https://www.education.ie/en/Publications/Policy-Reports/Anti-Bullying-Procedures-for-Primary-and-Post-Primary-Schools.pdf

* Sticks and Stones anti-bullying programme ~
http://www.sticksandstones.ie/anti-bullying-programme/resources/helplines/

* A National Anti-Bullying website ~ http://tacklebullying.ie/

* The Happiness Habit by Brian Colbert ~

www.amazon.com/Happiness-Habit-Choose-Path-Better/dp/0717147762

* List of Wayne Dyer books ~
https://www.drwaynedyer.com/products/

Books for Children

* Relax Kids: Aladdin’s Magic Carpet: And other Fairy Tale Meditations for Princesses and Superheroes by Marneta Viegas, 2004 ~
https://www.amazon.com/Relax-Kids-Meditations-Princesses-Superheroes/dp/1903816661

* LouLouRose – Its Always There – Childrens Meditation ~
https://www.youtube.com/watch?v=qTIsv9CFuNQ

* Louise Shanagher is a children’s therapist that provides creative and wellbeing workshops, mindfulness classes as well as individual therapy sessions. Louise along with talented artist Rose Finnerty produced a series of children’s books

 

Youth mental health

Youth_Mental_Health

“If You Tolerate This Your Children Will Be Next” Manic Street Preachers

Many children and young people are in distress and struggling with their emotional well being. The National Youth Mental Health Taskforce Report 2017 discusses helping young people develop self-worth, self-acceptance, coping mechanisms, active listening, the use of digital technologies and safe spaces in local community.

“People come to parenthood with different capacities, different beliefs and values. Prevention and early intervention has been shown to be more cost-effective when compared to intervention in later life” [1].

Some recommendations in the report include ~

5.1 “The Department of Education and Skills should support teaching professionals in schools and centres for education with the knowledge and skills to understand their role in supporting young people with mental health issues and how to access information about services and supports available to them”.

6.1 “The current provision of counselling and mental health supports in higher level institutions should be maintained and enhanced”

10.1 “A funded strategic national research programme on youth mental health will be developed”

Youth WRAP (Wellness Recovery Action Plan)

Youth WRAP is “Wellness Recovery Action Plan by and for Youth. This WRAP presents a system that helps young people make their lives more the way they want them to be, to choose and enjoy more of the things they want to do, and to get through the hard times that can come with finishing school, finding work, and moving into new situations for home, school and family” [2]

This book Youth WRAP “will help you

  • Do what you want with your life

  • Discover your own simple, safe Wellness Tools

  • Develop a daily plan to help you stay as well as possible

  • Identify upsetting events or circumstances and develop action plans for responding to them

  • Create a strategy to gain support and stay in control of your wellness during and after a crisis” [3]

In this paragraph I summarise some of the information from a set of WRAP slides on WRAP for Adolescents [4]. Adolescents is a time for change and difficult transitions, new responsibilities and experiences and less family supervision and support. Writing a WRAP plan is an opportunity to develop self-awareness. It teachers personal responsibility and self-advocacy, helps build new habits and life strategies and helps the person discover interests and opportunities. At times of transition people can develop mental health challenges. WRAP can help a person deal with these issues and to put a plan in place for when another crisis may develop in the future. WRAP can be used to address an issue like beginning, improving or ending a relationship. Avoiding alcohol may be part of a daily maintenance plan, if alcohol adds to the person’s difficulties. I recommend reading the information in this presentation [4]. There is also a WRAP App [5] and a WRAP App Demo [6].

Some organisations in Ireland provide WRAP training and WRAP facilitator training.

Youth Groups

Foróige “is the leading youth organisation in Ireland and has been working with young people since 1952. Our purpose is to enable young people to involve themselves consciously and actively in their development and in the development of society” [7].

Children Hearing Voices

There are a number of experts in the field of Voice Hearing including Dutch Psychiatrist Dr Marius Romme and his wife Sandra Escher. Also Jacqui Dillon, Rai Waddingham and Eleanor Longden. Jacqui, Rai and Eleanor were victims of serious abuse as children but have worked hard on their healing and are now helping others.

Rai Waddingham runs courses on how to help young people with mental health difficulties [8]. One of the courses she has given in NUI Galway was “Supporting Young People who have Distressing Beliefs & Paranoia” and also courses to help those who hear voices. Jacqui Dillon also runs training course [9].

This is a summary from a presentation in Trinity College at the launch of Irish Hearing Voices Network in 2015.

What helps children who hear voices ?

  • Learn ways of coping with the voices ~ send the voices away, negotiate with them, distract from them … This way a child can feel more in control of the voices

  • It’s about understanding the voices, empowering the child and giving them hope

  • The child needs to learn skills to manage overwhelming emotions such as fear, sadness, hurt, anger and shame

From a multi-disciplinary point of view the child would need extra help in school when it comes to building self-esteem and also to learn relaxation techniques. There are therapeutic ways of dealing with aggression. Within the HSE there are Occupational therapists and Play therapists.

Rights of children

More people die in Ireland from prescribed drugs than illegal ones! Article 33 of The UN Convention on the Rights of the Child refers to protecting children from psychotropic substances [10]. In my opinion children have a right to be protected against chronic use of prescribed psychotropic substances due to the known damage these drugs can cause to the brain and body.

In the Universal Declaration of Human Rights [11], Article 23 states that “Everyone has the right to work … and to protection against unemployment”. Article 26 states “Everyone has the right to education”. It’s impossible to study or learn when on high doses of a cocktail of drugs! Education is usually an important factor when it comes to getting employment.

CAMHS (Child and Adolescent Mental Health Services)

Children are sometimes referred to CAMHS (Child and Adolescent mental health services) where the end up seeing a Psychiatrist. While some may feel they have been helped by CAMHS, here are a few of the tragedies that I’m aware of of young people who have had contact with this service.

Dan Hogan (17) was a “bright, kind and sporty teenager who was passionate about rugby” [12]. He died in July 2014. Shortly before his death he was traumatised by a 26 day involuntary stay in St Joseph’s Adolescent Inpatient Unit in Fairview. “I want things to be back to normal and just be with my family. I can’t do this much more, it’s exhausting, so exhausting. I’m emotionally wrecked, tired. I feel like an elastic band that has been stretched so far” he said.

The Dublin Coroner’s Court heard that he had nightmares about his stay in hospital. “Hospital was torture and traumatising and was physically, emotionally and mentally exhausting, like nothing I have experienced before. I felt alone and that no one close to me understood what I was going through” he wrote in his diary.

CN (16 at the time, now 21)

These are the words of a young girl that was forcibly medicated with a cocktail of powerful psychotropic substances by CAMHS via the High Court (in the same hospital as Dan). “Sitting on my bed suffering in pain alone. All by myself and nobody cares. I feel so much pain it’s unbelievable. I really want to go home but nobody will let me go home. I have given up. I have lost all hope.”

