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, active listening, the use of digital technologies and safe spaces in local community.

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

Some recommendations in the report include ~

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

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

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

Youth WRAP (Wellness Recovery Action Plan)

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

The book Youth WRAP “will help you:

  • Do what you want with your life

  • Discover your own simple, safe Wellness Tools

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

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

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

In the next paragraph I summarise some of the information from a set of WRAP slides on WRAP for Adolescents [4].

Adolescents is a time for change and difficult transitions, new responsibilities and experiences, 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 asists 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 therapists and Play therapists.

Rights of children

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

In the Universal Declaration of Human Rights [11], Article 23 states that “Everyone has the right to work … and to protection against unemployment”. Article 26 states “Everyone has the right to education”. It’s impossible to study or learn when on high doses of a cocktail of drugs! Education is 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” [12]. He died in July 2014. Shortly before his death he was traumatised by a 26 day involuntary stay in St Joseph’s Adolescent Inpatient Unit in Fairview. “I want things to be back to normal and just be with my family. I can’t do this much more, it’s exhausting … 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 21)

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

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

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

Does the judge, the High Court or CAMHS check how she is now and if their intervention has helped or harmed ? The answer is NO. So they do not learn and therefore this can easily happen to other children / adolescents. 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.” [14].

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

Jake McGill

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

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

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

Room for improvement in Child and Adolescent Psychiatry Worldwide !

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

Dr Biederman and others led to a 40 fold increase children and adolescents misdiagnosed with bipolar disorder between 1995 (20,000) and 2003 (800,000). In the space of 8 years or so! [19].

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

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

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

Conclusion

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

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

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

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

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

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

There is a short video below about a young teenager in the US called Natalie Gehrki [28]. Prescribing psychotropic substances, including antidepressants, to young people can have tragic consequences. Especially at the level that some doctors and mainstream Psychiatry prescribe cocktails of these mind altering drugs.

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

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

References

[1] National Youth Mental Health Taskforce Report 2017 ~

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

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

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

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

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

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

[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] 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

[11] The Universal Declaration of Human Rights ~

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Other useful information and links

* 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/

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

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

* The Council for Evidence-based Psychiatry. Also see Support & Withdrawal Advisers sections for links to help with drug withdrawal ~ http://cepuk.org/

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

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

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

* Parenting Positively ~ Helping Teenagers to Cope with Bullying ~

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

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An Open Dialogue around ‘Psychosis’

“The deepest hunger of the human heart is to be understood” Stephen Covey

Psychosis_hand

Cabiria, 1914 (from a silent movie by Giovanni Pastroni). Trying to capture how terrifying Psychosis sometimes feels like, which is difficult and the clip that goes with this photo reminded me of the experience.

In November 2014 I went to the launch of the lengthy report “Understanding Psychosis and Schizophrenia” by the British Psychological Society (BPS) in London. There I got to meet and hear from some of the top experts and clinical Psychologists in the UK. A revised version was published in 2017 [1].

‘Psychosis’ is a loss of touch with reality, which is usually temporary. Because the general population don’t understand it, they can overreact. The person themselves may feel quite confused & scared. Especially if it’s their 1st experience. It can involve unusual perceptions e.g. the person feels they are under attack from evil and the need to protect themselves. In my experience, how I protected myself was influenced by religious upbringing. I even started to go to Latin mass to try and calm my brain down. While some would have frowned upon that at the time, for me it was a coping mechanism. I only occasionally go to a church these days. Usually to light a candle and to sit in silence for a while.

As an example of one of my “psychotic breaks”, in my last experience I decided that the town I live in, which is prone to flooding as it is built on a river, was going to become immersed in water. I checked into a hotel that was a few stories high & took a bus to a ‘safer’, inland county. At the time I was frightened. It wasn’t based on reality but could have been based on news reports and worries about climate change. Stress and lack of sleep would have been a trigger, plus the fact that I was still going through drug withdrawal. It took at least two years to get the main effects of long term use of prescribed psychotropic drugs out of my system and I was left with long term sleep issues, the effects of which I still feel to this day.

Psychosis can be triggered by anti-depressant use and severe lack of sleep / stress [2]. I had been on anti-depressants for anxiety / panic attacks for 3 years when I had a ‘psychotic break’ in August 2008. Other illicit drugs can also trigger psychosis e.g. skunk cannabis [3].

Trying to make sense of the symptoms can help. In the context of the person’s life. As through making sense of experiences or learning to process them, a person is more likely to recover.

