Irish Mental Health Service

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

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

The Mental Health Commission (MHC)

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

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

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

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

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

Human Rights

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

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

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

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

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

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

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

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

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

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

Informed Consent

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

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

Pat Bracken

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

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

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

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

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

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

Conclusion

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

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

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


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

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

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

References

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

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

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

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

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

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

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

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

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

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

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

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


Other Relevant Resources

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

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

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

http://www.slieile.ie/

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

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


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

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

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


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

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

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

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

Articles on Open Dialogue pilot project in Bantry, West Cork

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

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

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

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

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

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Factors that can affect emotional health and what can help

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

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

Stress

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

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

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

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

Difficulties in relationships

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

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

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

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

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

Rumination

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

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

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

  • Identify the thought or fear

  • Think about the worse case scenario

  • Let go of what you can’t control

  • Look at mistakes as learning opportunities

  • Schedule a worry break

  • Mindfulness

  • Exercise

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

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

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

Bullying

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

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

  • Demonstrate Assertive Behaviour

  • Saying No is Acceptable

  • Encourage your teen to express feelings positively

  • Show courtesy and respect for others

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

  • Encourage your teenager to make new friends

  • Acknowledge when your teenager is doing well

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

  • Listen to your teenager

  • Ask your teenager how you can help.

The document also includes advice on what not to do.

Exercises that can help improve our emotional well being

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

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

Vision Board

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

Having structure in life and managing time

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

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

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

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

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

  • Downtime – Setting aside time to simply to be here

  • Play time – to have fun and enjoy yourself

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

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

Bibliotherapy

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

Meditation

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

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

Mindfulness

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

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

Exercise

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

Social Inclusion

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

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

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

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

Motivation

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

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

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

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

Social media

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

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

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

Conclusion

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

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

References

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

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

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

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

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

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

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

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

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

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

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

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

Other useful Resources

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

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

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

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

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

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

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

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

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

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

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

* The Happiness Habit by Brian Colbert ~

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

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

Books for Children

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

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

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

 

Family, friends and community

Empathy

“If you can’t get rid of the family skeleton, you may as well make it dance” George Bernard Shaw

When it comes to healing from emotional distress, support from others and within the community is vital for successful recovery. Despite all the talk in the media about mental health, sadly people can find themselves without support or understanding. Lack of support can inhibit and delay the healing journey.

Families need accurate information on what can help a person in distress. “In the field of mental health people need to be as informed as possible as some day, without much warning, we can find ourselves, a relative or a friend coming in contact with the current system … Giving someone a Psychiatric diagnosis is an immensely powerful act which has profound implications for their identity, relationships, place in the community, employment, health and future.” ~ clinical Psychologist Lucy Johnstone [1]. Dr Johnstone highlights that the process of recovery has to start with the most accurate description of what is going on for the person. Listening non-judgmentally with empathy is something to aim for, hard as that might be. Find out what is going on in the person’s life. It can sometimes be more convenient to slap on labels and blame genetics than address issues and struggles within the individual and their family or within society itself.

We have been conditioned in the biomedical view, which benefits the pharmaceutical industry but doesn’t necessarily help the person to heal to the best of their potential. It is possible to get people through recovery and back to being a productive member of their community. This could mean paid work but there are also ways a person can voluntarily contribute to their community and this requires some recognition. It is not always possible if the person is on high doses of strong tranquilizers which can affect their ability to get motivated and function e.g. in a work environment. While no one should stop or change prescribed drugs without expert advice, long term exposure to these drugs can cause brain damage which I will write about in other blogs.

Critical Psychiatrist Dr Philip Thomas in his book Psychiatry in Context explains that it can be hard to measure non-specific factors that aid recovery e.g. trusting human relationships [2]. He points out that it is necessary to engage with people in emotional distress within the social and cultural contexts of the communities they come from. It may be possible to find out from communities what helps people in that community regain a sense of well being, so that people can be productive and have purpose and meaning in their lives.

Forces in society that damage family relationships

Dont_cage_me

“Sometimes you got to accept the fact that certain things will never go back to how they used to be”

I recently re-watched the great classic movie One Flew Over the Cuckoo’s Nest and wish I had seen this movie at 18. While it is now over 40 years old and has cult status, there is a lot to be learned from this awesome movie. I do believe that mainstream Psychiatry is a powerful and controlling group that has the potential to cause a lot of damage to family relationships inter-generationally. As my father had an emotional crisis when I was about three years old, a lot of what I was led to believe about “mental illness” for the first few decades of my life is based on fiction and not fact. I had been indoctrinated from an early age into my families and societies way of viewing and dealing with mental health issues.

When I had my own crisis and direct experience a decade ago, instead of using an Open Dialogue approach to engage with me [5], family members were questioned and this information was then used as “collateral”. This made it feel like everyone was working against me instead of with me. The terminology is something I became aware of when I got my notes under Freedom of Information! Reading such notes can be very traumatic and I do not recommend it unless you have a good support person to go through this process with you. I was left with Post Traumatic Stress, feeling fearful, unsafe and hyper vigilant. While the feelings are starting to ease, this has lasted almost a decade so far! When I went through Regression therapy with Ivor Browne, it turns out the Post Traumatic experience I carry is very much intertwined with memories of my father been locked away on several occasions throughout my childhood.

In my experience, starting with how the person can be forced into an “Acute Unit” without use of a mental health advocate or Open Dialogue, I found the overall approach taken by the system to be highly traumatic and damaging. It destroys trust between family members. Sometimes the family is already struggling with past issues, trauma and dysfunction and this adds another layer of damage to the situation. What is needed is family therapy.

If friends/relatives spy and gossip about the person in distress, this is very unhelpful. If the person becomes aware of this, it can lead to a breakdown of trust and relationships. When trust is gone sometimes it’s gone for good! Sadly I am not talking about “paranoia” but evidence based fact. But a certain amount of paranoia can easily become a survival mechanism. While some people have been occasionally good to me financially to help me through the destruction caused e.g. loss of career, on an emotional level I went from feeling I was part of a family to feeling very much alienated and disconnected from them. I am still close to some cousins in my extended family and have started to build back some trust with relatives in the previous generation. People that have been very good to me, especially in my younger days. But as I’ve said the approach of Psychiatry can cause lots of damage.

