Survival

“We all experience periods of stress, sadness, and self-doubt. These don’t make us mentally ill, they define us as human” ~ Dr Howard Forman

To try to capture the idea of comparing a mental health issue like Manic Depression to a physical health issue, I feel this blog is helpful: “A mental health diagnoses is a label that is based on a consensus about clusters of experiences rather than laboratory tests … Difficult life experiences can mean a person can become extremely distressed. Blaming the brain creates a situation where people’s life stories are not heard, and the need for social justice is ignored” Flo Ballamy [1].

Anxiety / Panic Attacks

Back in 2004 I was experiencing severe anxiety / panic attacks. Some of these symptoms were rooted in childhood trauma. Diet can also be a factor. You have to be careful with caffeine, alcohol, sugar etc Hormones and iron levels may have played a part, as well as what was going on in my life at the time. I once ended up in an ambulance and in A&E due to the severity of the symptoms. When I got there no one explained what was going on. I got no advice and it happened again. I was prescribed the antidepressant Citalopram to help with these severe symptoms. Initially the drug did seem to help but long term I’m left with more serious symptoms.

While I still suffer from anxiety, especially if tired, I rarely get dreadful panic attacks. I went for therapy at the time and it helped a bit. I was taught to accept panic attacks, instead of fighting them. Correct breathing is important and having the correct Oxygen/Carbon Dioxide levels in the blood. There is an article by Dr Aine Tubridy & Dr Michael Corry entitled What’s Happening? Am I Dying?  [2]. Both doctors are now deceased which is a great loss to this country.

Depression

“Emotions like anger, depression, and anxiety can undermine our success, but the answer is not in repressing emotions. Emotions need to move, and settle into calmer patterns so that they can reliably support our success with insight, energy, and joy” Deepak Chopra

In an interview with Tommy Tiernan on RTE Michael Harding talked about Depression. His view is that Depression is normal and not an illness. An amazing opportunity for growth. “You are letting go of a whole cluster of narratives … you have woven them around you for years …. and in Depression, something breaks them. They can’t sustain themselves and they start to fall off you. You are letting go of yourself in some sense, the self you have constructed”. It feels horrible, like a death but is also a growth point. Michael Harding is a writer and columnist for the Irish Times. It was great that someone can verbalise what I experience at times. Other people’s experience may be a bit different.

If we search to see exactly what’s going on in our lives we usually find the cause of low mood and then we can try to work towards a solution. Not getting enough daylight can affect mood and leave a person with SAD (Seasonal Affective Disorder). In cold weather sitting beside a toasty, wood burner lifts my mood. I feel grateful for it.

“The deadliest thing that we can do when it comes to depression and anxiety is to ignore the deep underlying reasons why they are rising and continue to refuse to deal with them. It’s a terrible betrayal of the most vulnerable people” Johann Hari.

Loneliness and Mental Health

Johann Hari has written a very good book called Lost Connections [3, 4 includes interview]. “Far from being a defect, Hari argues that depression is actually a rational and self-preservatory response to the fragmentation of community life in the contemporary world” [5]. He writes that Loneliness hovers over our culture today like a thick smog. “Meaningful contact is something we are innately designed to crave … but our socio-economic system is predicated on individualism”.

In Ireland a Loneliness taskforce has been set up with the help of people like Senator Dr Keith Swanick. This is an extract from their report “Lonely people suffer disproportionately with mental health issues, cognitive decline, hypertension, and are more likely to be admitted for residential or nursing care … Loneliness is the public health crisis of this generation. The Loneliness Taskforce is seeking to increase awareness of the loneliness epidemic which exists across Ireland. We want to be the catalyst which sparks a nationwide conversation and encourages those who may be lonely to take the first step. We want to inspire the spirit of volunteerism, to connect communities and to equip people with awareness and knowledge of what loneliness is and how to deal with it. We want those among us who are experiencing loneliness to be enabled to seek help, and for that help to be readily available” [6].

The taskforce “recommended pilot projects be set up in rural and urban areas to combat loneliness. It said modules on loneliness should be developed for schools, and local and national organisations should be encourage to promote inclusion and encourage membership. It also recommended improved broadband connectivity and rural transport links” [7].

As someone that’s been on this planet for nearly half a century I have witnessed the demise of a sense of belonging and community spirit. In the 70s and 80s I grew up on a farm. Neighbours helped each other out. We met at Mass and in the local community hall, as well as visiting each other’s homes. Now I am unlikely to see my neighbours. While one was very good when I went through major surgery last year, they don’t call. Occasionally you get to speak to them. Recently a four year old, who has yet to be conditioned into this way of life, asked me “Do you have a birthday present for me?”. It was her birthday the day before. I gave her a nice children’s book.

Friends occasionally make contact on social media but with their busy lives it can be hard to meet up. In the last decade my family relationships have also declined. I lost my career and find myself with a very limited social circle and with lots of time to myself. Sometimes that can be great as you get time to think, to read, to write or to go for a nice walk. But overall a person can find themselves on the edge of society, not really feeling like they belong anymore. Life needs purpose and meaning. I get meaning from activism, reading, writing and occasionally helping out with children, where my teaching skills come in handy. As well as showing an interest in environmental and mental health issues on a local, national and international level.

