Posts tagged psychopathology
Posts tagged psychopathology
Severe mental illness: How Virginia’s system fails and a mother’s grief
By Wanda Yvonne Parks
February 9, 2014
Watch full video HERE
I am Jason Daniel Tully’s mother. He passed away on April 25, 2013, at the age of 25, in a jail isolation cell. I have waited this long to respond because an autopsy had to be done. It showed he suffered from schizoaffective disorder and a heart condition. I have no ill feelings towards the Hampton City Jail for their efforts to save my young son’s life. He suffered tremendously with severe mental illness for numerous years.
My son passed away in an isolation jail cell three days after being discharged from a local hospital. He was discharged from Maryview Hospital in Portsmouth after I insisted with his treating psychiatrist that he was not ready to be released. Instead, he was sent home by a cab. One hour later, the police placed him in jail after a psychotic episode.
Jason Daniel was the light of my world, very special and full of kindness. I am a former social worker. My passion has always been and always will be to help those with mental illness.
My sincere sympathyand prayers extend to state Sen. Creigh Deeds about his personal tragedy and loss of his son, Austin. I am sure that Sen. Deeds is facing a difficult time of pain and loss.
I am still unable to explain what it is like to watch your child develop a mental illness. Often, they are denied the help needed. My son was brilliant, kind and had a successful future ahead of him, but he could not beat his illness. Jason Daniel could never, ever accept that his functioning level had decreased so desperately. He said, “My dreams are gone.”
Jason Daniel served a nearly one-year sentence in jail from approximately March 2012 until Feb. 26, 2013. On Feb. 26, he was released from Hampton Roads Regional Jail with bleeding sores in his feet, deep wounds in his legs, a tremendous loss of weight, broken tooth, deep beard and a scar and dent on his forehead. He was so ill that he could barely walk. He went to Riverside Behavioral Health Center where he was denied treatment.
I explained to the Hampton Court that Jason Daniel would need community support services if released. If a mentally ill person is in a hospital for an extensive period of time, or in jail, their disability income (if they have any) is suspended and it takes someone to help them get it reinstated, which can take time.
Otherwise, they are homeless. As the Hampton Roads Regional Jail informed me, “nine times out of 10, the mentally ill are put out on the streets.”
I am trying to get my son’s records. I have contacted Eastern State Hospital (the state psychiatric facility in James City County) where my son was for a short time while incarcerated. I was told, “since he is deceased you cannot get his records.” The Hampton Roads Regional Jail told me I would have to go to court and “then you would be beating your head against a brick wall.” The jail also told me that “isolation can be done indefinitely.” Jason Daniel had a severe mental illness but he had an incredible heart and was always honest. He told me, “Mom, I was put in isolation for a very long time. Bad memories mom. Very bad memories.”
I am speaking from both professional and personal experience. Often one can ask for help and crisis intervention; however an ECO (emergency custody order) or TDO (temporary detention order) is many times not approved because someone does not meet “imminent” criteria for inability to care for self or a danger to self or others. Hospitalization is then not provided. Or, if it is, the patient is often released from the short-term hospital before they are stable. So many times, jail is the outcome. Isolation there with the mentally ill is often done.
Many times I sought fervently for hospitalization for my son and my patients. Not just short-term psychiatric facilities, but especially long-term, such as Eastern State. It was denied when my son pleaded for help.
Although there is proposed legislation for funding for the mental health system, I am deeply concerned that some necessary services will not be met. For example, housing for the mentally ill is a serious problem.
My intentions are not aimed at those who serve the severely mentally ill in jail. My question is why do those who suffer from such a serious mental illness have to be sent to such a dark and lonely place of isolation, without social interaction and activities? Why are the mentally ill released, alone, without sufficient support? Our mental health system has truly failed.