This young girl is being forcibly medicated with anti-psychotic medication against her mother’s wishes in a HSE run adolescent psychiatric unit. The girl’s mother said she had researched these drugs and was very concerned by medical evidence showing side-effects” [13, blog by Leonie Fennell]. “I have the utmost respect for this girl’s mother. She obviously loves her daughter very much and feels very strongly about her ‘care’. She even went as far as getting an expert witness, Dr Bob Johnson, former consultant psychiatrist at Parkhurst Prison, to speak in the High Court. He said he believed the girl was suffering from post- traumatic stress disorder from a childhood incident, which was triggered by bullying and moving to a new school”.

I occasionally meet this young woman, who is now in her early 20s. It is obvious that the drugs have seriously harmed her and the whole experience with CAMHS has left her with life long trauma. She had severe akathisia and cannot sit still for very long. The long term use of these drugs have caused her to become erratic and sometimes violent.

Does the judge, the High Court or CAMHS check how she is now and if their intervention has helped or harmed ? The answer is NO. So they do not learn and therefore this can easily happen to other children / adolescents. For myself who knows what the drugs are like, having taken them as an adult, it was like watching a serious tragedy unfold from 2013. A young girl’s life completely destroyed ! There has to be a better way and there is !

Elisha Gault

Elisha and her family were “sent home to try and cope without direction other than to remove medication from the home and told a follow-up appointment would be made.” It took place two weeks later, when “they determined Elisha was not in need of their services.” [14].

Elisha had already tried to take her own life which means she was in a high risk category. But the system didn’t seem to see it that way. She had allegedly been the victim of sexual abuse in 2012 [15]. A file had been prepared for the DPP but the family got a letter from the Gardai in January 2018 saying the matter would not be pursued! Elisha died in March 2018.

Jake McGill

Jake McGill had been prescribed Prozac six weeks before he took his own life in March 2013. “There is evidence to suggest that antidepressants increase the risk of suicide and suicidal ideation in children and adolescents” [16]. “A proposed amendment to the Coroner’s Bill. The bill, to be known as ‘Jake’s Amendment’, would amend the Coroner’s Act of 1962 to allow for a coroner to return a verdict of iatrogenic (medically-induced) suicide” [17].

“Jake, who was diagnosed with Asperger’s syndrome, was given the antidepressant drug despite research stating that it has no benefit for children with Asperger’s syndrome and despite the emerging evidence of harm. The coroner in Jake’s case rejected a suicide verdict for Jake. This was due to an email that Jake wrote 24 hours before he took his own life, through no fault of his own. He was writing to a friend and he conveyed his concerns about the medication he was taking, and that he was feeling worse because of it. He said he felt drugged out of his mind and was trying to suppress the bad feelings. Based on those words that were brought to the coroner’s attention, the coroner said that this child was not in his right mind and that he would not elaborate on the medication. He asked Jake’s parents what verdict they would like, open or narrative. They chose an open verdict.” [18].

While the amendment wasn’t passed I admire Jake’s parents (with the support of Leonie Fennell and her husband) in trying to bring this change about.

Room for improvement in Child and Adolescent Psychiatry Worldwide !

On July 2, 2011, the Harvard Crimson reported that nationally known child psychiatrists Joseph Biederman, M.D., Timothy Wilens, M.D., and Thomas Spencer, M.D. were found to have violated conflict of interest policies of Harvard Medical School and the Massachusetts General Hospital. They had failed to report all of the income they earned from pharmaceutical companies to Harvard University and Massachusetts General Hospital” [19].

Dr Biederman and others led to a forty fold increase children and adolescents misdiagnosed with bipolar disorder between 1995 (20,000) and 2003 (800,000). In the space of 8 years or so! [19].

Antidepressants carry a black box warning in the US for young people and in my opinion they should not be put on these mind altering drugs. “Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults” [20].

Another drug that I have an issue with is Ritalin which works on the dopamine system of the brain. “Stimulant medications commonly used for ADHD may carry a slight increased risk (1 per 1,000) of triggering some of the same Psychiatric symptoms as those seen in Schizophrenia and mood disorders, even in patients who did not have previous Psychiatric problems. These Psychiatric symptoms include Hearing voices, Paranoia (becoming suspicious for no reason) and Mania” [21]. Considering all that is going on in the pharma world I would question the word “slight”.

Children who are put on Ritalin may show short term improvements but long term, by messing with the natural brain chemistry, they are put at risk of more serious mental health issues. There has to be a better way!

Conclusion

Even though many of us were aware of this tragedy already, last week on a programme called “The Big Picture ~ Young and Troubled” on the Irish RTE channel it became clear that we are failing young people in distress. The National Youth Mental Health Taskforce Report 2017 gives recommendations that need to be acted on. Investigations and reports gathering dust on shelves are of no use if things don’t change.

I have included links to information below on play therapy, childhood bereavement, bullying, hearing voices, self-harm, alcohol, eating disorders, LGBT, gambling and parenting courses. Some of my other blogs cover Bipolar, Psychosis, Open Dialogue, Nutrition and other important areas. Sleep is also an important factor and switching off technology in the evening [22, 23]. The quality of sleep can directly impact how a person feels and functions.

Nutrition is an important part of mental/physical health. We should be eating less sugar and less processed / more natural foods. Food allergies and sensitivities are more common there days. Gut health is very important. See book “Healthy Food, healthy Gut, Happy Child” [24].

For expert information on trauma and Post Traumatic Stress check out the great work of Peter Levine [25, 26] and also Dr Bessel van Der Kolk [27]. I have also included some of their work below.

Three years ago I contacted the Ombudsman for children and asked the relevant Minister to introduce a national policy on parental controls on internet services to help prevent children accessing certain inappropriate material but I didn’t get very far with that ! It is an important issue that is not been addressed.

I think that everyone who deals with children, including parents, should get some training to help them. From birth up and even education before pregnancy e.g. Informed consent about being on antidepressants in pregnancy which I have written about in another blog.

As austerity policies are put in place, it is important that child and adolescent services do not suffer. Unresolved issues from childhood can lead to life long problems which costs society a lot more in the long run. Investment should be made in education, occupational therapy, play therapy, art therapy and psychological services. As well as helping young people develop coping skills. So that they can handle difficult emotions. WRAP (Wellness Recovery Action Plan) may be of use to some and help give structure to their life journey.

There is a short video below about a young teenager in the US called Natalie Gehrki. Prescribing psychotropic substances, including antidepressants, to young people can have tragic consequences. Especially at the level that some doctors and mainstream Psychiatry prescribe cocktails of these mind altering drugs.

“The ethical use of psychotropic drugs is perhaps the single most important aspect of Psychiatric care that requires urgent attention” Dr Philip Thomas (Critical Psychiatrist). We need to wake up. It’s already too late for some of the young people mentioned above. Now is a chance for society and the mental health system to reflect and improve how we support the next generation.