Peer Support

“Peer support workers are typically individuals who have had personal lived experience of mental health issues and who now enjoy a good level of recovery. They are generally employed in a professional role to use their expertise and experience to inspire hope and recovery in others who are undergoing similar mental health experiences” [8, 9].

Before a person can support others they need to have dealt with the majority of their own issues and to continue working on themselves.

Carers

If caring for someone who experiences mental health difficulties, the long term goal should be to enable that person and keep them as independent as possible, so that they do not become too reliant on someone else e.g. doing their own laundry, some cooking, housework and having a diary to organise their week. Carers need to look after themselves:

  1. Take time out for you
  2. Learn relaxation strategies
  3. Know your limits – know what you can and cannot do
  4. Ask for help – you don’t have to solve and manage every problem by yourself
  5. Eat and sleep well
  6. Solve one problem at a time
  7. Find a support network
  8. Plan for a relapse

These are Tips from FutureLearn course “Caring for People with Psychosis and Schizophrenia” [10].

Complementary Therapies

In order to reprogram the subconscious mind, you need to relax the body. Release the tension. Let the emotions go. Get to a state of openness and receptivity. Think good things about yourself” Louise Hay

Various complementary therapies can help with our emotional and physical well being, even if sometimes it offers temporary relief from distressing thoughts and feelings:

  • Massage
  • Aromatherapy
  • Acupuncture [11]
  • Reiki
  • Emotional Freedom Techniques (EFT) (tapping on specific points to release emotions) [12]
  • Bio-energy
  • Meditation
  • Mindfulness Meditation [13]
  • Yoga
  • Bibliotherapy (the use of books as therapy)
  • Chiropractic care (adjustment of the spine)

“Misalignment of the spine (specifically the first, second or third vertebrae) can cause pressure in the area of the brain steam which can cause interference neurologically and chemically” [14].

For more long term benefits we need a daily plan for our well being e.g. having a WRAP (Wellness Recovery Action Plan) in place can allow a person to create a wellness toolbox [15]. Tools that help you feel better and stay well. I write about WRAP elsewhere.

When I make Yoga, Mindfulness and Meditation part of my daily routine I see more lasting benefits. When doing Yoga I use Youtube videos with Tara Stiles [16]. Sometimes routines get upset by life events so it is important to get back on track as soon as possible afterwards.

Individual Care Plan

Individual care plans are written up for people who have been in a hospital setting. It is “a documented set of goals developed, regularly reviewed and updated by the resident’s multi-disciplinary team, so far as practicable in consultation with each resident. The individual care plan shall specify the treatment and care required which shall be in accordance with best practice, shall identify necessary resources and shall specify appropriate goals for the resident. For a resident who is a child, his or her individual care plan shall include education requirements” [17].

Dr Gabor Maté

“When there is no enemy within, the enemy outside cannot hurt you” African proverb

In the last week of June 2018 a number of trauma and addiction experts were in Belfast at a Trauma Summit. Bessel van der Kolk, Dan Siegel, Gabor Maté and others. Dr Gabor Maté, who has written a number of books [18], also gave a talk in University College Cork.

Soteria / Mosher

Dr. Loren Mosher learned how to listen and to attempt to find meaning in the distorted communications of his patients and their families [19]. He refers to Psychiatric care as “authoritarianism, the degradation ceremony, the induction and perpetuation of powerlessness, unnecessary dependency, labelling, and the primacy of institutional needs over those of the persons”.

Under the influence of the work of R D Laing between 1969 and 1971 Dr Mosher designed and implemented the Soteria Research Project. “Soteria is a Greek word meaning salvation or deliverance”. “the Soteria method can be characterized as the 24 hour a day application of interpersonal interventions by a nonprofessional staff, usually without neuroleptic drug treatment, in the context of a small, homelike, quiet, supportive, protective and tolerant social environment”.

Those that took part in the Soteria project were more likely to be living independently and had fewer readmissions. “Roughly two-thirds of newly diagnosed persons with schizophrenia recover with little or no drug treatment in 2 to 12 weeks”.

“In 1984, Ciompi and his co-workers in Berne/Switzerland founded a first European Soteria house which continues to function successfully after more than 30 years. Eventually, the Soteria idea spread out to Germany, Scandinavia and other parts of the world where it was realised under various forms” [20].

For people to have Recovery spaces, they need to be with supportive people who can tolerate, be patient and interact with the person in Psychosis. The idea of having crisis houses is built into the Vision for Change Irish mental health policy document (2006 to 2016) which is currently been upgraded [21]. “A crisis house is used for crisis intervention and for acute respite purposes … A crisis house is not an intensive treatment option but rather a place of refuge, of understanding, and of support for individuals in crisis. The facility is not restrictive and offers each user an opportunity to deal with issues surrounding their lives by accessing appropriate interventions such as counselling, family therapy, psychology, social work or other available holistic options as required… they may offer an alternative to in-patient care for a proportion of those who would otherwise be admitted to hospital”. Sadly the concept of crisis houses has not really been implemented.

What would have eased the sometimes unbearable trauma I experienced over the past decade ?