We are advised to talk about our mental health struggles but in general we also need to be careful when doing so and to protect ourselves e.g. career wise. Some people in our communities are not so understanding about struggles with emotional distress. At the same time there are good people, therapists and organisations out there e.g. Samaritans (116 123). 

R D Laing

Sometimes the dysfunction within families can trigger mental health issues. Scottish Psychiatrist R D Laing did studies on this using game theory (based on the work of mathematician John Nash) [3].

Family members may not be the best people to try to re-engage the person or motivate them. Occupational therapists and other support people should be involved. If I had a family member or friend with mental health issues I would acknowledge any true progress they are making and wouldn’t compare them to others. Everyone’s journey is unique.

Impact of mental health struggles of a parent on their children

“it is essential to try to open up the hidden area and collusion going on within the family” Ivor Browne

When a parent experiences mental health difficulties this also will affect the family unit and children, including the stability of the environment the person grows up in. Family therapy may be needed to help families through difficult times.

If the parent is / was on medication, the sedative nature of the drugs can impact on the parents ability to function and motivate themselves e.g. work, cook meals, get the children out to school or engage with their children. Watching a parent experience depression, mania or ‘psychosis’ can affect the child.

By being aware of inter generational trauma and what can be done to support each generation, it is possible to help families to function better. My goal would be that the next generation in my family will have an accurate picture of what mainstream Psychiatry is about and a more accurate picture of what Manic Depression is and what can trigger it. This would help them of avoid pitfalls of what has become an inter-generational trap. They need to be armed with the correct knowledge that will protect them, so that they do not become a victim of what I see as a damaging system.

As the oldest of four siblings, I grew up in an environment where my father was on up to 14 pills a day and given Electric shock treatment which had a huge impact on him, his relationship with my mother, my childhood and family life. I was unaware of the risks of getting involved with the Psychiatric industry and allowed myself to be referred by my GP for help with severe anxiety / panic. While I’m not discouraging people from getting psychological help when they need it, allowing myself to be referred to a Psychiatrist and into the public system was a big mistake that has cost me dearly on many levels.

Mainstream Psychiatrists are medical doctors that mainly prescribe drugs and get people onto cocktails of drugs. Only a relatively small percentage of them are trained therapists. Despite all their power and control in society e.g. in the courts, they can’t help a person in distress without the correct skill set! When I eventually got to see Prof Ivor Browne, who is a Psychiatrist and trained therapist, while I’m not trying to say he is perfect, the difference between seeing him and the other amateurs was huge. Even when I read back on my notes now from being in the system between mid 2008 and early 2012, the “help” I received was inadequate on many levels. With the exception of the help I received from Orla the Occupational therapist. More investment is needed in Occupational therapy.

In my blog on Genetics I explore the fact that some people can’t process drugs like anti-depressants and there is a genetic aspect to that. I have a 1st cousin that took a similar SSRI to the one I did (Citalopram & Escitalopram respectively). We both ended up with the same diagnosis. So I would recommend that people related to me, particularly on my paternal side, to steer away from these mind altering psychotropic drugs and to find alternative ways of managing their distress.

True_Friends

Strategies to enable family and friends to help someone through mania and/or Psychosis

  • While I don’t agree with all the information in this link some of it may be helpful. How to avoid a manic episode [4].

  • Start with the most accurate description of what may have triggered the Psychosis (loss of touch with so called reality) and anything that may be fueling it e.g. Severe lack of sleep, drugs (prescribed or street), alcohol. Address any of these issues appropriately.

  • An Open Dialogue approach is needed, if possible, which has been known to have very good recovery rates. See separate blog.

  • Address the stigma within families from the start. Not all families are supportive of each other. R D Laing believed that ‘psychosis’ and ‘Schizophrenia’ is incubated within family environments. Sometimes there may be other causes e.g. Drug use, including prescribed psychoactive substances.

  • Minor or major tranquilizers are not a “cure”. Short term they can help a person who is in mania and/or psychosis to relax and get some sleep. Depending on the person and the drug, as each person reacts differently to each drug. For example, I found 5 mg of Olanzapine used short term to be helpful.

  • Relevant courses, including online ones, can provide knowledge but are sometimes funded by or influenced by the pharma world e.g. Free online courses on FutureLearn.

  • Charities like Grow and Shine provide some support

  • Support is also needed for kids whose parents experience mental health difficulties eg play therapy and counseling, to reduce inter generational trauma [6]

  • Work on a sense of Self. Both the person in distress and their supporters can do this. There is a good book called Selfhood with exercises by Dr Terry Lynch [7].

  • Coming off medication should be an option for most people but that requires specialised, expert advice and close monitoring. It would need to be done slowly under the supervision of someone who has the expertise. Usually a GP or other doctor but the question is do they have the most accurate information and knowledge ? [8, 9]

  • If a person hears voices there are organisations out there that can help e.g. Hearing Voices Network and Intervoice [10, 11]

  • When the person is in a good place learn about WRAP (Wellness Recovery Action Plan) and help them develop a WRAP plan [12]. There are some organisations in Ireland that provide training in WRAP e.g. Suicide or Survive.

Social stigma and discrimination

Research by the Mental Health Foundation (Pull Yourself Together report) found that 56% of people suffering from mental distress had experienced discrimination by family and 51% said they had experienced discrimination by friends. Many of the respondents reported that relatives and friends had distanced themselves, sometimes to the extent that people felt ostracised and socially isolated. Many people also reported being on the receiving end of name calling, labelling, and unhelpful instructions such as “Pull yourself together”. [13]

If you don’t feel accepted or feel unwanted, stigmatised or excluded, healing from emotional health issues can be seriously affected. Your sense of belonging within your family of origin can diminish or become non-existent.

Many of us have persevered in the face of discrimination and social stigma. We have witnessed the death of our old self and the “reemergence of a new self out of the ashes of the old” [2]. This can be quite a painful process. You experience a sense of loss. Sometimes it can be hard to let go of what was to embrace the new reality. But this is sometimes a necessary part of the healing process, including stepping away from relationships that increase distress. Either temporarily or more long term. Life is short. Sometimes we really only appreciate people when they have passed away. As someone who lost a close friend recently in tragic circumstances, we need to learn to appreciate people more while they are still around and to be as supportive as possible.