{ Important Do not stop or change prescribed psychoactive drugs without consulting your prescriber, due to the dangers of withdrawal. Any changes need to take place under the supervision of an expert. Some of what I write in my blog is my own opinion. It is not medical advice.
Samaritans provide a listening ear ~ 116123 Also Childline ~ 1800 666666 }

References

[1] National Youth Mental Health Taskforce Report 2017 ~

http://health.gov.ie/wp-content/uploads/2017/12/YMHTF-Final-Report.pdf

[2] Youth WRAP ~
http://mentalhealthrecovery.com/youth-wrap/

[3] Youth WRAP, Mary Ellen Copeland, 2012 ~
https://www.wrapandrecoverybooks.com/store/youth-wrap_moreinfo.html

[4] Wellness Recovery Action Plan for Adolescents (Slides from 2012) ~
http://www.mentalhealthexcellence.org/wp-content/uploads/2013/10/Copeland_ChildrensSummitpresentation_2012.pdf

[5] WRAP App ~ https://www.wrapandrecoverybooks.com/store/the-wrap-app_moreinfo.html

[6] WRAP App Demo ~ https://www.youtube.com/watch?v=0BK_jLMToeM

[7] Foróige Youth Services ~ https://www.foroige.ie/

[8] Rai Waddingham ~ http://www.behindthelabel.co.uk/about/

[9] Jacqui Dillon’s page ~ Training, consultancy and resources on mental health, hearing voices, psychosis, dissociation, trauma, abuse and recovery ~ http://www.jacquidillon.org/

[10] UN Convention on the Rights of the Child ~
https://www.unicef.org.uk/what-we-do/un-convention-child-rights/

[11] The Universal Declaration of Human Rights ~

http://www.un.org/en/universal-declaration-human-rights/index.html

[12] Teen who took own life ‘failed by mental health services’ (in 2014) ~
https://www.irishtimes.com/news/crime-and-law/courts/coroner-s-court/teen-who-took-own-life-failed-by-mental-health-services-1.2583248

[13] An Irish mother’s fight against forced medication (2013) ~
https://leoniesblog.com/2013/04/27/justice-george-birmingham-forced-medication-dr-michelle-harley-zuclopenthixol-lundbeck-maryanne-godboldo/

[14] Mother of drowned teenager ‘appalled’ at local mental health services ~
https://www.irishtimes.com/news/social-affairs/mother-of-drowned-teenager-appalled-at-local-mental-health-services-1.3463130

[15] Mother of tragic Elisha Gault reveals she told family about sexual abuse ~
https://www.independent.ie/irish-news/mother-of-tragic-elisha-gault-reveals-she-told-family-about-sexual-abuse-36821501.html

[16] Irish parents on losing their son to suicide aged 14 ~
https://www.independent.ie/life/health-wellbeing/mental-health/irish-parents-on-losing-their-son-to-suicide-aged-14-after-turning-the-life-support-machine-off-i-threw-the-bottle-of-prozac-against-the-wall-31392882.html

[17] Jake’s Amendment ~ http://antidepaware.co.uk/jakes-amendment/

[18] Coroners (Amendment) Bill 2016: Second Stage ~
https://beta.oireachtas.ie/en/debates/debate/seanad/2017-10-18/10/

[19] Child Bipolar Disorder Imperiled by Conflict of Interest, Stewart L Caplan MD, 2011
www.psychologytoday.com/blog/your-child-does-not-have-bipolar-disorder/201107/child-bipolar-disorder-imperiled-conflict

[20] Suicidality and Antidepressant Drugs ~
https://www.fda.gov/downloads/Drugs/DrugSafety/InformationbyDrugClass/UCM173233.pdf

[21] FDA Warns About ADHD Medication Connection to Psychosis and Cardiovascular Events ~
www.schizophrenia.com/sznews/archives/004802.html

[22] How smartphone light affects your brain and body ~
http://uk.businessinsider.com/blue-light-sleep-affects-body-2016-11

[23] Episode 11: Good Sleep Habits and Sleep Misconceptions with Dr Guy Meadows ~
https://drchatterjee.com/guymeadows/

[24] Healthy Food, Healthy Gut, Happy Child: The Real Dirt on Raising Healthy Kids in a Processed World, Dr Maya Shetreat-Klein, 2012
https://www.amazon.com/Healthy-Food-Gut-Happy-Child/dp/1509816100

[25] Peter Levine’s Secret to Releasing Trauma from the Body ~
https://www.youtube.com/watch?v=s1RnTipiU_Q

[26] Waking the Tiger: Healing Trauma by Peter Levine, 1997 ~
https://www.amazon.com/Waking-Tiger-Healing-Peter-Levine/dp/155643233X

[27] The Body Keeps the Score by Dr Bessel van der Kolk, 2015 ~
https://www.amazon.co.uk/Body-Keeps-Score-Transformation-Trauma/dp/0141978619/


Other useful information and links

* The Big Picture: Youth Mental Health, all this week on RTE (April 2018) ~
http://www.hotpress.com/The-Big-Picture-Youth-Mental-Health-all-this-week-on-RTE/22048411.html

* I share therefore I am: a narrative inquiry of young adults experience of personal disclosure on Facebook ~ Colman Nortor, 2017 ~ www.doras.dcu.ie/21824/

“The findings suggest that online personal self-disclosure may function as an opportunity for users to express their preferred identities and may also be used for processing, managing and expressing difficult emotions and in turn address a users’ psychological need for recognition and validation”

* Dr Michael Corry at 19 mins discusses the lack of training of Psychiatrists in the area of therapy ~ www.theenchantingvalley.ning.com/video/dr-michael-corry

* The Council for Evidence-based Psychiatry ~ http://cepuk.org/

* The Tragic Consequences of Prescription Pills & children/teenagers ~ Natalie Gehrki ~
https://www.youtube.com/watch?v=1haYwZGcSRY

* The Efficacy of Play Therapy With Children: A Meta-Analytic Review of Treatment Outcomes ~

https://pdfs.semanticscholar.org/c74c/5352290babfa53960f1f6e74c2591ef3e88b.pdf

* Parenting courses ~ Stress and mental health toolkit ~ http://www.helpme2parent.ie/Stress-&-Mental-Health-Toolkit.html

* Parenting Positively ~ Helping Teenagers to Cope with Bullying ~

https://www.barnardos.ie/assets/files/publications/free/Teenagers%20and%20Bullying_web.pdf

* Lesbian, Gay, Bisexual and Transgender Service Users ~ Guidance for Staff working in Mental Health services ~ includes lots of resources (pg 10) ~
http://www.mhcirl.ie/File/LGBT_SU_Guide_for_staff.pdf

* BeLonG To LGBT Youth Service (age 14 to 24) ~
http://belongto.org/

* Self-harm distraction techniques ~
https://spunout.ie/health/article/self-harm-and-distraction-techniques 

* Self harm ~ http://www.3ts.ie/need-help/self-harm/

* Self harm guide ~ http://www.selfhelpguides.ntw.nhs.uk/3ts/leaflets/selfhelp/Self%20Harm.pdf

* Good interview with Ruth O’Doherty and Ivor Browne on overcoming self harm ~
https://cdn.radiocms.net/media/001/audio/000016/93403_media_player_audio_file.mp3 

* Alcohol and You ~
http://www.selfhelpguides.ntw.nhs.uk/3ts/leaflets/selfhelp/Alcohol%20and%20You.pdf