  • A Soteria type house would have been a great idea
  • An Open Dialogue approach at the time of my initial crisis, where I would have be involved in the decision making around my own care
  • Been told the truth i.e. antidepressants coupled with stress brought on the severity of my symptoms
  • Less reliance on a biomedical / drug approach and short term use of tranquilizers
  • More training for GPs in the field of mental health (as I felt they were out of their depth)
  • Family therapy as there is intergenerational trauma within the family and also damage from Psychiatry in the previous generation. Psychiatric intervention caused damage in relationships. I did not want my family involved in my admission and it has caused the relationships with all involved to break down. Psychiatry have a lot to answer for. They cause severe emotional distress with their current approach!
  • Introduction to WRAP (Wellness Recovery Action Plan) much earlier on
  • Less reliance by myself on self-sabotaging coping mechanisms and more regular work on my underlying traumas
  • Work on relaxation in the morning, especially when I wake early.

Ivor Browne said to me once “Stop trying to save the world and save yourself!”. At the same time we all need some meaning and purpose in our lives. It’s about getting the balance right.

A person should be enabled by the system and helped back to being a productive member of society. While ethical use of some tranquilizers can have a place in healing, it is hard to function if sedated with a cocktail of overused drugs long term. I gained 25 lbs in weight on those drugs but have managed to get back to my original weight after several years. I ran away from the mental health system in January 2012. I don’t recommend leaving the system until you have a good support system in place. The person that helped me most was the Occupational therapist Orla.

Appreciation of my Freedom is something I will work with and never take for granted. Through self-awareness I have the skills to care for myself one day at a time, to take a break if needed, to be more self-disciplined and to reach out in times of crisis. It was and still is a battle for survival. I survived!

References

[1] Time to change for Time to Change? By Flo Bellamy, 2014 ~

http://discursiveoftunbridgewells.blogspot.co.uk/2014/01/flo-bellamy-does-diagnosis-simply.html

[2] What’s happening ? Am I dying ? (work of Dr Aine Tubridy and Dr Michael Corry, RIP)
http://wellbeingfoundation.com/panic-and-anxiety.html

[3] Lost Connections: Uncovering the Real Causes of Depression – And the Unexpected Solutions, Johann Hari, 2018
https://www.amazon.co.uk/Lost-Connections-Uncovering-Depression-Unexpected/dp/163286830X

[4] Johann Hari: Lost Connections (recorded interview) ~
https://www.madinamerica.com/2018/01/johann-hari-lost-connections/

[5] Lost Connections review: Shedding the shame of depression ~
https://www.irishtimes.com/culture/books/lost-connections-review-shedding-the-shame-of-depression-1.3386584

[6] A connected Island ~ An Ireland free from loneliness, a report from the Loneliness Taskforce, 2018 ~
https://lonelinesstaskforce.files.wordpress.com/2018/06/loneliness-taskforce-a-connected-island-an-ireland-free-from-loneliness.pdf

[7] Loneliness Taskforce calls for funding of €3m to combat isolation ~
https://www.irishtimes.com/news/ireland/irish-news/loneliness-taskforce-calls-for-funding-of-3m-to-combat-isolation-1.3530467

[8] Recovery in Practice (Peer Support definition) ~

https://www.hse.ie/eng/services/list/4/mental-health services/advancingrecoveryireland/recovery-in-practice/

[9] Mental health Peer Support ~
https://www.hse.ie/eng/about/our-health-service/making-it-better/mental-health-peer-support.html

[10] Caring for People with Psychosis and Schizophrenia (next course in Sept 2018) ~

https://www.futurelearn.com/courses/caring-psychosis-schizophrenia

{ Sponsored by a drug company hence biomedical view ! But some interesting tips on how to help people who may have ‘paranoia’ etc }

[11] Traditional Chinese Medicine (TCM) as a Basis for Treating Psychiatric Disorders: A Review of Theory with Illustrative Case, Aung et al, 2013

“TCM-based therapies do provide relief for patients who suffer from anxiety, depression, PTSD, sleep disorders, and many other conditions that plague the human mind and spirit”
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3870484/

[12] Emotional Freedom Techniques (EFT) – Gary Craig ~

https://www.youtube.com/watch?v=jp5npsxYhY0

[13] Mindfulness featuring Jon Kabat Zinn ~
https://www.youtube.com/watch?v=zsxE7cv83X0

[14] The Mental Health Benefits Associated with Chiropractic Care ~
http://www.arcadiachiro.com/the-mental-health-benefits-associated-with-chiropractic-care/

[15] Wellness Recovery Action Plan (WRAP) ~
www.mentalhealthrecovery.com

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

[17] Guidance Document on Individual Care Planning: Mental Health Services (Mental Health Commission document, April 2012) ~
https://www.mhcirl.ie/file/GuidanceOn_ICPMHS.pdf

[18 ] Books by Gabor Maté https://drgabormate.com/book/

[19] “Soteria and Other Alternatives to Acute Psychiatric Hospitalization: A Personal and Professional Review” by Dr Loren Mosher ~
http://www.moshersoteria.com/articles/soteria-and-other-alternatives-to-acute-psychiatric-hospitalization/

[20] Soteria Berne: An alternative treatment of acute schizophrenia ~
http://www.ciompi.com/en/soteria.html