Let_go3

References

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

My review of this book ~
https://www.amazon.co.uk/gp/aw/cr/rRZTSBCCI1MGDN/ref=aw_cr_i_1

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

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

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

[3] R D Laing used work of Nash and Game theory to study human relationships (18 & 25 mins)

www.ruthenians.net/kArpatia/portfolio/the-trap-episode-1-fk-you-buddy/

[4] How to Avoid a Manic Episode ~ www.bpso.org/nomania.htm

[5] A collection of resources on Open Dialogue practices ~ http://willhall.net/opendialogue/

[6] The Efficacy of Play Therapy With Children: A Meta-Analytic Review of Treatment Outcomes

http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.472.68&rep=rep1&type=pdf

[7] SELFHOOD: A Key to the Recovery of Emotional Wellbeing, Mental Health and the Prevention of Mental Health Problems, 2011 ~

www.amazon.com/SELFHOOD-Emotional-Wellbeing-Prevention-Psychology/dp/1908561009

[8] 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

[9] Information on Psychoactive drugs and drug withdrawal ~ www.comingoff.com

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

[11] Intervoice (International Hearing Voices Projects) ~ www.intervoiceonline.org

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

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

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


Other information that may be useful

* The 7 Habits of Highly Effective Families by Stephen Covey ~

www.amazon.com/Habits-Highly-Effective-Families/dp/0307440850

* Soteria ~ 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 ~ www.soterianetwork.org.uk

* “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

* Life After Suicide BBC Documentary 2014 “Documentary. Angela Samata explores why some people take their own lives and how those who love them come to terms with the loss” ~
www.youtube.com/watch?v=HdIxzeA1F2k

* Antidepressant-associated mania and psychosis resulting in psychiatric admissions. Yale study (2001) ~ www.ncbi.nlm.nih.gov/pubmed/11235925

* 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/

* “Understanding Psychosis and Schizophrenia” (revised version) ~
www.bps.org.uk/system/files/user-files/Division%20of%20Clinical%20Psychology/public/CAT-1657.pdf

* The Writings of Ivor Browne: Steps Along the Road, the Evolution of a Slow Learner ~ www.amazon.co.uk/Writings-Ivor-Browne-Evolution-Learner/dp/1855942194

Some of the papers in this book covers family and family therapy
“it is essential to try to open up the hidden area and collusion going on within the family where it is often seen as necessary to hold the patient in his or her sick and painful state as scapegoat and guardian of the secret” pg. 239

Ivor Browne

* Ivor Browne interview with Pat Kenny from 2013 ~ www.rte.ie/radio1/podcast/podcast_patkenny.xml

* Most people labelled as having Depression have suffered grief that hasn’t been resolved ~

https://www.herald.ie/lifestyle/health-beauty/most-people-labelled-as-having-depression-have-suffered-grief-that-hasnt-been-resolved-31216116.html

* Music and Madness, Prof Ivor Browne, 2008 ~

http://www.amazon.co.uk/Ivor-Browne-Music-Madness/dp/0955226120

* Sanity, Madness and the Family by R D Laing ~
https://www.amazon.com/Sanity-Madness-Family-Schizophrenics-psychology/dp/0140134662


Definitions

Family therapy “is a type of psychological counseling (psychotherapy) that helps family members improve communication and resolve conflicts” www.mayoclinic.org

Family systems therapy draws on systems thinking in its view of the family as an emotional unit. When systems thinking—which evaluates the parts of a system in relation to the whole—is applied to families, it suggests behavior is both often informed by and inseparable from the functioning of one’s family of origin”

https://www.goodtherapy.org/learn-about-therapy/types/family-systems-therapy

Pharmacogenetics “is the study of inherited genetic differences in drug metabolic pathways which can affect individual responses to drugs, both in terms of therapeutic effect as well as adverse effects” (Wikipedia)

Play therapy “a form of counseling or psychotherapy in which play is used as a means of helping children express or communicate their feelings”.

For more information see www.playtherapy.ie

Mental health and violence

Despite all the anti-stigma campaigns, when tragedy strikes, through sensational headlines, society is led to believe that “the mentally ill” are some type of sub-class of potentially dangerous people when in reality anyone can develop mental health difficulties.

People with mental health difficulties are generally no more dangerous than the rest of society. Street drugs and/or alcohol can disinhibit the person and increase the risk of violence or the risk of being a victim of violence. For some this also includes prescribed psychoactive substances or withdrawal from these drugs.

While I use this quote I do not use the term “mental disorder” myself. “It’s time that, as a society, we begin to knock down stereotypes and start breaking down the stigma associated with mental disorders. The first stereotype to go down – permanently, we hope – is that people who suffer from depression, anxiety, schizophrenia, an eating disorder, or any other type of mental disorder, are somehow more violent than others. This simply isn’t true, unless they are involved in substance abuse. Use and abuse of substances such as drugs or alcohol is often correlated with an increase in violence anyway (e.g. due to impaired judgment)” [1].

“Mental disorders are neither necessary, nor sufficient causes of violence …It is far more likely that people with a serious mental illness will be the victim of violence” [2].

“Although the drug manufacturers are quick to downplay this connection as anecdotal or coincidental mounting scientific evidence points to a strong correlation between the use of psychiatric drugs in general, and SSRIs in particular, and violent behavior” [3].

Harry Kennedy, head of the Central Mental Hospital, said that since they stopped prescribing benzo / tranquilizer medication in their prison clinics the suicide rates there had fallen [4].

Some people have carried out violent acts and it has been blamed in the media on “paranoid Schizophrenia” but when you look a little closer into it the person may have been abusing drugs and alcohol e.g. a certain high profile case where friend’s of the perpetrator told police “he regularly smoked skunk cannabis, took cocaine and had been known to drink whole bottles of spirits each day” (case involving Nicholas Salvador ~ quote from the Guardian newspaper). That is enough to poison anyone’s brain / body and make some act out of character or carry out unimaginable acts.

Akathisia

If a person does not take prescribed drugs correctly e.g. stops the drugs ‘cold turkey’, this can lead to a drug withdrawal state and even akathisia (a severe inner restlessness) which can sometimes lead to serious problems.

Akathisia has two sides, or faces: outer, objective restlessness and inner, subjective agitation. The outer, visible restlessness caused by akathisia particularly affects the legs and may be mild, moderate, or severe. In mild cases, patients find it difficult to sit or stand comfortably. They may adjust their posture frequently, shifting their weight from one foot to the other while standing, or crossing and uncrossing their legs white sitting. In moderate cases, patients are more visibly jittery and fidgety, tapping their feet on the floor or pacing. In severe cases, patients are visibly agitated, find it difficult to sit still, and are driven to pace back and forth… Akathisia can be extremely dangerous, especially in patients who have not been warned about the side effect and mistake it for a worsening of their psychiatric condition. Akathisia can trigger panic reactions in patients, increase paranoia, and drive patients to suicide and violence.” [5].