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[Article of Interest] The Problem With How We Treat Bipolar Disorder
By Linda Logan
The last time I saw my old self, I was 27 years old and living in Boston. I was doing well in graduate school, had a tight circle of friends and was a prolific creative writer. Married to my high-school sweetheart, I had just had my first child. Back then, my best times were twirling my baby girl under the gloaming sky on a Florida beach and flopping on the bed with my husband — feet propped against the wall — and talking. The future seemed wide open.
I don’t think there is a particular point at which I can say I became depressed. My illness was insidious, gradual and inexorable. I had a preview of depression in high school, when I spent a couple of years wearing all black, rimming my eyes in kohl and sliding against the walls in the hallways, hoping that no one would notice me. But back then I didn’t think it was a very serious problem.
The hormonal chaos of having three children in five years, the pressure of working on a Ph.D. dissertation and a genetic predisposition for a mood disorder took me to a place of darkness I hadn’t experienced before. Of course, I didn’t recognize that right away. Denial is a gauze; willful denial, an opiate. Everyone seemed in league with my delusion. I was just overwhelmed, my family would say. I should get more help with the kids, put off my Ph.D.
When I told other young mothers about my bone-wearying fatigue, they rolled their eyes knowingly and mumbled, “Right.” But what they didn’t realize was that I could scarcely push the stroller to the park, barely summon the breath to ask the store clerk, “Where are the Pampers?” I went from doctor to doctor, looking for the cause. Lab tests for anemia, low blood sugar and hypothyroidism were all negative.
Any joy I derived from my children was now conjoined with grief. I couldn’t breathe the perfume of their freshly shampooed hair without being seized by the realization that they would not always be under my roof. While stroking their backs, I would mentally fast-forward their lives — noses elongating, tongues sharpening — until I came to their leave-taking, until I reached my death and, ultimately, theirs.
I lost my sense of competence. If a colleague remarked on my intelligence, I mentally derided him as being too stupid to know how dumb I was. If someone asked what I did for a living, I would say, “Nothing” — a remarkably effective conversation stopper. I couldn’t bear the thought of socializing; one night I jumped out of the car as my husband and I were driving to a party.
Despite having these feelings in my mid-30s, when my kids were 8, 5 and 3, I was thriving professionally: I had recently completed my Ph.D. in geography, had just finished co-teaching a semester at M.I.T. as a lecturer and was revising my dissertation on spec for a respected university press. Yet several nights a week, I drove to the reservoir near my home, sat under a tree and, as joggers and their dogs ran past, thought about ending it all. There was a gun shop on the way to my poetry group; I knew exactly where to go when the time came.
My day, once broken by naps, gradually turned into lengthy stretches of sleep, punctuated by moments of wakefulness. My husband and I didn’t explain to the kids that I was depressed. “Mommy’s a little tired today,” we would say. A year or so earlier, a therapist told us to tell the children. “But they’re just kids,” we said. “What do they know?” “They know,” she said. When we eventually spoke to them, my oldest daughter came to me and asked: “Why did you keep it a secret? I thought all mothers were like you.”
After a few weeks of stopping at the reservoir, as suicide eclipsed all other thoughts, I finally told my husband about my worsening psychic pain. The next day I was hospitalized. It was June 1989. Even though we were living in Boston, we decided I should go to Chicago to work with the psychopharmacologist who, 15 years earlier, restored the health of my father, who had also been hospitalized for depression. As the cab pulled away from our house, I turned and saw three children’s hands pressed against the screen of an upstairs window. This is the way the world breaks.
The moment the psych-unit doors locked behind me, I was stripped of my identity as wife, mother, teacher and writer and transformed into patient, room number and diagnosis. I couldn’t open a refrigerator without permission. If I were on suicide watch, I had to ask before going to the bathroom. I was told when to sleep and when to wake, when to eat and when to go to group. My routine, which at home had cleaved so closely to my children’s, now revolved around the clattering sounds of the food trays being brought three times each day from the service elevators into our unit. With my husband and children nearly 1,000 miles away, I was severed from my fixed stars. I missed my children’s smells, the way they used to wrap their bodies around my legs when I was on the phone. I brought my son’s comforter to the hospital for my bed. I remembered him with one leg thrown across the covers, a small foot peeking out from his pajamas.