[21] Vision for Change ~
https://www.hse.ie/eng/services/publications/mentalhealth/mental-health—a-vision-for-change.pdf

Other Relevant Information

* Loren Mosher M.D. talks about Soteria Project and non-drug treatments for Schizophrenia ~ https://www.youtube.com/watch?v=qnryFXxl7yU

* Feeling negative emotions is not a mental illness, say Psychologists ~
https://www.independent.co.uk/life-style/health-and-families/healthy-living/negative-emotions-mental-illness-depression-health-crisis-pathologising-wellbeing-psychology-a8277251.html

* Yoga Nidra 20 Minute Guided Meditation ~
https://www.youtube.com/watch?v=7H0FKzeuVVs

* Sudarshan Kriya yogic breathing in the treatment of stress, anxiety, and depression, Brown et al, 2005 ~ https://www.ncbi.nlm.nih.gov/pubmed/15750381

* Associations between loneliness and perceived social support and outcomes of mental health problems: a systematic review, Wang et al, 2018 ~
https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-018-1736-5

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Psychoactive 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 (1955). There is a line in it where Jane Wyman goes to the doctor after the breakup 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 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 fuelled my symptoms, caused damage and delayed my healing. While a person may need some tranquilizers if in acute distress or Psychosis, what they really need is someone to listen with empathy non-judgmentally, to try to understand what’s happening 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. After I had an adverse reaction to the drug Citalopram, I was put on Olanzapine 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. 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 brain’s ability to repair some of the damage and injury.

Over a 3 year period I was given Olanzapine, Seroquel/Quetiapine, Lamictal, Lithium, Rivotril and a number of other drugs. When it came to the large cocktail of drugs I was put on, no doctor seemed to care about the weight gain or damage their prescribing habits caused. There are lawsuits in the US relating to the drug Zyprexa / Olanzapine [3]. According to Robert Whitaker in his book Anatomy of an Epidemic twenty people died in the trial for Zyprexa, a scandal in itself.

Withdrawal from prescribed psychoactive substances

It is necessary 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 and 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 with nutrition, exercise, getting enough sleep (if possible), talking therapy and holistic work on health.

Relapse on discontinuation of psychoactive drugs can be a form of drug withdrawal state [4]. In other words a person may experience return of symptoms while coming off the drugs. In the current biomedical system, any relapse will usually be seen as a sign of “illness” as opposed to the process of withdrawal.

In 2011, when I was trying to withdraw from the drugs, I was told by a doctor 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 for sure I wanted to get off these drugs. I was going to show him that I can do this. At the same time, without support from doctors or others, it was a bumpy ride.

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 free of the drugs and Psychosis 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 night sleep and continue to work on that. My circadian clock is also out of sync.

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

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 entitled Resources to help withdraw from prescribed Psychoactive drugs.

Yearly explosion in prescribing of antidepressants

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 antidepressants 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 which is a 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 into 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 Psychosocial 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 (presented by George Hook 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 antidepressants. 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 was 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 during the interview that antidepressants are safe at 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 certain prescription drugs they can end up alive and brain damaged.

In Ireland in 2009 there was the very tragic Shane Clancy case, which involved an overdose of the SSRI antidepressant drug Citalopram. SSRI = Selective Serotonin Reuptake Inhibitor. The tragedy happened 17 days after starting this mind altering drug. Thankfully Shane Clancy’s mother Leonie Fennell and Prof David Healy got to speak on the George Hook show shortly after that. I had complained to the programme and made Leonie aware of it.

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 antidepressants 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.”

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

Placebo

This is from an article by Charlotte Blease [11].  Irving Kirsch is a Harvard Professor.

“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)”. At the same time there are a significant number of us that these drugs are not suited to and can make our symptoms worse.

DSM (Diagnostic and Statistical Manual)

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

DSM stands for Diagnostic and Statistical 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 overdiagnosis and overprescribing 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 used but it is the one that can cost 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.

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” [12]. “The HSE wants pharmaceutical companies to name those in receipt of payments for travel, sponsorship, medical education, grants and other activities” [13].

“Irish doctors share €6.8m payments from pharma companies” [14]. “Details of the payments made by IPHA (Irish Pharmaceutical Healthcare Association) members and some other companies are available in the report on transferofvalue.ie. Subsequent reports will be published on a yearly basis and made publicly available for three years”. In 2016 one high profile doctor and author, that promotes the use of antidepressants and influences public opinion, received a payment of €32,000 from Lundbeck.

It was 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. This is also relevant when doctors / Psychiatrists go to the High Court with their “expert” advice which influences the judge.

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 [15].

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. In my experience 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. There has to be a better system than the current one !

The Power of the Subconscious mind

I have learned a lot about the power of the subconscious mind from a book by Dr Joseph Murphy [16]. “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 subconscious 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 informed by a doctor that I would need to be on the antidepressant 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. I was told I was ill and had a disorder. Bipolar Affective Disorder. BPAD for short in doctors notes.

Luckily, through some miraculous intervention and through the help of people like Ivor Browne I eventually started to realise that it was the drugs that were fuelling 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. Due to the conditioning of society and the lack of support, breaking free from the indoctrination of the flawed biomedical approach was no easy task.