I once stopped Olanzapine (an expensive major tranquilizer) cold turkey as I had not been given correct advice or warning by a particular private hospital on the dangers of withdrawal. I ended up in what I now know to be akathisia and would not wish it on anyone! The severe inner restlessness is hard to describe in words. I had pins and needles going down my arms. I thought I was having a “nervous breakdown” but when I met Prof Ivor Browne 3.5 years later he explained that these are the symptoms of drug withdrawal.

It shouldn’t have taken 3.5 years to learn from a man in his eighties this vital, important information! The mental “health” system never informed me that this was the problem which would have helped me a lot. They also never informed me that anti-depressants can cause mania/psychosis ! I ended up back in hospital for 1 whole month and the following year is a blur. A lost year! I had been broken down by what I see as a dysfunctional system. My self-confidence and general mental/physical health was left in tatters by my “care”. I ended up pumped with 9 foolscap pages of damaging drugs. Pharma did well out of my suffering but I was left damaged and struggling! I still feel the damage a decade on. Luckily I did not become violent because of these mind altering drugs but can see how this could happen.

Note: Do not stop or change prescribed psychoactive drugs without advice, due to the dangers of withdrawal. The vast majority of people do not become violent on prescribed psychoactive drugs but a significant number of people do. There is a need for more awareness about this serious problem and what can be done to avoid incidents or tragedies as much as possible.

References

[1] Dispelling the Myth of Violence and Mental Illness ~ www.psychcentral.com/archives/violence.htm

[2] Violence and mental illness: an overview ~ www.ncbi.nlm.nih.gov/pmc/articles/PMC1525086/

[3] Medicated to Death: SSRIs and Mass Killings ~
www.corbettreport.com/medicated-to-death-ssris-and-mass-killings/

[4] Cutting jail benzo use reduces violence ~

www.irishexaminer.com/ireland/cutting-jail-benzo-use-reduces-violence-215716.html

[5] The Antidepressant Solution: A Step-by-Step Guide to Safely Overcoming Antidepressant Withdrawal, Dependence, and “Addiction” by Dr Joseph Glenmullen (2006) ~

https://www.amazon.com/Antidepressant-Solution-Step-Step-Overcoming/dp/074326973X

Other relevant information

Trigger warning some may find a few of the links below distressing or triggering.

* “Prescription Drugs Associated with Reports of Violence Towards Others” ~ Thomas Moore and Dr Joseph Glenmullen (2010) ~

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

* “A lecture by Prof David Healy from the Institute of Psychological Medicine and Clinical

Neurosciences at Cardiff University on the over 100 drugs that can cause violence” (2013)

www.vimeo.com/67245935

* Are prescription drugs to blame for school shootings? Dr. Healy explains how prescription drugs can lead to school shootings ~

www.rxisk.org/rxisk-asks-are-prescription-drugs-to-blame-for-school-shootings/

* Dr. Peter Breggin’s Testimony at Veterans Affairs Committee On

“Antidepressant-Induced Suicide, Violence and Mania: Implications for the Military”:

http://breggin.com/dr-breggin-testifies-before-congressional-committee/

* Suicidality, violence and mania caused by SSRIs: A review and analysis ~

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

* 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) ~ 2011 ~

www.youtube.com/watch?v=R8ReARNiAHI

* Forensic Psychiatist Yolande Lucire ~ Adverse reactions to Psychiatric drugs (2013) ~

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

* Pysch drug link to violent episodes analysed ~ Article that discusses the Shane Clancy case. His mother Leonie Fennell works hard at raising awareness about the dangers of anti-depressants ~
http://www.irishexaminer.com/ireland/pysch-drug-link-to-violent-episodes-analysed-400571.html


* BBC Panorama ~ A Prescription for Murder?
Reporter Shelley Jofre investigates the mass killings at the 2012 midnight premiere of a Batman movie in Aurora, Colorado ~ http://www.dailymotion.com/video/x5v0dgt

* “I killed my 11 year-old son” – BBC Stories ~ David Carmichael ~
https://www.youtube.com/watch?v=dwJ1TJSa7Ao


* David & Kim Crespi – Oprah Full Interview (Note ~ David Crespi is still heavily medicated during this interview, which would affect how he responds to questions. Mainstream media have a tendency to play down the effect of prescribed psychotropic drugs on people’s mental state) ~

https://www.youtube.com/watch?v=7PtmjIOROrE

* Woman fighting for prescription warnings after husband kills twins. Kim Crespi “believed from the second he confessed that her husband committed the crimes in a ‘medication induced psychosis’ brought on by a cocktail of medications he’d recently been prescribed”. This also includes the David Carmichael tragedy ~
http://www.wbtv.com/story/25443655/uncommon-killers-david-crespi-and-david-carmichael

* http://www.crespifamilyhope.org/

* Case where Akathisia came up as factor ~ Man on murder charge pleads guilty to manslaughter ~
https://www.irishexaminer.com/ireland/man-on-murder-charge-pleads-guilty-to-manslaughter-276030.html

* The Pill That Steals Lives, A Family’s Nightmare on Mental Health Street (Katinka Neuman) ~
https://www.youtube.com/watch?v=M1rAAPklkGQ

* The Pill That Steals Lives: One Woman’s Terrifying Journey to Discover the Truth about Antidepressants, Katinka Nueman, 2016 ~

https://www.amazon.com/Pill-That-Steals-Lives-Antidepressants/dp/1786061333

* A blog by Bob Fiddaman, covering the dangers of antidepressant medication, the pharmaceutical industry and medicine regulators ~
https://fiddaman.blogspot.ie/

* This site by Brian, who lost his son to Citalopram, promotes awareness of the dangers of antidepressants ~ http://antidepaware.co.uk/

* Document on how to stop anti-depressants ~

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


* Website about psychiatric medication, how it functions and the withdrawal process ~
http://www.comingoff.com

A Perspective on Suicide

“Some days you will be the light for others and some days you will need some light from them. As long as there is light, there is hope and there is a way” Jennifer Gayle

Caring_for_myself

I am not sure what the solution is to the tragedy of suicide. People need to feel that are loved and belong, including working on loving themselves. They also need to feel their life has meaning and a purpose. Viktor Frankl, a holocaust survivor, writes about this in his book Man’s Search for Meaning [1, 2].