* Drugs ~ https://spunout.ie/health/category/drugs

* Controlling anger ~
http://www.selfhelpguides.ntw.nhs.uk/3ts/leaflets/selfhelp/Controlling%20Anger.pdf

* Other self help leaflets ~ http://www.selfhelpguides.ntw.nhs.uk/3ts/

* Eating disorders association of Ireland ~ https://www.bodywhys.ie/

* Irish childhood bereavement network ~ http://www.childhoodbereavement.ie/

* The voices in my head, Eleanor Longden TED talk, 2013
https://www.ted.com/talks/eleanor_longden_the_voices_in_my_head

“Eleanor Longden was just like every other student, heading to college full of promise and without a care in the world. That was until the voices in her head started talking … turning her life into a living nightmare. Diagnosed with schizophrenia, hospitalized, drugged, Longden was discarded by a system that didn’t know how to help her. Longden tells the moving tale of her years-long journey back to mental health, and makes the case that it was through learning to listen to her voices that she was able to survive”

* Sandra Escher: Children and Young People who Hear Voices Part 2 ~
https://www.youtube.com/watch?v=9QJhY9ns0Uw

* Children Hearing Voices, Sandra Escher, 2010 ~
https://www.amazon.com/Children-Hearing-Voices-Sandra-Escher/dp/1906254354

* Launch of the Hearing Voices Network in Ireland (2015) ~
http://www.iimhn.ie/launch-of-a-hearing-voices-network-in-ireland/

* A WRAP workbook for kids ~
https://www.wrapandrecoverybooks.com/store/wrapkids.html

{ an easy to read workbook style book that guides kids aged 7-14 through creating their own Wellness Recovery Action Plan }

* Young People’s mental health ~ https://www.jigsaw.ie/

* One Good Adult (Jigsaw YMH) ~ https://vimeo.com/97326672

* Mental Health Ireland ~ teens ~ http://www.mentalhealthireland.ie/teens/

* Spun Out ~ Ireland’s youth information website ~ https://spunout.ie/health/category/mental-health

* Irish Society for Prevention of Cruelty to Children ~ https://www.ispcc.ie/

* The objective of this site is to promote awareness of the dangers of antidepressants ~ www.antidepaware.co.uk

* Caring for patients with suicidal behaviour: An exploratory study ~
https://www.researchgate.net/publication/5821268_Caring_for_patients_with_suicidal_behaviour_An_exploratory_study

* We’ve become too complacent about the mental wellbeing of others’ – priest’s warning after high number of suicides in town ~
https://www.independent.ie/irish-news/news/weve-become-too-complacent-about-the-mental-wellbeing-of-others-priests-warning-after-high-number-of-suicides-in-town-36830689.html


* Your Child Does Not Have Bipolar Disorder: How Bad Science and Good Public Relations Created the Diagnosis, Stewart L. Caplan MD, 2011 ~
https://www.amazon.com/Your-Child-Does-Bipolar-Disorder/dp/0313381348

* Guide for stopping anti-depressants (under supervision of medical professional) ~

https://rxisk.org/guide-stopping-antidepressants/

* Coming Off Psychiatric Medication ~ www.comingoff.com (information for Prescribers)

* Psychiatric Drug Withdrawal A Guide for Prescribers, Therapists, Patients and their Families by Dr Peter Breggin, 2012 ~

www.breggin.com/index.php?option=com_content&task=view&id=296

* Padraig Bannon ~ My Problem with Gambling ~
www.youtube.com/watch?time_continue=136&v=q3FVpazHGus 

* “If You Tolerate This Your Children Will Be Next” Manic Street Preachers
https://www.youtube.com/watch?v=cX8szNPgrEs


Nutrition and mental health

wordcloud_Nutrition(2)

“Most behaviour change requires a certain amount of skill and desire by itself is simply not enough” Brian Colbert

“My first recommendation to someone with Manic Depression would be a full consultation with a nutritionalist” … who will “give you a personally tailored nutritional strategy to help relieve your symptoms” Patrick Holford [1].

“If mood changes are not owing to any drug intake (caffeine, alcohol or cocaine), the possibility of food allergy or hypoglycaemia (low blood sugar) should be carefully investigated. If your blood sugar levels are in serious imbalance, severe mood swings can result”. He also discusses the condition pyroluria which is linked to depleted B6 and zinc.

“A hyperactive thyroid can induce mania, while an underactive thyroid can trigger depression, so thyroid function is well worth investigating”. Lack of light and SAD (Seasonal Affective Disorder) can lead to Depression. A light box might be a good investment. Under the guidance of a nutrition therapist he mentions the use of of amino acid tryptophan. If a person is on medication they would need to watch out for any contraindications when it comes to taking supplements at the same time.

Eating oily fish or taking fish oils can have benefits for the brain, heart, skin and immune system. There are 2 types of Omega-3 fats. DHA and EPA. EPA can help with Depression. Flaxseed oil is a vegetarian alternative [1].


High homocysteine levels in the blood can increase the likelihood of suffering from Depression.
“Several important, mood associated vitamins and minerals (folate, vitamins B12 and B6, and zinc) are responsible for the conversion of homocysteine to the non-harmful cysteine”… “
By embracing the concept of biochemical individuality, that every patient is different. That their genetic, biochemical and nutritional status impacts how a person feels, and how, in turn, they are treated, we are able to make well informed decisions about how to help” James Greenblatt MD [2].

“Both cytokines and inflammation have been shown to rocket during depressive episodes, and in people with Bipolar, to drop off in periods of remission”….”A diet rich in trans fats and sugar has been shown to promote inflammation, while a healthy one full of fruit, veg and oily fish helps keep it at bay. Obesity is another risk factor, probably because body fat, particularly around the belly, stores large quantities of cytokines” … “stress, particularly the kind that follows social rejection or loneliness, also causes inflammation, and it starts to look as if depression is a kind of allergy to modern life – which might explain its spiraling prevalence all over the world as we increasingly eat, sloth and isolate ourselves into a state of chronic inflammation” [3]. Curcumin which is a component of turmeric has anti-inflammatory properties and also Omega-3.

Allergies can cause mental and physical health symptoms. An allergic reaction can lead to inflammation in the body.

“Several studies have also found an association between the receipt of antibiotics and an increased incidence of psychiatric disorders, perhaps due to alterations in the microbiome” [4]. “While animal models focus on the bacterial composition of the intestinal tract, studies to date in individuals with psychiatric disorders also point to the possible role of viruses and fungi”.

Alcohol

Sometimes people with mental health difficulties may have resorted to unhelpful coping mechanisms in dealing with their problems eg drinking too much. Dual Diagnosis is a term used to refer to cases where a person has both a mental health issue and addiction issues. This usually leads to a worsening of symptoms. Alcohol can fuel Manic Depressive symptoms. It can make the highs higher or the lows lower.

The person may need assistance in dealing with such a problem and needs to want to stop or want to change their habit. There is help out there for people who want to make such changes so that they can have a better quality, more productive life e.g. Alcoholics Anonymous meetings [5]. You don’t need to be an alcoholic to attend such services. There is also a good Allen Carr book on how to control alcohol [6].