I could still be living the “illness” and “disorder” model of mental health but decided that believing in this on a conscious and subconscious level was unhelpful, harmful and kept me stuck. Even though I have self-sabotaged throughout the years and tried to numb out some of the feelings, I persevered, while dealing with a lot of emotional distress and turmoil created by the whole ordeal.

“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). I am a work in progress, still dealing with the aftermath and stress, but a lot further along the road that I would be if I kept feeding my subconscious the biomedical view of emotional distress.

In my experience mainstream Psychiatry is really a belief system. One that is very lucrative for the pharma industry but not very helpful long term for the person in distress, who wants to heal and live a productive life. Natural balance, harmony, meaning, purpose and Peace of Mind are important to me. I still have days that I struggle and those are the days I need to stay self-aware, rest and mind myself. Mental and physical health requires daily work and the ability to deal with any setbacks. I now feel hopeful of healing most days, whereas when sedated with drugs I felt no real hope at all.

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 “Time to abandon evidence based medicine?”, (2012) ~  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] 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

[13] “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

[14] Irish doctors share €6.8m payments from pharma companies, 2016

https://www.irishtimes.com/news/health/irish-doctors-share-6-8m-payments-from-pharma-companies-1.2705795

[15] 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

[16] 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 Information

* 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/

* 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

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

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

* 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, Peter Gøtzsche, 2013

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

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

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

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

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

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

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

* Will Self ~ Psychiatrists: the drug pushers ~

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

Resources to help withdraw from prescribed Psychoactive drugs

* Many People Taking Antidepressants Discover They Cannot Quit ~
https://www.nytimes.com/2018/04/07/health/antidepressants-withdrawal-prozac-cymbalta.html

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

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

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

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

* An independent drug safety website to help you weigh the benefits of any medication against its potential dangers. www.rxisk.org

* Council for Evidence Based Psychiatry ~ www.cepuk.org

* Council for Evidence-Based Psychiatry Support Page ~ http://cepuk.org/support/

* Recovery stories ~ http://cepuk.org/recovery-stories/

* Withdrawal Advisers ~ http://cepuk.org/withdrawal-advisers/

 

 

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 writes inspection reports. 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.

In 2008 I was locked away after having an adverse reaction to the antidepressant Citalopram which I was prescribed for anxiety / panic attacks three years earlier. Once locked into the Acute Psychiatric Unit, which caused me unimaginable stress and trauma, 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. 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 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. 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. While the job was probably gone at this stage I assumed I would have basic human rights to try and protect it. No one seemed to care about the long term consequences. 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. 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.

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”. I was locked into a building for three weeks, pumped full of a cocktail of damaging and sedating drugs for three years and spent years withdrawing from these drugs with no support or guidance. This had a detrimental effect on my career, my job prospects and every aspect of my life.

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 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), trained as a Life Coach, Massage therapist 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.

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 severely 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, researching and writing this book etc. While dealing with my own recovery and distress. Activism has a role in ensuring 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.

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). See [7, 8].

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, 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.

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 do not have informed consent about drugs, putting their health and lives at risk. For example with the major tranquilizer Olanzapine, people are not informed of all the known risks e.g. diabetes, weight gain and shrinkage of the brain. 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 [9]. It includes anti-depressants at 21 minutes and discusses the pharma industry in general. The longer a drug is on the market the more that is known about it. 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 [10].

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 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 [11].

”…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.

“In Africa, I witnessed how people could recover from the most traumatic experiences with a strong sense of community support. To recover from illness, people need to have a sense of hope, purpose and meaning in their lives and ultimately, this comes more from the culture, economy and relationships they have.” Dr Pat Bracken [12].

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” [13]. 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.

Conclusion

Psychiatry have taken the work voluntary and reinvented it for their own purposes.

”…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…” [11]. The current Minister for Mental Health is Jim Daly (since June 2017). The time has come for real change at an administrative, 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 unnecessarily. 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 [14]. Rest in Peace to Teresa and others who have lost their life.

You can read about the latest Mental Health Commission Report from 2017 [15]. It shows a system in chaos. Those of us who survived this system have a lot to offer when it comes to suggesting and helping bring about change. Currently the Department of Health are reviewing A Vision for Change mental health policy document (2006 to 2016). An Oversight Group have held meetings with the public. We will see how this moves forward but I don’t feel very confident of much progression. I attended one of the public consultations in August 2018 in Brunswick St, Dublin. As someone that has survived the system, I felt more informed and aware that some in the Department of Health. Some seemed unaware of the importance of Occupational therapy, Soteria type crisis houses, Trauma informed care, Open Dialogue and other ways of improving the current system.

References

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

[2] Mental Health Commission 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 ~
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] “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

[8] 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

[9] 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

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

[11] Psychiatry beyond the current paradigm, Dr Pat Bracken et al, 2012  ~
https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/psychiatry-beyond-the-current-paradigm/0EF061925997CA565C223DFE22BC3BEA/core-reader

[12] Fresh take on mental health care, 2012 (article by Sylvia Thompson on work of Dr Bracken) ~
www.irishtimes.com/news/health/fresh-take-on-mental-healthcare-1.540987

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

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

[15] Mental Health Commission Annual Report 2017 ~
https://www.mhcirl.ie/File/2017_AR_Incl_OIMS.pdf

Other relevant information

* 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/

* 2015 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, 2017 ~
https://www.irishtimes.com/opinion/reform-of-mental-health-law-should-put-patient-s-voice-to-the-fore-1.3156755

Factors that can affect emotional health and what can help

20180514_174317.jpg

“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 raises 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 include Yoga, meditation, mindfulness, watch diet / alcohol / caffeine, exercise, learning to breathe properly, time management, 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.