There are nearly always reasons for living, no matter how bad things feel. It is important that we give encouragement to others in our family and community [3]. Over the last number of years I’ve met some people who saw themselves as well meaning, giving all sorts of judgements and “insights” into my life. As well as criticism. Without any empathy or understanding about my life journey. This led to feelings of frustration and discouragement. Listening non-judgmentally would have been a lot more helpful.

For over 3 years I was prescribed the anti-depressant Citalopram to help with anxiety and panic (until August 2008). I now suffer from a condition called Tardive Dysphoria which I strongly believe is connected to taking prescribed psychotropic drugs in the past. Medical journalist Robert Whitaker has written about this [4]. I am a lot more prone to suicidal ideation since these drugs than before taking them. While some people may feel they have benefited from anti-depressants, for others they have caused major problems.

In the US these drugs have a black box warning due to the increased risk of suicide in younger people, especially when starting, stopping or changing the dosage [5]. Anti-depressants are way over-prescribed. They are very powerful, mind altering drugs.

In suicidal mode the idea that all the pain will end might feel good at the time, but whatever emotional pain a person is going through will pass. It is important to reach out to someone, even if they don’t feel like doing that at the time. I once heard a man who has been through suicidal thoughts say that he did not want to pass his pain onto other people. When someone takes their own life it is devastating for those in this person’s circle i.e. family, friends and the community.

There is probably a reason or something causing their distress. Maybe a multitude of things that seem to be going wrong at the same time. It is easy to get overwhelmed and to go into a state of shock/high anxiety when faced with what seem like unsolvable problems e.g. worrying about a mortgage.

If people feel suicidal they shouldn’t be afraid to discuss how they feel with someone they can trust, a helpline, the Samaritans (116 123) or a private therapist. If a person has a problem, there is nearly always a solution. Sometimes the advice of others is necessary, as the person may feel they are in a fog and cannot think clearly or see any solutions.

As a society and community we need to be more supportive of each other. People may need to look at lifestyle e.g. alcohol, nutrition, stress and the various aspects of their life. If doctors were to take a more Psycho-social approach, as opposed to a biomedical approach, I do believe we may see some progress. Or maybe those in distress need an alternative to going to the busy GP surgery that is dealing with such a wide range of medical problems.

A number of years ago, in a documentary that covered suicide, I heard a doctor say that if someone takes an overdose of medication, they can end up alive and brain damaged. Probably worse off that before the overdose. Knowing this may deter a person from taking an overdose. While not being judgemental of a person in a very distressed state, drowning in the sea, lakes, canals or rivers is also a bad idea. A person can end up missing for weeks, causing even more distress to their family, friends and those that care about the person in their community. Not forgetting the huge level of dedication, effort and time that can go into searching for the the body, sometimes in very cold, risky, dangerous and difficult conditions. From listening to a friend who volunteers with sub aqua search and rescue/recovery, the body can end up in a bad state.


ASIST (Applied Suicide Intervention Skills Training)

One of the things that has helped me in dealing with suicidal thoughts, while also giving me the skills to be able to help others, is ASIST. Applied Suicide Intervention Skills Training is a

“two-day interactive workshop in suicide first-aid. It is suitable for all kinds of caregivers … people responding to family, friends and co-workers. ASIST trains participants to reduce the immediate risk of suicide and increase the support for a person at risk. It helps them seek a shared understanding of reasons for suicide and reasons for living.

The workshop provides opportunities to learn what a person at risk may need from others in order to keep safe and get more help. It encourages honest, open and direct talk about suicide as part of preparing people to provide suicide first aid. Participants also consider how personal attitudes and experiences might affect their helping role with a person at risk” [6, 7].

Suicides Rise Dramatically with Increasing Psychiatric Care

While some people may have had a positive experience with the mental health system, I feel that it wasn’t a suitable place for me. I was never told at the time that my symptoms could be caused by anti-depressants. An ambulance and police arrived at my house with my family and I was locked away for 3 weeks. I had not harmed myself of others and had no intention to do so. I do feel that Psychiatric intervention harmed me as opposed to helped. The only aspect that did help was Occupational therapy and the therapist Orla who got me into a course with the National Learning Network and into a work placement, one year on from my nightmare with the system.

Danish studies has been done on the link between Psychiatric care and suicide. Extract from this article [8] ~ As the amount of involvement that people have with Psychiatric professionals and Psychiatric care increases, the likelihood that they will commit suicide rises steadily and dramatically, according to a study in Social Psychiatry and Psychiatric Epidemiology. Taking Psychiatric medications makes people nearly 6 times more likely to kill themselves, while having spent time in the previous year in a Psychiatric hospital makes them over 44 times more likely to kill themselves … an accompanying editorial suggested the findings more likely showed that “Psychiatric care might, at least in part, cause suicide.”

I am hoping that coroners will keep an accurate record of what prescribed medication that the person may have been on at the time they died. Whether they had recently started to take Psychoactive medication e.g. anti-depressants or stopped taking such medication. It appears that sometimes this information can be overlooked. As many deaths are not recorded as suicide, we do not have an accurate picture of the number of people in this country that take their own lives every year.

Be_kind_to_yourself

Wellness Recovery Action Plan (WRAP)

A few years ago I got to do WRAP training with the charity Suicide or Survive. This training combined with ASIST has helped build up my resilience which I need to face into each new day and week. Having a WRAP plan in place can help a person who is experiencing emotional distress to stay well and to move forward. The 5 key concepts in WRAP are: Hope, Personal Responsibility, Education, Self-advocacy (standing up for yourself) and Support [9, 10].

A WRAP plan has sections on Triggers, a Wellness Toolbox, Daily Maintenance Plan, Early Warning Signs, When things are Breaking down, Crisis Plan and Post Crisis Planning.

WRAP can help the person identify triggers (events and/or reactions to people that can make their symptoms worse) and also to list activities that can help the person feel better. It may also be important for the person to write a crisis plan, so that if the person finds themselves in a crisis it has been outlined what their wishes are.

It is vital to establish who is there to support a person in their recovery and to build on this if necessary e.g. family, friends, connecting to others in recovery or by attending meetings with mental health support groups (e.g. Grow).