My own journey
I found writing this blog helpful as there is so much information out there we can get lost. This has helped me pull that information together. It will inspire me as I move forward. I am currently taking a magnesium supplement as I suffer with insomnia [7]. I know that I have a problem with inflammation in my body and I’m working on it. I noticed after my last antibiotic that my mood went a bit ‘high’. I took a course of probiotics, which doctors should recommend.

Sleep is a big part of healing and recovery and I need to make it a priority. I need to stay self-aware of anything that can impact the quality of my sleep. I found this interview between sleep expert Dr Guy Meadows and Dr Rangan Chatterjee helpful [8]. I’m also taking Krill oil and have changed to a more vegetarian based diet, while reducing dairy. Mental / physical health requires daily work and dedication. But the idea of becoming healthier, more balanced, with more energy to get through the day is a good motivator.

References

[1] 500 Health and Nutrition Questions Answered by Patrick Holford, 2004 ~
https://www.amazon.co.uk/500-Health-Nutrition-Questions-Answered/dp/0749924934

[2] Can a Simple Blood Test Solve Depression? Testing for Homocysteine Can Help in Depression Treatment by James Greenblatt MD
https://www.psychologytoday.com/us/blog/the-breakthrough-depression-solution/201110/can-simple-blood-test-solve-depression

[3] Is depression a kind of allergic reaction? A growing number of scientists are suggesting that Depression is a result of inflammation caused by the body’s immune system ~

https://www.theguardian.com/lifeandstyle/2015/jan/04/depression-allergic-reaction-inflammation-immune-system

[4] The microbiome, immunity, and schizophrenia and bipolar ~

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5503102/

[5] Alcoholics Anonymous ~
http://www.alcoholicsanonymous.ie/

[6] Allen Carr’s Easyway to Control Alcohol, 2009 ~
https://www.amazon.com/Allen-Carrs-Easyway-Control-Alcohol/dp/1848374658

[7] Magnesium – How it affects your sleep ~
https://www.thesleepdoctor.com/2017/11/20/magnesium-effects-sleep/

[8] Episode 11: Good Sleep Habits and Sleep Misconceptions with Dr Guy Meadows ~
https://drchatterjee.com/guymeadows/

Other useful information

* The Breakthrough Depression Solution: A Personalized 9-Step Method for Beating the Physical Causes of Your Depression, James Greenblatt MD, 2011
https://www.amazon.com/Breakthrough-Depression-Solution-Personalized-Physical/dp/1934716553

* New research suggests gut microbiome plays a role in Bipolar ~

http://www.psypost.org/2017/05/new-research-suggests-gut-microbiome-plays-role-bipolar-disorder-48953

* Action plan for Bipolar ~
http://www.foodforthebrain.org/nutrition-solutions/bipolar-disorder/action-plan-for-bipolar-disorder.aspx (magnesium is discussed)

* Think Twice: How the Gut’s “Second Brain” Influences Mood and Well-Being ~

www.scientificamerican.com/article/gut-second-brain/


*
Omega-3 fatty acid supplementation in patients with recurrent self-harm. Hallahan et al 2007 ~
http://bjp.rcpsych.org/content/190/2/118

* The Feel Good Factor: 10 Proven Ways to Feel Happy and Motivated

by Patrick Holford, 2010

www.amazon.com/Feel-Good-Factor-Proven-Motivated/dp/0749953160

* Antibiotic exposure and the risk for depression, anxiety, or psychosis: a nested case-control study

https://www.ncbi.nlm.nih.gov/pubmed/26580313
(Recurrent antibiotic exposure shown to increase risk of anxiety & Depression)

 

 

Anti-depressants and Pregnancy

Baby_in_womb

“The risks and potential harm to normal fetal development”

The public need to be made aware of the risks of taking antidepressants during pregnancy. It is not about fear mongering but instead about informed consent. Some women may decide to stay on these drugs if already on them. Others may decide to withdraw from the drug but need to do that slowly under the supervision of an expert.

There is a free course on anti-depressants in Pregnancy available online presented by Dr Adam Urato [1]. The aim of the course is to give women correct information about anti-depressants. As over 10% of the population are on anti-depressants (in places like the UK, US and Ireland) all women of childbearing age should be educated about these drugs and have informed consent about any risks. Dr Urato points out that at least 50% of pregnancy are unplanned so women need to know the risks up front, as opposed to during the pregnancy.

While these drugs are promoted by some as safe during pregnancy one of the key messages that Dr Urato tries to get across is that “chemicals have consequences”, especially during pregnancy. The course discusses the many changes a woman goes through during pregnancy, both physical and emotionally. This can make pregnancy a more difficult time to withdraw and come off these drugs. The rest of this section contains some summarised information from this very good course. The course contains many references and links to studies.

The emphasis of the biomedical model is on the “chemical imbalance” theory of Depression which has never been proven [2]. It is not clear if low serotonin is linked to Depression. Serotonin comes from tryptophan which is an amino acid. There are many natural sources of tryptophan e.g. Cottage cheese, sunflower and sesame seeds, hummus, oats, chocolate etc

A babies developing brain is fed by the placenta, which makes serotonin in early development. SSRI antidepressants (Selective Serotonin Re-uptake Inhibitors) are a foreign chemical that disrupts the serotonin system. These drugs also affect and are toxic to male sperm. They cross the placenta from mother to baby. “Animal research provides reason to worry that SSRIs taken during pregnancy may cause abnormal brain development in humans”. The drugs can cause miscarriage, preeclampsia, preterm birth, heart problems, increase risk of brain malformation, smaller foetal head size and pulmonary hypertension [3]. Some studies showed increased rates of autism [4].

When a baby is born it can even have higher serum levels of the drug than the mother! Some babies have newborn behavioural syndrome. This may be a result of direct toxicity. When the serum levels of the drug falls they can also have withdrawal symptoms.

Dr Urato deconstructs the “conventional wisdom” where some compare the use of antidepressants to insulin. Complications increase when the mother is exposed to SSRI drugs whereas complications increase for the mother when they are a diabetic and not on insulin. So comparing the two drugs is not such a good idea.

Dr Urato tells us that the public get fooled by industry paid Scientists who cast doubt on the human data. At the same time the FDA have a black box warning due to increased risk of suicide for some age groups. Dr Urato mentions the work of Irving Kirsch who found the difference between using SSRIs and a placebo to be small [5]. Because the widespread use of these chemicals is causing problems, non-chemical approaches to Depression should be prioritised. “You can’t get something for nothing when it comes to chemical exposure”. Society is organised to get out commerical messages instead of warnings. There are lots of conflicts of interest out there and links between professional societies and the drug industry.

We are the first society to encourage chemical consumption during pregnancy. Dr Urato finishes on the following note “If society can’t protect its pregnant women and babies really who can it protect ?”.

In the section Other relevant links there is a Panorama documentary The Truth About Pills and Pregnancy, researched and presented by Shelley Jofre, which I highly recommend.

Post-natal Depression (PND)

After childbirth progesterone and other hormone levels drop, the woman has been through the shock and/or elation of childbirth and sleep may be lacking as the person adapts to having a new baby to look after. Some women get post-natal depression which can last for weeks or months. Various interralated factors contribute to PND including stress, sleep deprivation, hormonal changes, change of lifestyle and social status.