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 experiences and interactions with others is an important part of everyday living. Isolation from others can affect mental health.

If you feel betrayed by others this can affect your future relationships. 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, there is 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
  • 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 … Bullying can occur at any age, in any environment, and can be long or short-term” [3].

Tips on “How can I help my teenager respond to bullying” can be found in a Barnardo’s document on positive parenting [4]. “Showing little reaction or response can be a useful tool”.

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 start of this chapter 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, inspirational authors out there e.g. Wayne Dyer, Louise Hay, Stephen Covey, Joe Dispenza, Deepak Chopra and Sadhguru. Some of these authors/motivational speakers can help a person understand how to live more in the present and 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.” (Wikipedia).

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

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]. It’s also good to get out into green areas and away from traffic.

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.

While some solitude and alone time is important, integration into community life is a goal in recovery, as isolation and withdrawal from society can hinder progress. Goals can be set 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. Stevens 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 workforce.

Social Media

Social media can be a great way to connect to others. You also need to be able to protect yourself from any bullying and step away from communications that you are not comfortable with. Internet safety is important for adults and children [9]. Unless you are self-disciplined about time spent on social media it can take up a lot of time and become an addiction in itself.

“I share therefore I am” takes a look at young adults experience of personal disclosure on Facebook [10]. “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”.

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 health I try to get the day off to a good start with a few Yoga stretches, some meditation and a healthy breakfast and make that a habit.

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 breathe correctly, not to catastrophize 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.

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 (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

[9] Top Ten Internet Safety Tips – Ensuring Online Safety For Your Family ~
https://www.netnanny.com/learn-center/safety-tips/

[10] 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/

Other relevant information

* A Pragmatic Guide to the Power of the Now by Eckhart Tolle ~
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/

* 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

* Where is Happy? by Lou Lou Rose ~ https://www.lilliputpress.ie/product/where-is-happy
* 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 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 2017 National Youth Mental Health Taskforce Report discusses helping young people develop self-worth, self-acceptance, coping mechanisms and active listening. Also the use of digital technologies and safe spaces in local communities.

“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].

The book Youth WRAP may “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 the next paragraph I summarise some of the information from a set of WRAP slides on WRAP for Adolescents [4].

Adolescence is a time for change and difficult transitions, new responsibilities and experiences, as well as less family supervision and support. Writing a WRAP plan is an opportunity to develop self-awareness. It teaches personal responsibility and self-advocacy (being able to stand up for self), helps build new habits and life strategies and assists 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” [7a].

“Comhairle na nÓg are child and youth councils in the 31 local authorities in Ireland. They enable young people to have a say in decisions affecting their lives” [7b].

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 and Play therapists.

Music Therapy

“Music therapy support children with self-regulation and emotional expression through the creative process of music making. This is achieved within the context of an attuned therapeutic relationship with a trained professional” Siobhan Nelligan, Music Therapist.

Organisations involved in Music Therapy include the Irish Association of Creative Art Therapists (IACAT) and the British Association for Music Therapy (BAMT). The Blue Box Creative Learning Centre in Limerick [10] and Every Day Harmony in Belfast [11] provide Music and Creative Arts Therapy services to children in Ireland.

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 [12]. In my opinion children have a right to be protected against chronic use of prescribed psychotropic substances and cocktails of these drugs due to the known damage these drugs can cause to the brain and body.

In the Universal Declaration of Human Rights [13], 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 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 they 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. Young people who have had contact with this service.

Dan Hogan (17) was a “bright, kind and sporty teenager who was passionate about rugby” [14]. 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 … 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.

NC (16 at the time, now 22)

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.”

Blog by Leonie Fennell ~ “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 …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” [15].

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 lifelong trauma. She has 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 High Court or CAMHS check how she is now and if their intervention has helped or harmed? If they do not learn, this can easily happen to other children / adolescents. I know how harmful these overused drugs can be, 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.” [16].

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 [17]. 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” [18]. There was 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” [19].

“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.” [20].

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

Autism and the tragic case of Oliver McGowan

Oliver McGowan died in hospital in the UK in 2016. Quote from Oliver’s mother Paula McGowan “Sadly my son, who had mild disabilities was given anti-pychotics (major tranquilizers) to treat his seizures and agitation even though we told doctors he was allergic to these medications. They caused his brain to swell so badly it was bulging out of his skull”.

To create awareness about what happened to Oliver, a petition has been set up :

“My son Oliver was only 18 when he died in hospital on 11 Nov 2016. I believe his death could have been prevented if his doctors and nurses had received mandatory training. He had autism and a mild learning disability, and they weren’t trained to understand how to make reasonable adjustments for him.” [21].