WRAP can even be used to help write an advance directive, where the person can specify such things as acceptable and unacceptable treatments. Including prescribed psychoactive drugs that have worked in the past and ones that don’t and whether or not a person sees Electric shock treatment (ECT) as an option for them.

Reasons to Stay Alive

I’ve just re-read Matt Haig’s very good book “Reasons to Stay Alive” [11]. In severe Depression a person may feel there is no hope or future. Matt highlights how it can feel like you are inside a tunnel that is blocked at both ends. “You are walking around with your head on fire and no one can see the flames”. When he went through a major crisis he didn’t want to be dead. He just didn’t want to be alive.

Drinking and smoking too much can be a big factor. As can diet and not getting enough sleep. Matt suffered from Anxiety, Panic attacks and Depression and compared that to being in a swamp with whirlpools in it. He writes “Minds have their own weather systems. You are in a hurricane. Hurricanes run out of energy eventually. Hold on”.

He compares his symptoms of emotional distress to back pain “It doesn’t really help me, when the pain flares up, that millions of other people suffer from back problems”. He lists some of his “Weapons for the war” ~ writing, reading, talking, traveling, yoga, meditation and running. Some of the things that help him with panic include yoga, slower breathing, meditation, acceptance (“Don’t fight things, feel them”), live in the present and Love.

One person tweeted this message to him about suicide “The hole you’d leave is bigger than the pain you suffer by being”.

“The key is in accepting your thoughts, all of them, even the bad ones. Accept thoughts but don’t become them”. Writing about things your enjoy can help. And refer back to that when you don’t feel so good.

Conclusion

There are no easy answers to suicide. But I do feel, based on the number of suicides I’ve heard of recently, our approach doesn’t seem to be working. I think it is time that we get some honesty from those with the power to influence public opinion. Instead of drug pushing, we need to hear that the “chemical imbalance” theory was an elaborate marketing campaign that sadly is not based on fact or Science. Some celebrity doctors, in their rush to push the drugs, forget about the significant number of people that these drugs are not suited to. Some of us don’t metabolize the drugs very well ( I have discussed this in the blog on Genetics). A pill is not going to mend a broken relationship or bring back a job that is lost. Or help with the bereavement process. There is no pill that cures life. At most it is a temporary sticking plaster but not a long term solution.

And if someone does decide to go down the biomedical route, they deserve full informed consent about these drugs. Something myself and many others didn’t get. People in distress also need crisis houses to go to, as an alternative to Acute Psychiatric units. An example of this in the UK is The Maytree [12]. Such crisis housing is part of the policy document Vision for Change which is now over 10 years old [13]. We need a new plan and a new vision.

At the moment there seems to be a lot of emphasis on celebrity culture and hearing the stories of celebrities. While that can provide short term inspiration, in a crisis the person in distress needs to have their own set of tools and resilience to battle through a rough patch. There is also a danger when mental health is over talked in the media. Family and communities may feel that the issues are been dealt with and may not realise someone in their own circle is in distress and needs support.

Relationship_with_self

References

[1] Man’s Search for Meaning ~ Viktor Frankl
https://www.amazon.com/Mans-Search-Meaning-Viktor-Frankl-ebook/dp/B009U9S6FI

[2] Man’s Search for Meaning ~ Meaning as a Cure for Depression and other ills ~
https://www.psychologytoday.com/blog/hide-and-seek/201205/mans-search-meaning

[3] Viktor Frankl ~ Why Believe in Others ~
https://www.ted.com/talks/viktor_frankl_youth_in_search_of_meaning

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

[5] Antidepressant Use in Children, Adolescents, and Adults ~

https://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/UCM096273

[6] ASIST leaflet (Applied Suicide Intervention Skills Training) ~
http://www.hse.ie/eng/services/list/4/Mental_Health_Services/NOSP/Training/ASISTleaflet.pdf

[7] Information on ASIST training ~ http://www.yourmentalhealth.ie/get-involved/news-events/

[8] Suicides Rise Dramatically with Increasing Psychiatric Care ~
https://www.madinamerica.com/2014/09/suicides-rise-increasing-psychiatric-involvement/

[9] WRAP (Wellness Recovery Action Plan) ~ http://mentalhealthrecovery.com/

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

[11] Reasons to Stay Alive ~ Matt Haig

http://www.matthaig.com/reasons-to-stay-alive/

[12] Suicide sanctuary ~
www.maytree.org.uk/

[13] Vision for Change ~
http://www.hse.ie/eng/services/publications/Mentalhealth/Mental_Health_-_A_Vision_for_Change.pdf

Other links that may be useful

* Psychopharmacologist & Psychiatrist Prof David Healy “Time to abandon evidence based medicine?” At 6 minutes he discusses the hiding of negative data from anti-depressant clinical trials ~
http://www.youtube.com/watch?v=A3YB59EKMKw

* Promoting awareness of the dangers of anti-depressants ~
http://antidepaware.co.uk/

* The dangers of giving anti-depressants to children. Jake McGill (14) ~
https://www.independent.ie/irish-news/courts/mother-of-boy-14-who-died-of-selfinflicted-gunshot-wound-welcomes-open-verdict-inquest-34115868.html

* Community Action on Suicide Prevention Education and Research (CASPER) ~
Maria Bradshaw, mother of Toran Henry (Maria now lives in New Zealand) ~
https://www.independent.ie/regionals/wicklowpeople/lifestyle/maria-leads-suicide-fight-30596376.html

* Pysch drug link to violent episodes analysed ~ Article that discusses the Shane Clancy case. His mother Leonie Fennell works hard at raising awareness about the dangers of anti-depressants ~
http://www.irishexaminer.com/ireland/pysch-drug-link-to-violent-episodes-analysed-400571.html

* Cutting jail benzo use reduces violence ~

www.irishexaminer.com/ireland/cutting-jail-benzo-use-reduces-violence-215716.html

Harry Kennedy, head of the Central Mental Hospital, said that since they stopped prescribing the medication in their prison clinics, the suicide rates there had fallen.