Usually the people around you will not understand and might not be supportive. I went through my last ‘psychotic break’ alone (2012). I would not recommend that but maybe getting through it alone is why I no longer fear it. There was also a Spiritual aspect to the experience and I wish I kept notes at the time to give me more insight into what I was going through. In my terrified state, particularly at night time, with no support around me, I used the online work of Sean Blackwell to help me through. “Bipolar or Waking up?” [4, 5, 6]. I do believe this was more of an awakening and a spiritual journey. A part of my own evolution as a soul on this planet.

A significant percentage of people hear voices and for many this is not a problem. If the person hears voices that are distressing or ask them to harm themselves or others and the person finds this overwhelming, they would need help and support in coping with the voices. There are people who have managed to integrate their voices into their lives, without been affected negatively by them e.g. Eleanor Longden [7] , Jacqui Dillon [8] and Rai Waddingham [9]. Dutch Psychiatrist Dr Marius Romme has also done a lot of great work in the Hearing Voices Movement [10]. Some children also hear voices and may need support.

Others experience hallucinations. If the hallucinations affect a persons quality of life, including ability to work, sleep and relate with others, the person may need help in dealing with their experiences.

Open Dialogue

I’m a believer in the Open Dialogue approach, where the person should be involved as much as feasibly possible in decision making about their care or treatment plan [11, 12].

Open Dialogue includes the gathering of clinicians, family members, friends and other relevant persons for a joint discussion. It was started in Lapland by Jaakko Seikkula et al. It is also used in other countries eg the Parachute project in New York [13]. In West Cork a successful pilot project was implemented [14, 15]. It would be great to see widespread use of this approach. If a more traditional, backward approach is used it can lead to more dysfunction within a family and the fracturing of relationships, sometimes long term, in my experience. It is important to get the approach right at the start. Not everyone will want family involved in their care.

I write more about the trauma of what happened me in 2008 in the blog Anti-depressants are great, until you have an Adverse Drug Reaction, where I outline some of the things that would have helped at that crucial time. Because of the way people in ‘psychosis’ are treated, I ended up with Post Traumatic stress for the past decade, which is only starting to ease recently. It has improved via therapy and hard work on my self, but it is something that will probably always be there are a protective force in my life. A necessary hyper vigilance and a lack of trust in others!

I have learned as much as I can about what is helpful when a person is in distress. I’ve dedicated several years to learning via reading, listening to audio/visual presentations (of experts I respect), courses, conferences and various short training sessions. A summary version of what happened to me can be found under Other Relevant Resources at the end of this blog.

During my first ‘psychotic break’ (where I had not harmed myself or others) I needed:

  • truth and honesty about the anti-depressant drug I was on & its adverse effects (2)

  • An Open Dialogue approach

  • Re-assurance that my stay in the hospital was temporary ( the survival part of my brain was convinced I would be there for a very long time, possibly forever. This left me in a very distressed and agitated state and naturally so)

In places like Finland, where they employ the Open Dialogue approach and where prescribed psychoactive drugs are not the main form of treatment, they have proven that recovery is possible. They use early intervention and involve the person in decision making. In general, instead of the person ending up on disability, they go back to being productive members of society.

Below is now 89 yr old Prof Ivor Browne giving a talk in the National College of Ireland in 2015. As opposed to being “anti-drug”, Prof Ivor Browne believes in using the lowest dosage of tranquilizing drugs possible for as short a time as possible. Ivor explained that people need help in understanding the psychotic process. He also recognises the importance of therapeutic relationships, personal friendships and loving relationships, when it comes to healing from trauma and distress. What are referred to as “Anti-psychotics” e.g. Olanzapine, as mainly major tranquilizers.

Anti_psychotics

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’. Soteria is a network of people in the UK promoting the development of drug-free and minimum medication therapeutic environments for people experiencing ‘psychosis’ or extreme states [16]. If a person is a carer for someone in emotional distress e.g. a family member, the long term goal should be to enable the person they are caring for.

The public have learned to associate the word ‘psychosis’ with violence and there is not necessarily a link, unless drugs or alcohol are involved [17, 18]. That can include prescribed psychotropic substances or withdrawal from these drugs [19].