GPs sometimes prescribe anti-depressants which I fail to see as any kind of solution, not forgetting that some women breastfeed and that would expose the newborn to SSRIs. And if the woman gets pregnant again on these drugs there are risks to the developing foetus.

Support groups can help where a person gets to meet other mothers who may be able to emphasise with them. There are also more natural approaches to fighting PND/Depression [6].

{ Important Do not stop or change prescribed psychoactive drugs without consulting your prescriber, due to the dangers of withdrawal. Any changes need to take place under the supervision of an expert. Some of what I write in my blog is my own opinion. It is not medical advice. But I have done quite a bit or reading and research, including going through the course I refer to and use information from in the blog. The aim is informed consent, something I didn’t get when I started the SSRI Citalopram. I wasn’t aware of all the risks as an adult and I was unaware of the risks if I had become pregnant while on them.

Samaritans provide a listening ear ~ 116123 }

 

References

[1] Antidepressants & Pregnancy ~ The risks & potential harm to normal fetal development ~
Free Course ~ https://education.madinamerica.com/p/antidepressants-pregnancy

[2] Depression Delusion: The Myth of the Brain Chemical Imbalance by Dr Terry Lynch, 2015 ~
http://doctorterrylynch.com/depression-delusion/

[3] Prenatal exposure to antidepressants and persistent pulmonary hypertension of the newborn: systematic review and meta-analysis ~ www.bmj.com/content/348/bmj.f6932

[4] Exposure to selective serotonin reuptake inhibitors during pregnancy and risk of autism spectrum disorder in children: a systematic review and meta-analysis of observational studies

https://www.ncbi.nlm.nih.gov/pubmed/25498856

[5] Antidepressants and the Placebo Effect: The Emperor’s New Drugs by Irving Kirsch ~ www.youtube.com/watch?v=LQ_EixhrFaw

[6] Natural Remedies to treat Post Natal Depression / Depression ~
http://holisticsaffron.com/5-natural-remedies-to-prevent-and-treat-postnatal-depression/

Other relevant links

* Antidepressants and Pregnancy: Who Says They Are Safe? by Dr Urato (2014)

 https://www.madinamerica.com/2014/12/antidepressants-pregnancy-says-safe/

* Antidepressant Birth Defects Warnings and Alerts ~
https://www.baumhedlundlaw.com/prescription-drugs/antidepressant-birth-defects/warnings-and-alerts/
“The FDA uses a pregnancy category system to classify potential risk to a fetus when medication is taken during pregnancy. The FDA has declared the majority of SSRI antidepressants, a pregnancy “Category C” drug. This pregnancy category means that animal reproduction studies have shown an adverse effect on the fetus … “

* The effects of maternal depression and maternal selective serotonin reuptake inhibitor exposure on offspring (Pawluski, 2013) ~ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3659337/

* Panorama – The Truth About Pills And Pregnancy (15 mins in) ~

www.youtube.com/watch?v=BMAEJ1exKPU (researcher Shelley Jofre)

* Birth Defect Glossary ~ https://www.baumhedlundlaw.com/prescription-drugs/antidepressant-birth-defects/glossary/

* Citalopram (Celexa) Birth Defects ~ https://www.baumhedlundlaw.com/prescription-drugs/antidepressant-birth-defects/celexa-information/

* Open verdict at inquest into death of Anna Byrne ~
https://www.independent.ie/irish-news/courts/open-verdict-at-inquest-into-death-of-anna-byrne-28903356.html

* Taking antidepressants in pregnancy may raise risk of an autistic child, study suggests ~
https://www.telegraph.co.uk/science/2017/07/19/taking-antidepressants-pregnancy-may-raise-risk-autistic-child/
* Women of childbearing age ‘should not be allowed to take antidepressants’ says Prof Louise Howard from King’s College London ~
https://www.telegraph.co.uk/women/womens-life/9631088/Women-of-childbearing-age-should-not-be-allowed-to-take-antidepressants.html


*
Antidepressant use during pregnancy and the risk of major congenital malformations in a cohort of depressed pregnant women: an updated analysis of the Quebec Pregnancy Cohort ~
http://bmjopen.bmj.com/content/7/1/e013372

* Post-Natal Depression and Antidepressants ~ http://antidepaware.co.uk/antidepressants-and-post-natal-depression/

* Medicating Post-Natal Depression ~ http://antidepaware.co.uk/medicating-post-natal-depression/

* Episode 11: Good Sleep Habits and Sleep Misconceptions with Dr Guy Meadows ~
https://drchatterjee.com/guymeadows/

* Worse than the Disease: The Pitfalls of Medical Progress by Diana Dutton et al, 1988 ~
https://www.amazon.com/Worse-than-Disease-Pitfalls-Progress/dp/0521395577

“This book examines four medical innovations that epitomize the pitfalls of progress: DES, a synthetic estrogen prescribed to millions of women to prevent miscarriages, which produced devastating side effects; the artificial heart; the 1976 swine flu immunization program; and genetic engineering”

* Guide for stopping anti-depressants (under supervision of medical professional) ~

https://rxisk.org/guide-stopping-antidepressants/

* Coming Off Psychiatric Medication ~ www.comingoff.com (information for Prescribers)

* Psychiatric Drug Withdrawal A Guide for Prescribers, Therapists, Patients and their Families by Dr Peter Breggin, 2012 ~

www.breggin.com/index.php?option=com_content&task=view&id=296

 

Social stigma and Discrimination

Discrimination_wordcloud2

Monitoring and tackling discrimination is an important issue for Irish society” Frances McGinnity

“Discrimination takes place when one person or a group of persons are treated less favourably than others because of their gender, marital status, family status, age, disability, ‘race’ – skin colour or ethnic group, sexual orientation, religious belief, and/or membership of the Traveller community” [1]

Disability is “an impairment that may be cognitive, developmental, intellectual, mental, physical, sensory, or some combination of these. It substantially affects a person’s life activities” Wikipedia.

About 4 years ago I was sitting in a pub with a friend and the barman sat down close to us and said “You are Bipolar, you are on medication and the whole town knows about it!”. While I was aware of social stigma and discrimination and had experienced it, this was the first blatant “in your face” experience of it that I remember. I let it go at the time as I live in a relatively small town but since then I have been inspired to dedicate a complete blog to the subject (having touched on it in the last blog I wrote Family, Friends and Community).

By the way the barman had a lot of inaccuracies in what he said but it still affected me deeply. The “Bipolar” he mentioned (or Manic Depression to give the condition its correct name) is in fact an adverse reaction to antidepressants I took for anxiety, I am not on prescribed psychoactive drugs (since 2011) and I don’t know the “whole town”.

When researching this area I came across a lot of interesting books and resources. Erving Goffman’s book Stigma “is an illuminating excursion into the situation of persons who are unable to conform to standards that society calls normal. Disqualified from full social acceptance, they are stigmatised individuals. Physically deformed people, ex-mental patients, drug addicts, prostitutes, or those ostracised for other reasons must constantly strive to adjust to their precarious social identities. Their image of themselves must daily confront and be affronted by the image which others reflect back to them” [2]. This often happens in subtle ways.