Room for improvement in Child and Adolescent Psychiatry Worldwide

In 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 … They had failed to report all of the income they earned from pharmaceutical companies to Harvard University and Massachusetts General Hospital” [22].

Dr Biederman and others led to a 40 fold increase in children and adolescents misdiagnosed with Bipolar between 1995 (20,000) and 2003 (800,000). In the space of approximately 8 years [22].

Antidepressants carry a black box warning in US for young people. In my opinion they shouldn’t be put on these mind altering drugs. “Antidepressants increased the risk compared to placebo of suicidal thinking and behaviour (suicidality) in children, adolescents, and young adults” [23].

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 … and Mania” [24]. 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!

Even though many of us were aware of this tragedy already, in April 2018 on RTE, in a programme called The Big Picture, Young and Troubled 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 in Other Relevant Information on Play therapy, childhood bereavement, bullying, hearing voices, self-harm, alcohol, eating disorders, LGBT, gambling and parenting courses.  Sleep is an important factor and switching off technology in the evening [25, 26]. The quality of sleep can directly impact how a person feels and functions.

Nutrition is also an important part of mental/physical health. We should be eating less sugar, less processed and more natural foods. Food allergies and sensitivities are more common these days. Gut health is very important. See Healthy Food, healthy Gut, Happy Child [27].

For expert information on trauma and Post Traumatic Stress check out the great work of Peter Levine [28, 29] and also Dr Bessel van Der Kolk [30].

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 antidepressants in pregnancy, which I have written about in another chapter.

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 lifelong 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.

There is a short video about a young teenager in the US called Natalie Gehrki [31]. 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.

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

[7a] Foróige Youth Services ~ https://www.foroige.ie/
[7b] Comhairle na nÓg ~ https://www.comhairlenanog.ie/who-we-are/

[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] Creative Art Therapy for Children and Young People, Limerick ~ www.bluebox.ie

[11] Everyday Harmony, Music Therapy, Belfast ~ http://www.everydayharmony.org/

[12] UN Convention on the Rights of the Child ~
https://downloads.unicef.org.uk/wp-content/uploads/2010/05/UNCRC_united_nations_convention_on_the_rights_of_the_child.pdf

[13] The Universal Declaration of Human Rights ~

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

[14] 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

[15] 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/

[16] 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

[17] 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

[18] 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

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

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

[21] Petition “Prevent avoidable deaths by making autism/learning disability training mandatory” ~ https://petition.parliament.uk/petitions/221033

[22] 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

[23] Suicidality in Children and Adolescents Being Treated With Antidepressant Medications :
https://www.fda.gov/drugs/drugsafety/postmarketdrugsafetyinformationforpatientsandproviders/ucm161679.htm

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

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

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

[27] 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

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

[29] Healing Trauma – Peter Levine – audio book ~
https://www.youtube.com/watch?v=a9zJjxp-Rgs

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

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

Other relevant information

* Music therapy for children and adolescents with behavioural and emotional problems: a randomised controlled trial ~ https://onlinelibrary.wiley.com/doi/full/10.1111/jcpp.12656

* The Teenage Guide to Stress, Nicola Morgan, 2014 ~
https://www.nicolamorgan.com/product/the-teenage-guide-to-stress/

* The Big Picture : Young and Troubled (April 2018) ~
www.rte.ie/news/player/2018/0426/10873228-the-big-picture-young-and-troubled/

* 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/

* 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

* 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 ~ www.ispcc.ie

* 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

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

* 7 Ways to Help Students Who Struggle with Anxiety ~

www.weareteachers.com/7-ways-to-help-students-who-struggle-with-anxiety/

* An inquest into the death of Thomas Oliver McGowan at Southmead Hospital revealed the medication “most likely” led to brain swelling ~
https://www.bristolpost.co.uk/news/bristol-news/heartbreaking-video-oliver-mcgowan-medication-1468148

* “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

When it comes to Manic Depression, Patrick Holford recommends a full consultation with a nutritionist who can “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”. Under the guidance of a nutrition therapist he mentions the use 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.

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]. Lack of light and SAD (Seasonal Affective Disorder) can lead to Depression. A light box might be a good investment. It is important to get some natural light early in the morning or throughout the day. In Ireland we sometimes don’t get much sunlight in the winter months.

James Greenblatt MD

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].

“Is depression a kind of allergic reaction?”

“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” [3].

Curcumin which is a component of turmeric has anti-inflammatory properties and so has Omega-3. Allergies can cause mental and physical health symptoms. An allergic reaction can lead to inflammation in the body.

Antibiotics

“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 resort to unhelpful coping mechanisms in dealing with their problems e.g. 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 and the lows lower.

The person may need assistance in dealing with such a problem and must want to stop or 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

Sleep is a big part of healing and recovery. I struggle with sleep and my circadian cycle. I need to stay self-aware of what can impact the quality of my sleep. Magnesium can help with insomnia [7]. I found this interview between sleep expert Dr Guy Meadows and Dr Rangan Chatterjee helpful [8]. I also listened to an interview with the sleep doctor Michael Breus PhD and got some valuable tips. His website can be found here [9].