* Denmark ~ “Antidepressant regulations tightened following suicide”:

www.cphpost.dk/news/antidepressant-regulations-tightened-following-suicide.8243.html

* Kerry coroner makes emotional plea over suicides ~
www.irishtimes.com/news/crime-and-law/kerry-coroner-makes-emotional-plea-over-suicides-1.1365157

* ‘Suicide remains a taboo subject, something few people are prepared to talk about’

www.youtube.com/watch?v=US-oM-wBBxI

* Life After Suicide BBC Documentary 2014 “Documentary. Angela Samata explores why some people take their own lives and how those who love them come to terms with the loss”.
www.youtube.com/watch?v=HdIxzeA1F2k

* For prescribers ~ Guide to Stopping anti-depressants ~
http://www.rxisk.org/guide-stopping-antidepressants/

* Website about psychiatric medication, how it functions and the withdrawal process ~
http://www.comingoff.com

When suicide comes in clusters ~ What can we do to prevent copycat suicides ?
www.psychologytoday.com/blog/media-spotlight/201208/when-suicides-come-in-clusters

* Alcohol and suicide, Kendall, 1983 ~
www.ncbi.nlm.nih.gov/pubmed/6648755

* Smoking and Suicide: A Meta-Analysis ~

www.ncbi.nlm.nih.gov/pmc/articles/PMC4938402/

* Suicidal Ideation and Suicide Attempts in Treatment-Seeking Pathological Gamblers ~
www.ncbi.nlm.nih.gov/pmc/articles/PMC3397475/

* Stages of Compulsive Gambling ~
http://www.elementsbehavioralhealth.com/addiction/stages-of-compulsive-gambling/

{ Note ~ What I discuss in part of this blog is my own experience and is not medical advice. We all have our own unique journey. Do not stop or change prescribed drugs without advice. Change has to be done slowly under the supervision of an expert, due to the dangers of withdrawal  }

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 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 may be unsupportive. 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 has 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 9 years. 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 hyper vigilance and a lack of trust in others.

Hence 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 end up back as productive members of society.

Below is now 88 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. It is important to keep the person as independent as possible, so that they do not become too reliant on someone else e.g. doing their own laundry, some cooking, housework / cleaning and having a diary to organise their week. The carer also needs to take good care of themselves.

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].

* waiting on approval to include extra tips on how to help people who are in psychosis and what doesn’t help. Also advice for carers on self-care.


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

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

 * Adverse effects of Prescribed Psychotropic substances (e.g. the anti-psychotic Olanzapine) may be found in my initial blog “Some of the many useful links…”

Lithium

To write about the subject of Lithium I have consulted Dr David Healy’s book “Mania: A Short History of Bipolar Disorder” [1]. Some quotes and information at the start of this blog are from his book. I am in awe at the level of detail and research that must have gone into it.

As an alkaline substance, Lithium was initially used to treat gout and rheumatic conditions. “While using Lithium to treat gout, Garrod reported that patients often showed a general sense of well-being”, pg. 92. Considering the more recent knowledge about inflammation that functional medicine doctors discuss, I find this fact interesting.

“The key individual in the emergence of a prophylactic use of Lithium for mood disorders is Carl Georg Lange”, pg. 94. Another person to use Lithium with some success in treating Manic symptoms in patients was John Cade in Australia. However the toxic effect of Lithium carbonate caused the death of some of his patients. “The use of Lithium was linked to cardiac difficulties and it was banned by the FDA in 1949 … The question of toxicity highlighted the need to establish a safe dose and to be able to monitor treatment”.

“But consider what makes for a placebo response. The natural history of mood disorders means that many will improve within a few weeks whether treated or not. It is also widely thought that sensible clinical advice on matters of diet, life-style, alcohol intake, and work and relationship problem solving may make a difference. It is suspected that patients’ perceptions that they are being cared for by a medical expert may make a difference, and this effect may be enhancing by being given a substance they think will restore chemical imbalance to normal – even if that imbalance is mythical and the substance is placebo. The fact that the patients present themselves for treatment may also make a difference. All of these factors are reflected in the placebo response. But it is not possible to quantify the distinct contribution of these components” pg. 129.

I now want to talk about my own experience with Lithium and some of the things I learned when on it. It may under certain conditions lead to kidney damage and/or damage to the thyroid. If a woman becomes pregnant on Lithium it can damage the developing foetus.

In 2008, after my Adverse Drug Reaction to the anti-depressant Citalopram and when mainstream Psychiatry had hastily labelled me “Bipolar 1” (while ignoring advice in DSM-IV-TR) I was put on Lithium [3]. According to this book, “Bipolar 1” only affects about 1 in 100,000 people, so it is a rare condition. I’ve also learned that from Prof Ivor Browne. From my reading, I do believe that the overuse of anti-depressants is one of the factors in the current Bipolar “epidemic”.

When I was introduced to Lithium, it appeared to be informed consent at the time. Someone talked to me about this drug and I was given some material to read, but it wasn’t true informed consent. I wasn’t fully aware of the truly toxic nature of this drug. I was put on 1000 mg and ended up on that dosage for nearly 2 years. I had regular blood tests to see if the the Lithium levels were in the so called therapeutic range, as well as thyroid function tests.

After the anti-depressant Citalopram caused mania / psychosis or what I refer to as “SSRI induced Bipolar type symptoms” in August 2008, I have 9 foolscap pages showing the large cocktail of expensive drugs I was on from when I left hospital in October 2008 up until August 2011. While on Lithium (and Seroquel) I had a long Manic episode in 2010, for about 3 months. I don’t remember Seroquel having any benefit at all. I don’t feel that Lithium did anything for me therapeutically either, in a true sense. I was eventually switched from Seroquel to Olanzapine in June 2010 and things improved i.e. I eventually came out of that horrendous episode, which may have seemed fun at the time but I also remember feeling that I just wanted the “manic” feeling to end.

I also decided to come off Lithium towards the end of that “episode” and I let the Psychiatrist know. I withdrew from Lithium in jumps of 200 mg, which is far too fast a rate. As I write this I wonder why the Psychiatrist didn’t give me a strict warning and a better withdrawal plan. I was still going to see him on a regular basis (up until January 2012 when I left mainstream Psychiatry behind me and their drugs, other than a few 5mg Olanzapine that I kept on standby for a while but then they eventually went out of date, which in hindsight meant this whole disaster was coming to some kind of ending).

When jumping down off Lithium at what I now realise was a fast rate, I would have gone into withdrawal, with all the symptoms that goes with that. I became very depressed after coming off it and, due to the brainwashing about Manic Depression, felt that this was just part of “my illness”. I was lethargic and lay in bed with not much interest in life. Based on what I now know about the complexity of the withdrawal process, I see this differently [4].