“New research entitled Who experiences discrimination in Ireland? Evidence from the QNHS Equality Modules published jointly by the ESRI and the Irish Human Rights and Equality Commission (IHREC) examines people’s experiences of discrimination at work, in recruitment and in accessing public services (education, transport, health, other public services) and private services (housing, banks/insurance companies, shops/pubs/restaurants)”.

“Discrimination can be damaging to the individuals who experience it, in terms of their self-esteem, well-being and for their material outcomes, such as their income and access to valued positions and services. There are also costs at a societal level. Discrimination in the labour market may be economically inefficient, as the skills of individuals are not effectively used. Discrimination can also undermine social cohesion. Monitoring and tackling discrimination is therefore an important issue for Irish society.” lead author Frances McGinnity in study for the Economic and Social Research Institute (ESRI) [3].

Approaches to overcoming Social Stigma and Discrimination

One of the key ways of overcoming social stigma and discrimination is Education. But people also need to be more supportive of each other in families, our social circle and communities. I sometimes find empathy is lacking and people can be very judgemental about others. Listening non-judgementally, while keeping certain boundaries, is an important part of supporting people going through emotional distress.

The following three quotes are taken from a report ~ Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change (2016). Chapter 4 ~ Approaches to reducing Stigma [4].

Educational anti-stigma interventions present factual information about the stigmatized condition with the goal of correcting misinformation or contradicting negative attitudes and beliefs. They counter inaccurate stereotypes or myths by replacing them with factual information”.

“In contact-based behavioral health anti-stigma interventions, people with lived experience of mental illness or substance use disorders interact with the public describing their challenges and stories of success”.

Peer support is where “people with lived experience who work as health care team members and foster the provision of nonjudgmental, nondiscriminatory services while openly identifying their own experiences. When integrated into service-provision teams, peers can help others to identify problems and suggest effective coping strategies”. I did very well in an interview for a part-time position as a Peer Support worker but unfortunately don’t have a car so couldn’t take up this position in my local service area.

Protest and Advocacy is another method. “Protest strategies are rooted in advancing civil rights agendas. In the context of this report, protest is formal objection to negative representations of people with mental illness or the nature of these illnesses. Protests are often carried out at the grassroots level by those who have experienced discrimination and by advocates on their behalf”. In a way this blog is a protest!

A review by Dr. Eleanor Longdon and Dr. John Read evaluates the effects of mental health anti-stigma campaigns. They “found that although biomedical explanations of mental illness predominate in current anti-stigma discourse, not only are they ineffective but they also tend to increase stigma. Conversely, evidence indicates that psycho-social explanations of psychosis are effective in reducing stigma and humanizing those who live with the condition” [5].

Referring to the same study “There is a reasonably substantial evidence base supporting the hypothesis that anti-stigma campaigns which frame psychosis as a meaningful response to adversity are effective. They are a more promising approach to ‘humanizing’ people with complex mental health problems than strategies based on models of disease and disability” [6].

Relating this to my own personal experiences of adversity I’ve have a number of traumas over the past number of months, on top of my other diagnoses . A few of them include a cancer diagnosis, major surgery which left me temporarily physically disabled (as it cut through my core muscles), the breakup of a relationship, loss of an uncle that I was close to in early December 2017 and the loss of my friend to the Shannon river in January 2018. He was missing for 37 days and I spent the first 2 weeks searching for him and giving some feedback on the extensive search to family members who lived on the other side of the globe. It has all taken it toll on me and I particularly notice this in the past month. It’s taken a lot of resilience to get through. I sometimes underestimate my own coping ability, even if I have some coping strategies that aren’t perfect !

Employment

Discrimination when it comes to employment is another area of importance. “People seen as ‘mentally ill’ are often avoided, treated harshly and subject to discrimination. For example, although having a job can be very important in people’s recovery, employers are less likely to offer work to someone if they know that they have a psychiatric diagnosis and unemployment rates for people with a ‘psychotic’ diagnosis are very high” [7]. This report by the British Psychological Society has a lot of information on stigma and discrimination, including the effect of racial discrimination on mental health.

As an example of what can happen in employment I came across article on a website called Sprudge. After Sharon “revealed to her employer that she had had, and been successfully treated for, bipolar disorder, she says the cafe owner became very withdrawn and Sharon was later let go via a phone call” [8].

In Ireland there is an organisation called Employability that does help people with disabilities get back into the workforce. It’s an employment support service that provides the person with a job coach.

Being Supportive

This is a world full of social stigma and discrimination. But also some good, supportive people. Social stigma can be a trigger for the person and can seriously impact their recovery. Due to the subtle nature of social stigma I notice people may initially seem nice but then use information you gave them against you. Some of the things we say can be thrown back at us in dis-empowering ways. These days people are asked to talk and share their story around any mental health struggles. But the reality is we need to be careful who we share with. At the same time if someone is in deep distress or about to take their own life they should reach out to others who care or ring a helpline (e.g. The Samaritans 116 123).

I find it a bit frustrating that people seem more comfortable complaining about symptoms of mental health issues than they are at supporting the person in overcoming or managing their condition. For example a person with Manic Depression/Bipolar who seems to be developing hypomanic or manic symptoms may need help in identifying some habits that are not helping them (e.g. over spending or drinking to try to cope with the symptoms). There are certain ways to help or even to phrase feedback to the person that is more effective than others. See my blogs on:

  • Tips on dealing with symptoms of Bipolar and

  • Family, Friends and Community (in section Strategies to enable family and friends to help someone through mania and/or Psychosis).

“From the perspective of people with lived experience of a mental health condition, recovery is an individual process of discovering one’s own strengths, values, meaning and aspiration; a self-determined journey that can take place inside or outside the mental health system, through personal development, through partnership relationships with professionals, through peer support or through community support. It is a process of reconnecting with life that can happen for some with the continuation of symptoms while for others, a reduction in symptoms is important” from a document by Mental Health Reform [9].

As someone that went through the mental health system, found it harmful overall and ran away from it 6 years ago I think there is a misconception that its the responsibility of doctors and this system to fix people. There is a danger when we hand over responsibility to others to “fix” us, instead of doing our best to take personal responsibility for our own healing journey. I learned this the hard way! I’m not recommending running away from the system, as you need supports in place and everyone’s journey is unique. There are parts of the system that I found helpful e.g. Occupational therapy and I had a very good Occupational therapist called Orla.

Seeing as none of us live in a vacuum and we are all very much interconnected, families, communities and society in general can benefit from helping people on their healing journey. People who have lived through difficult symptoms and experiences may need some ongoing support in their community. This would also take some of the pressure off the already stretched mental health service. At the same time this system should be able to provide timely psychological support, especially to children. At the moment it seems to be still very biomedical based, with a focus on drugs and blaming faulty genes!