I take Omega-3 and I’m trying to change to a more vegetarian based diet, while reducing dairy. I’ve been learning about the potential health benefits of intermittent fasting which may not be suited to everyone [10]. For me the plan is to have 3 meals a day and not to eat late in the evening. According to microbiologist Kiran Krishnan fasting can increase the number of certain important microbes in the gut. I need to work on my gut microbiome [11] and to take Vitamin D [12, 13]. My energy levels need work and I plan to take CoQ10 [14]. As the menopause approaches that will require some patience and acceptance [15].

Mental / physical health requires daily work, planning 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? by Caroline Williams, 2015 ~

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/

[9] The Sleep Doctor, Dr Michael Breus PhD ~
https://www.thesleepdoctor.com/

[10] Intermittent Fasting: Surprising update, Monique Tello MD, 2018 ~
https://www.health.harvard.edu/blog/intermittent-fasting-surprising-update-2018062914156

[11] The gut microbiome composition associates with bipolar disorder and illness severity, Simon et al, 2017  ~

https://www.sciencedirect.com/science/article/pii/S0022395616307725

[12] Mood disorders and complementary and alternative medicine: a literature review ~ “Low levels of vitamin D have been identified in patients with major depressive and other mood disorders”, Quereshi et al, 2013 ~ www.ncbi.nlm.nih.gov/pmc/articles/PMC3660126/

[13] Vitamin D: a potential role in reducing suicide risk? Tariq et al, 2011 ~

https://www.ncbi.nlm.nih.gov/pubmed/22191178

[14] Role for a water-soluble form of CoQ10 in female subjects affected by fibromyalgia. Di Perro et al, 2017 ~
https://www.ncbi.nlm.nih.gov/pubmed/27974102

[15] Flipping the Script on Menopause: Dr. Christiane Northrup (interviewed by Dr Kelly Brogan)
https://www.youtube.com/watch?v=0xA9Mzd6IDY

Other relevant 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

* 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)

* The Myth of Diagnosis by Dr Mark Hyman MD (Functional medicine doctor) ~
https://drhyman.com/blog/2018/05/04/the-myth-of-diagnosis/

* Is there a better way to treat Depression ? Dr Kelly Brogan speaking to Dr Chatterjee ~
https://www.youtube.com/watch?v=DKifzrD2a38

* The 4 Pillar Plan: How to Relax, Eat, Move and Sleep Your Way to a Longer, Healthier Life by Dr Ranjan Chatterjee, 2017 ~
https://www.amazon.co.uk/Pillar-Plan-Relax-Longer-Healthier/dp/0241303559

 

 

Anti-depressants and Pregnancy

There is a free course on antidepressants in Pregnancy, available online, presented by Dr Adam Urato [1]. The aim of the course is to give women correct information about anti-depressants. This is not 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.

As over 10% of the population are on antidepressants (in places like the UK, US and Ireland) all women of childbearing age should be educated about these drugs. Dr Urato points out that at least 50% of pregnancies are unplanned so women need to know the risks upfront, 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 “low serotonin” theory of Depression has never been proven and is mainly a marketing myth. Serotonin comes from tryptophan which is an amino acid. Dr Urato lists natural sources of tryptophan e.g. Cottage cheese, sunflower and sesame seeds, hummus, oats, chocolate etc

He explains that a baby’s developing brain is fed by the placenta, which makes serotonin in early development. SSRI antidepressants (Selective Serotonin Reuptake Inhibitors) cross the placenta from mother to baby and disrupt the serotonin system. The drugs can cause miscarriage, preeclampsia, preterm birth, heart problems, increase risk of brain malformation, smaller foetal head size and pulmonary hypertension [2]. Some studies showed increased rates of autism [3]. Some babies are born with newborn behavioural syndrome. These drugs also affect male sperm.

Harvard Professor Irving Kirsch found that the difference between using SSRIs and a placebo to be small [4]. Non-chemical approaches to Depression should be prioritised [5].

There is a Panorama documentary which I highly recommend: The Truth About Pills and Pregnancy, researched and presented by Shelley Jofre [6].

Postnatal 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 having a new baby to look after. Some women get postnatal depression which can last for weeks or months. Support groups can help where a person gets to meet other mothers who may be able to empathise with them. There are other approaches to addressing PND/Depression [7].

{ Important Do not stop or change prescribed psychoactive drugs without consulting your prescriber, due to the dangers of withdrawal. This is not medical advice }

References

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

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

[3] 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

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

[5] How Should We Treat Depression in Pregnancy? by Dr Adam Urato, 2018
https://www.madinamerica.com/2018/04/how-treat-depression-pregnancy/

[6] Panorama – The Truth About Pills And Pregnancy (15 mins in) ~

www.youtube.com/watch?v=BMAEJ1exKPU (researcher Shelley Jofre, 2013)

[7] The Postpartum Experience and Women’s Health with Dr. Maggie Ney :

https://drhyman.com/blog/2019/01/03/bb-ep36/

Other relevant information

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

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

* A New Epidemic: Antidepressants During Pregnancy ~
https://davidhealy.org/a-new-epidemic/

* 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 … “

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

* 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/

* 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/

* 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

* 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

“DES, a synthetic estrogen prescribed to millions of women to prevent miscarriages, which produced devastating side effects”

* 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/

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