People in distress need hope that they can recover and heal. Education from reliable, unbiased sources is an important part of that healing journey. As are supportive and understanding people who can hold space for the person in distress. These support networks also need education around Psychosis, what is helpful and what is not. Being judgemental, getting into arguments with the person, being critical and dismissive of their experience is usually unhelpful. Trying to stay calm and creating a calm space for the person, where they are not over stimulated, might be helpful. Everyone is an individual and has their own unique journey and experience.

Note: This blog is not medical advice and is mainly based on my own experience. But also on my extensive interest and learning in the whole area. Do not stop or change prescribed psychotropic drugs without advice, due to the dangers of withdrawal. Any changes need to be made slowly, under the supervision of an expert in this field. At the start of my journey I was never given that advice from the ‘experts’ I was dealing with and this delayed my healing journey.

Minor and major tranquilizers did help me at times e.g. with sleep, which can help restore some normality. But overall, in hindsight, I found that the large cocktail of drugs I was on (over a 3 year period) fueled symptoms, as opposed to ‘curing’ them. “The ethical use of psychotropic drugs is perhaps the single most important aspect of Psychiatric care that requires urgent attention” Dr Phil Thomas [20, 21].

References

[1] Understanding Psychosis and Schizophrenia, revised version 2017 ~

https://www.bps.org.uk/system/files/user-files/Division%20of%20Clinical%20Psychology/public/CAT-1657.pdf (Edited by Anne Cooke)

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

[3] Smoking skunk cannabis triples risk of serious psychotic episode, says research, 2015 ~

https://www.theguardian.com/society/2015/feb/16/skunk-cannabis-triples-risk-psychotic-episodes-study

[4] Am I Bipolar or Waking Up? Sean Blackwell, 2011 ~

http://www.amazon.com/Am-I-Bipolar-Waking-Up/dp/1461178258

[5] Sean Blackwell’s work ~ www.youtube.com/user/bipolarorwakingup

[6] Corrina Rachel speaking to Sean Blackwell about Bipolar ~

www.youtube.com/watch?v=WLIeS6idzD4

[7] TED video by Eleanor Longden (Voice Hearing) ~

www.ted.com/talks/eleanor_longden_the_voices_in_my_head?language=en

[8] Jacqui Dillon (Voice Hearing) ~

www.rte.ie/radio1/doconone/radio-documentary-sounds-mad-hearing-voices-psychology.html

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

[10] Hearing Voices Network ~ www.hearing-voices.org

[11] OPEN DIALOGUE: an alternative Finnish approach to healing psychosis (by Daniel Mackler) ~

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

[12] A collection of resources on Open Dialogue and Open Dialogue practices ~

http://willhall.net/opendialogue/

[13] New York ‘Parachute’ programme for people with acute mental distress lands in the UK ~

https://www.theguardian.com/society/2015/oct/20/parachute-therapy-psychosis-new-york-uk

[14] Mental health pilot focus of Finnish film ‘Open Dialogue’ ~

http://www.irishexaminer.com/ireland/mental-health-pilot-focus-of-finnish-film-open-dialogue-393492.html

[15] A fresh approach to mental health ~
http://www.irishexaminer.com/lifestyle/features/a-fresh-approach-to-mental-health-396031.html

[16] Soteria ~ www.soterianetwork.org.uk

[17] ‘Mental disorders’ are neither necessary nor sufficient causes of violence ~ 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1525086/

[18] Dispelling the Myth of Violence and Mental Illness ~

https://psychcentral.com/archives/violence.htm

[19] Prescription Drugs Associated with Reports of Violence Towards Others

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0015337

[20] Psychiatry in Context : Experience, Meaning & Communities by Dr Philip Thomas

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

Dr Philip Thomas highlights the limitations of neuroscience in explaining Psychosis or distress. He also explores how Racism plays a key role in many black people’s experience of Psychosis.

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

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

Other relevant Resources

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

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

* One woman’s account of suffering from Psychosis ~

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

* Course ~ Caring for People with Psychosis and Schizophrenia (pharma funded which influences the advice given) ~

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

* Intervoice (International Hearing Voices Projects) ~ www.intervoiceonline.org

* Hearing Voices Network Ireland ~
http://hearingvoicesnetworkireland.ie/

* The Icarus Project ~ http://theicarusproject.net/

* CRAZYWISE – Official Extended Trailer ~ https://www.youtube.com/watch?v=iKfQd0bk214 

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

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

* 8 Tips to Help Stop Ruminating ~
www.psychcentral.com/blog/archives/2014/02/16/8-tips-to-help-stop-ruminating