How Prescribed drugs can have a disabling effect on the brain/body

Prescribed Psychotropic substances can have very damaging effects, especially when used long term. In 2005, a study funded by Eli Lilly, the maker of Zyprexa / Olanzapine, found that chronic / long term exposure to this major tranquilizer causes shrinkage of the brain, “significant reduction in brain volume that affects both gray and white matter” [10]. I first learned this from honest Psychiatrists Dr Peter Breggin and Dr Joanna Moncrieff. I was put on it at what I now consider too high a dosage (10mg) long term in 2008. I did not have informed consent about this powerful but potentially damaging drug!

Antidepressants that I took between 2005 and 2008 for anxiety/panic, led to mania and ‘Psychosis’. Psychosis is usually a temporary loss of touch with so called reality. There is a Yale study from 2001 that highlighted this but I was never informed of this link when I became unwell in 2008 [11]. I also suffer from Tardive Dysphoria where anti-depressant use turned mild/moderate Depression into a chronic and more severe condition [12]. And I have a physical hearing problem in the form of hyperacusis / misophonia. This can be very difficult to live with at times [13].

Conclusion

In the area of mental health there are various ways we can support each other on our life journeys including tolerance and listening non-judgmentally when someone is in distress. To quote from Ivor Browne, now in his 90th year, “the only real, lasting change comes when we help a person to bring about the painful work of change within themselves”. This needs to happen within a supportive environment and community. A community that strives to tackle social stigma and discrimination. As we are all interconnected this will mean a healthier, content and more productive community for those who live in it.

References

[1] Experience of Discrimination in Ireland: Analysis of the QNHS Equality Module ~
http://eprints.maynoothuniversity.ie/2873/1/RKOR_Discrimination.pdf

[2] Stigma: Notes on the Management of Spoiled Identity by Erving Goffman, 1986 ~

https://www.amazon.com/Stigma-Notes-Management-Spoiled-Identity/dp/0671622447

[3] Who experiences discrimination in Ireland?

https://www.esri.ie/news/who-experiences-discrimination-in-ireland/

Who experiences discrimination in Ireland? Evidence from the QNHS Equality Modules ~
https://www.ihrec.ie/app/uploads/2017/11/Who-experiences-discrimination-in-Ireland-Report.pdf

[4] Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change (2016). Chapter 4 ~ Approaches to reducing Stigma ~ https://www.nap.edu/read/23442/chapter/6

Study produced by the National Academies of Sciences Engineering Medicine in Washington DC ~
http://www.national-academies.org/

Patrick Corrigan ~ https://humansciences.iit.edu/faculty/patrick-corrigan

[5] Psychosocial Explanations of Psychosis Reduce Stigma, Study Finds ~

https://www.madinamerica.com/2018/03/psychosocial-explanations-psychosis-reduce-stigma-study-finds/

[6] ‘People with Problems, Not Patients with Illnesses’: Using Psychosocial Frameworks to Reduce the Stigma of Psychosis (Eleanor Longden & John Read, 2017) ~
https://www.ncbi.nlm.nih.gov/pubmed/28857755

[7] Understanding Psychosis and Schizophrenia. A report by the British Psychological Society from 2014. Updated in 2017 ~
https://www1.bps.org.uk/system/files/user-files/Division%20of%20Clinical%20Psychology/public/CAT-1657.pdf

I was at the launch of the original report in London in 2014 where I got to meet clinical Psychologist Dr Lucy Johnstone and had written a review of her book A Straight Talking introduction to Psychiatric Diagnosis shortly before that. I also got to know clinical Psychologists Anne Cooke and Peter Kinderman (now former president of the British Psychological Society). When they came to Ireland to speak in Trinity College in 2015 I was asked to go on The Last Word with Anne Cooke, where I was interviewed by Matt Cooper. Matt did a great job at interviewing us about ‘Psychosis’. A very misunderstood subject, where the public are trained to associate the word with violence and danger, which is usually not part of the experience! See link below for interview and I have a separate blog on ‘Psychosis’.

[8] Mental Health in the Service Industry: Confronting the Stigma ~
http://sprudge.com/health-series-part-iii-118876.html

[9] “Recovery … what you should expect from a good quality mental health service” by Mental Health Reform (2013) ~
https://www.mentalhealthreform.ie/wp-content/uploads/2013/03/MHR-Recovery-paper-final-April-2013.pdf

[10] “The Influence of Chronic Exposure to Antipsychotic Medications on Brain Size before and after Tissue Fixation…” ~ http://www.nature.com/npp/journal/v30/n9/full/1300710a.html

[11] Antidepressant-associated Mania and Psychosis resulting in Psychiatric admissions (2001) ~ www.ncbi.nlm.nih.gov/pubmed/11235925

[12] Tardive Dysphoria: Anti-depressants can turn mild/moderate Depression into a chronic condition
http://www.psychologytoday.com/blog/mad-in-america/201106/now-antidepressant-induced-chronic-depression-has-name-tardive-dysphoria

[13] What is hyperacusis ? http://www.hyperacusis.net/what-is-it/


Other relevant links

* Bar staff should get anti-racism training, says Traveller activist ~
https://www.irishtimes.com/news/social-affairs/bar-staff-should-get-anti-racism-training-says-traveller-activist-1.3330696


* Blind nun wins discrimination case against pub ~
https://www.irishtimes.com/news/blind-nun-wins-discrimination-case-against-pub-1.1185227

* Irish Human Rights and Equality Commission ~ https://www.ihrec.ie/

* Challenging the Public Stigma of Mental Illness: A Meta-Analysis of Outcome Studies ~

https://ps.psychiatryonline.org/doi/pdf/10.1176/appi.ps.201100529


* Pull Yourself Together! A survey on the stigma and discrimination faced by people who experience mental distress ~ by the Mental Health Foundation (2000) ~

https://www.mentalhealth.org.uk/publications/pull-yourself-together-update

* Psychiatry in Context : Experience, Meaning & Communities by Dr Philip Thomas 2015 ~

https://www.pccs-books.co.uk/products/psychiatry-in-context/

My review of this book ~ www.goodreads.com/user/show/46943899-anne

“It’s necessary to engage with people in emotional distress within the social and cultural contexts of the communities they come from. The author explores the impact racism has on the mental health of people in Black and Minority Ethnic communities.”

* “The Secret Life of a Manic Depressive” presented by Stephen Fry ~

www.topdocumentaryfilms.com/stephen-fry-the-secret-life-of-the-manic-depressive/


* Mental Health and the Service Industry: How to Get Help (from US) ~ https://talesofthecocktail.com/wellness/substance-abuse-addiction-insurance


Some of my efforts at tackling social stigma head on (2015)

A rebellion against that “in my face” local discrimination was to actually speak on radio and write an article at a National level the year after.

* One woman’s account of suffering from ‘Psychosis’ (which was an adverse reaction to antidepressants and fuelled by other prescribed psychoactive substances!) ~

www.todayfm.com/One-womans-account-of-sufferinbg-from-psychosis

* More on my experience ~ ‘I was unaware of potential adverse effects to my prescribed antidepressants’

https://www.independent.ie/life/health-wellbeing/mental-health/aines-story-i-was-unaware-of-potential-adverse-effects-to-my-prescribed-antidepressants-31218347.html