When my children visited, I had to resuscitate my maternal self, if only for an hour. I dragged myself to the shower, pulled on a pair of clean sweat pants and a fresh T-shirt and ran a streak of lipstick across my lips, hoping to look like a reasonable facsimile of a mother.
My doctor used my first hospitalization as a so-called washout, a period during which he planned to take me off the medication I was on and introduce several drugs in several different combinations. The prospect of polypharmacy — taking many drugs at once — seemed foreboding. I read about Prozac’s giving some people entirely new personalities: happier, lighter, even buoyant. “Who are you going to turn me into?” I asked my doctor.
“I’m not turning you into anyone,” he said. “You’ll be yourself, only happier.”
“I don’t think I even have a self anymore.”
“We’ll find your self.”
I was wary. “Just don’t turn me into Sandy Duncan.”
How much insult to the self is done by the symptoms of the disorder and how much by the drugs used to treat it? Paradoxically, psychotropic drugs can induce anxiety, nervousness, impaired judgment, mania, hypomania, hallucinations, feelings of depersonalization, psychosis and suicidal thoughts, while being used to treat the same symptoms. Before getting to the hospital, my daily moods ranged from bad to worse, each state accompanied by a profound depth of feeling. The first drug I was given was amitriptyline (Elavil), which, in the process of reducing my despair, blunted all my other emotions. I no longer felt anything. It was like going from satellite TV to one lousy channel.
For many people with mental disorders, the transformation of the self is one of the most disturbing things about being ill. And their despair is heightened when doctors don’t engage with the issue, don’t ask about what parts of the self have vanished and don’t help figure out strategies to deal with that loss.
Some in the mental-health field are beginning to recognize this need. Janina Fisher, a psychologist and the assistant director of the Sensorimotor Psychotherapy Institute in Broomfield, Colo., told me that there has been a “sea change” in the role the self plays in the therapeutic dialogue since the decades when I was sick. New therapies and treatment philosophies, founded mostly by clinical psychologists and other practitioners who are not medical doctors, recognize the role of the self in people with mental illness. Patients tell her, “I just want to be that person I used to be.” Fisher encourages her patients to recognize that their mental trauma is a part of their life, but shouldn’t dominate it.
In my own experience with Scheftner, whom I began seeing after my father’s doctor moved away, we talk about the self but only when I bring it up. That’s why I have enjoyed helping to run a support group for people with mental disorders, something I’ve been doing for the last three years. There are usually 8 of us, sometimes 12. We sit in the basement of a local library every Wednesday afternoon. Though we know one another’s innermost thoughts, we are intimate strangers, not friends. Like A.A. and other self-help groups, we’re peer-led: run by and for people with mental disorders. We talk one by one about the past week — small achievements, setbacks, doctor appointments, family conflicts. While the self is not always an explicit topic, the loss of self — or for those doing better, the reconstruction of the self — is a hovering presence in the group.
One day, not long ago, a middle-aged man came to our group. He told us that he spent the past year attending different grief groups, but none of them were right. “Why not?” someone asked. The man said: “Because everyone there was grieving over the loss of another person. I was grieving for myself. For who I used to be before I got sick and who I am now.”
During the 20-odd years since my hospitalizations, many parts of my old self have been straggling home. But not everything made the return trip. While I no longer jump from moving cars on the way to parties, I still find social events uncomfortable. And, although I don’t have to battle to stay awake during the day, I still don’t have full days — I’m only functional mornings to midafternoons. I haven’t been able to return to teaching. How many employers would welcome a request for a cot, a soft pillow and half the day off?
One morning, about five years ago, my husband and I were talking on the family-room sofa. I was still wearing my pajamas and had wool hiking socks on. As he rubbed my feet, he told me he was leaving. It was, at once, a scene of tenderness and savagery. A little later, he threw some clothes into a suitcase and moved out. But my self — devastated, grieving, angry — remained intact.