I felt that Lithium blunted my emotions and also remember the day when this “fog” lifted and I started to feel again. I cried when I realised what the drug had done to me. I regret taking Lithium.

My father was on Lithium for years and his thyroid was affected by it. While he died from prostate cancer, I sometimes wonder if the kidney failure he experienced towards the very end of his life had something to do with being on this drug long term.

An Unquiet Mind by Kay Redfield Jamison

When I first read An Unquiet Mind [2] a number of years ago, while still ingrained in the biomedical model and on the drugs, I thought it was a good book. When I re-read it recently I see things differently now, not forgetting that it’s over 2 decades since it was published (1995). Jamison is a talented writer.

When she talks about the marvelous kind of cosmic relatedness, “the webbings of the universe”, and how everything seems interrelated even when sometimes others can’t see, I can relate to that. It tries to describe in words the experience of mania / psychosis (loss of touch with so called reality), which is not so easy to write about or even to describe verbally. A person’s thoughts can become out of control and tolerance can be lacking from others.

She says in her book that she briefly took antidepressants but they only made her more dangerously agitated. She also claims that it is not uncommon for depressed doctors to prescribe anti-depressants for themselves and that the results can be disastrous.

Even though she praises Lithium as a wonder drug in her life, the efficacy and safety of Lithium is not as compelling as she claims. She also admits that she had she continued to experience fluctuations in mood while on Lithium. When she eventually had her dosage of Lithium reduced “it was as though I had taken bandages off my eyes after many years of partial blindness … I wept for the poignancy of all the intensity I had lost without knowing it and I wept for the pleasure of experiencing it again … the subtle, dreadful muffling of the senses”. I can relate to this when I think back to the time I was coming off Lithium.

Dr Jamison talks about the mind healing if it is given a chance. She also mentions how important love is in the healing process and that it can act as a very strong medicine.  The love and support of others helped her through.

Several times she refers to the hereditary nature of Manic Depression and she mentions ongoing genetic research, but in reality no true bio-markers have been found. Even today over two decades later. While Dr Yolande Lucire has discovered that there can be a problem metabolizing the drugs and there may be a genetic aspect to that [5], in general nothing of real significance has materialised because of genetic research into Manic Depression / Bipolar, that I’m aware of.

She talks about the brain-damaging effects of stopping medication. While people have to be very careful changing or stopping prescribed drugs, if anything the opposite is true. The drugs cause brain damage. Olanzapine, for example, which came to the market in 1996 [6].

Changes in the brain can sometimes be explained by treatment history, as opposed to “mental illness”. Symptoms are not always beyond our control and we are not as “beholden to medication” as some would like us to believe. But that takes patience, self-discipline, persistence and daily work on physical / emotional well-being. As well as tolerance of setbacks and support from others. I do not believe it is a life long illness or disease, but if you tell your sub-conscious that it can become a self-fulfilling prophecy.

Hope is another cornerstone of the healing process. I do feel that my symptoms were mainly iatrogenic i.e. caused by taking the SSRI anti-depressant Citalopram for anxiety (between 2005 and 2008). I haven’t experienced Mania / Psychosis in nearly 5 years (December 2012). I was prone to relapse for at least 2 years after all the drugging. I am now free of of prescribed psychoactive substances, but if I had to write how I got there I would find it difficult. Support from doctors was lacking. They seem to have no problem getting you on a drug but stopping their cocktail of drugs is frowned upon.

I still struggle with other issues e.g. sleep. I do not believe that I have Manic Depression / Bipolar. If I did I would not be ashamed to say it. But I no longer feel conditioned into believing this. I do however suffer from Tardive Dysphoria (long term, sometimes severe Depression after being through drugging and the whole ordeal). In some ways I miss the highs. I occasionally experience a mild high, but I’m not complaining. Or a bit of a mixed episode which I feel is connected to being on the drugs. Female hormones are also a factor. I’m all for personal responsibility, but the bottom line is I feel mainstream Psychiatry got it very wrong at the start and caused major, ongoing, devastating trauma in my life on many levels. I’m still coming to terms with that and learning to let go.

{ 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 people may feel they benefit from Lithium or other drugs I mention here. What I discuss in part of this blog is my own experience and is not medical advice. We all have our own unique journey }


References

[1] Mania: A Short History of Bipolar Disorder by Dr David Healy (2008)

https://www.amazon.com/Mania-History-Bipolar-Disorder-Biographies/dp/1421403978

[2] An Unquiet Mind by Kay Redfield Jamison (1995)

www.amazon.com/Unquiet-Mind-Memoir-Moods-Madness/dp/0679763309

[3] Article by Dr Peter Breggin ~
http://breggin.com/wp-content/uploads/2005/01/31-49.pdf

DSM-IV-TR “emphasizes that a diagnosis of Mania or Bipolar Disorder should not be made when the hypomania or mania first appears while the individual is taking a medication that can cause these symptoms”. DSM-IV-TR (2000) ~ Diagnostic and Statistics Manual. Fourth edition, text revision

[4] Coming off Psychiatric Medication ~ Advice for Prescribers ~
http://www.comingoff.com/lith.php

[5] http://www.drlucire.com/adverse-drug-reactions.html (Dr Yolande Lucire, Forensic Psychiatrist)

Dr Lucire explains that not all people are born with a full complement of metabolizing enzymes, increasing the risk of side effects which can range from mild to life-threatening. Changing dosage up or down and starting / stopping drugs are also crucial times, sometimes affecting the person months after stopping.

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

In 2005, a study funded by the maker of Zyprexa / Olanzapine, found that chronic / long term exposure to this major tranquilizer causes shrinkage of the brain. “significant reduction in brain volume that affects both gray and white matter”! I learned about this from honest Psychiatrists Dr Peter Breggin and Dr Joanna Moncrieff. I was put on Zyprexa, 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. Very short term use would have been enough and proper advice about withdrawal and stopping. Something I never got from a private hospital. I was let out the door with nothing but a prescription. I ran to the train and thought all was great.

2 weeks later I went into what I now know to be withdrawal and akathisia (a severe inner restlessness). I ended up back in hospital for a month, a broken woman. The year that followed is a complete blur and the last 9 years have been difficult because of what I was put through. Mainstream Psychiatrists I saw at the time withheld valuable but vital information.