Today, my mind is nimble. Creative writing has crept back into my life. I’ve made a couple of close friends in Chicago. My greatest pleasure is still my children — they’re starting careers, marrying, on the brinks of their lives. I’m looking forward to grandchildren, to singing the 1950s favorite “Life Is but a Dream” while spinning those babies under the stars of a falling night on a Florida beach. This June, I’m turning 60. I’m having a small party to celebrate my ingathering of selves. My old self was first to R.S.V.P.
[Article of Interest] Childhood Depression May Be Tied to Later Heart Risk
For these kids, obesity, smoking and inactivity more likely in adolescence, preliminary research shows
Teens who were depressed as children are more likely to be obese, to smoke and to be sedentary, a new study finds.
The findings suggest that depression during childhood can increase the risk of heart problems later in life, according to the researchers.
The study included more than 500 children who were followed from ages 9 to 16. There were three groups: those diagnosed with depression as children, their depression-free siblings and a control group of unrelated youngsters with no history of depression.
Twenty-two percent of the kids who were depressed at age 9 were obese at age 16, the study found. “Only 17 percent of their siblings were obese, and the obesity rate was 11 percent in the unrelated children who never had been depressed,” study first author Robert Carney, a professor of psychiatry at Washington University School of Medicine in St. Louis, said in a university news release.
The researchers found similar patterns when they looked at smoking and physical activity.
”A third of those who were depressed as children had become daily smokers, compared to 13 percent of their nondepressed siblings and only 2.5 percent of the control group,” Carney said.
Teens who had been depressed as children were the least physically active, their siblings were a bit more active and those in the control group were the most active, according to the study, which is scheduled for presentation Friday at the annual meeting of the American Psychosomatic Society in Miami. Although the study showed an association between childhood depression and obesity, smoking habits and inactivity later in life, it did not prove a cause-and-effect relationship.
These findings are cause for concern because “a number of recent studies have shown that when adolescents have these cardiac risk factors, they’re much more likely to develop heart disease as adults and even to have a shorter lifespan,” Carney said.
”Active smokers as adolescents are twice as likely to die by the age of 55 than nonsmokers, and we see similar risks with obesity, so finding this link between childhood depression and these risk factors suggests that we need to very closely monitor young people who have been depressed,” he said.
Note: Data and conclusions presented at meetings are typically considered preliminary until published in a peer-reviewed medical journal.
[Article of Interest] In Gun Debate, No Rift on Better Care for Mentally Ill
By Jeremy W. Peters
While the Senate has been consumed with a divisive debate over expanded background checks for gun buyers, lawmakers have been quietly working across party lines on legislation that advocates say could help prevent killers like Adam Lanza, the gunman in the Newtown, Conn., massacre, from slipping through the cracks.
Proponents say the plans, which stand a good chance of being included in any final gun-control bill, would lead to some of the most significant advancements in years in treating mental illness and address a problem that people on both sides of the issue agree is a root cause of gun rampages. Unlike the bitter disagreements that have characterized efforts to limit access to guns, the idea of improving mental health unites Republicans and Democrats, urban and rural, blue state and red state.
“This is a place where people can come together,” said Senator Debbie Stabenow, Democrat of Michigan, who has worked with some of the Senate’s most conservative Republicans on a piece of mental health legislation. “As we’ve listened to people on all sides of the gun debate, they’ve all talked about the fact that we need to address mental health treatment. And that’s what this does.”
The issue also appeals to members of Congress in another important way: it serves as a political refuge for Republicans and more conservative Democrats who are eager to offer a federal response to the shootings in Connecticut and Aurora, Colo., but have no interest in taking any action that could be seen as infringing on constitutional gun rights.
Senator John Cornyn of Texas, the No. 2 Senate Republican, who has not wavered in his opposition to tighter gun laws, met with families of Newtown victims and said he came away believing they wanted to attack mental health problems above all else.
“This is actually something we can and should do something about,” Mr. Cornyn said. “We need to make sure that the mentally ill are getting the help they need.”
Advocates for better mental health services said that many of them were initially uneasy about seizing on an event as tragic as the Connecticut school shootings to win improvements in care. And many have noted that very few violent crimes are committed by mentally ill people. But they came to believe that the current time was the best opportunity for real change, and that they might not get another one for a while.
“This is our moment,” said Linda Rosenberg, the president of the National Council for Community Behavioral Healthcare. “I hate the connection between gun violence and the need for better mental health care, but sometimes you have to take what you can get.”
The emerging legislation would, among other things, finance the construction of more community mental health centers, provide grants to train teachers to spot early signs of mental illness and make more Medicaid dollars available for mental health care.
There would be suicide prevention initiatives and support for children who have faced trauma. The sponsors of one of the bills estimated that an additional 1.5 million people with mental illness would be treated each year.
Ms. Stabenow’s measure has attracted backing from some of the Senate Republicans who are strongly backed by the National Rifle Association, including Marco Rubio of Florida and Roy Blunt of Missouri. Both of those lawmakers opposed the successful effort on Thursday to overcome a Republican filibuster and begin debate on a gun measure.
One of the proposals being negotiated, which has the support of Senators Tom Harkin, Democrat of Iowa, and Lamar Alexander, Republican of Tennessee, unanimously passed a Senate committee this week, something that could hardly be said about any of the gun legislation.
President Obama has also joined the effort. His budget includes $130 million for programs that would help detect mental illness in young children, train educators to spot those signs and refer the students to treatment.
Treatment for mentally ill people is but one of many issues before Congress, and it lacks not only headline-grabbing elements like semiautomatic weapons and gun-show loopholes, but also a backer like Mayor Michael R. Bloomberg of New York who can bankroll a multimillion-dollar advertising campaign to remind voters to contact their senators.
Nevertheless, the issue has moved rapidly through the Senate, because of the efforts of the mental health lobby and because many legislators have a personal connection to mental illness. Senator Harry Reid, the majority leader, spoke the other day about his father’s suicide by gun.
Senate Democratic aides said that there is likely to be at least one mental health bill offered as an amendment to the larger gun package. The problem will be accommodating all of the additions.
Democrats have to agree to allow Republicans the same number of amendments as they give themselves. To reduce the likelihood that Republicans will offer multiple amendments that could water down and even torpedo the gun bill, it is in Democrats’ interest to limit their amendments.
“It’s very difficult to come up with a system that’s foolproof,” [Ronald S. Honberg] said. “The bigger point is if you really want to improve mental health care in this country, then let’s improve mental health care.”
[Documentary of Interest] Coming Off Psych Drugs: A Meeting of the Minds
Description: In June of 2012, twenty-three people came together to discuss the subject of coming off psychiatric drugs. We were psychiatric survivors, therapists, mental health consumers, family members, and activists, united by a passion for truth-telling. More than half of us had successfully come off psych drugs, including cocktails of antipsychotics and mood stabilizers. What resulted from our three-day gathering was an unforgettable meeting of the minds.
This 75-minute documentary (directed by Daniel Mackler) offers a rare glimpse into the world of coming off psych drugs through the eyes of those who have done it. The film presents, among others, Will Hall, author of the world-renowned “Harm Reduction Guide to Coming Off Psychiatric Drugs,” Oryx Cohen, director at the National Empowerment Center, Laura Delano, blogger at www.madinamerica.com, and Daniel Hazen, noted psychiatric survivor and human rights activist.
Although this documentary is not medical advice, it intends to offer something even better: hope. In a world where increasing numbers of people are put on psychiatric drugs every day, where more than 20 percent of Americans already take them, and where so many are told they need to stay on them for life, COMING OFF PSYCH DRUGS offers proof that another way is possible.
Available at www.wildtruth.net