By the way, HealthyPlace.com is a wonderful site, full of information and support for mental health consumers and all that support them. Visit the site some time soon and enjoy.
Tuesday, 29 January 2013
Causes of Horrific Violence
By the way, HealthyPlace.com is a wonderful site, full of information and support for mental health consumers and all that support them. Visit the site some time soon and enjoy.
Monday, 28 January 2013
Finding "the one," part 1 of 2
One of the most intimidating aspects of mental health care can be actually finding a professional to work with. If there's insurance, then only certain practitioners will be accepted. If there's no insurance, there is the added task of finding someone within one's budget or who works on a sliding scale.
Following are two effective approaches to finding a mental health professional, although a combination of both is most likely to yield the best results. There are directories and there are recommendations.
DIRECTORIES
Short and simple: There's a list of people. Search for the ones nearby. Check specializations. Choose a few to look into further.
Outside of phone book-like listings, there appear to be two major types of websites that have names and contact information for mental health professionals, maybe even with a profile that lists personal statements and/or specifics at what each practitioner is good at. There are ones affiliated with specific associations and there are others that exist as a catalog that one usually pays to be on.
In terms of professional organizations, these will not include every single counselor or social worker or anything else in an area. But it will list its members and being a part of a respected organization is a good sign, seeing as there are criteria that must be met and maintained, usually including continuing education. Because each specific sub-field has its own groups, it can be useful to look at several different sites to get a broader range of options.
An example would be the American Psychological Association (APA). This group might be the most respected professional organization in the field. (Well, there's also the American Psychiatric Association, who are also APA. For a reminder of how psychiatrists and psychologists are different, click here.) APA's psychologist locator allows the user to search by location, gender, specializations, cultural sensitivities and so on. This locator can be found here.
When it comes to non-professional listings, there is usually money involved. This limits the amount of results. I went to one of the larger sites and my only result when including every possible type of mental health professional or clinic in a 20 mile area gave me one option – and it only dealt with a very specific population. I don't live in an unpopulated area at all.
The best comprehensive search engine of this sort might actually be the one that Psychology Today runs, which can be found here. It has very specific search options and gives more results than anywhere else I have found. In addition to standard information like that APA have options for, they can also filter for specifications such as the type of treatment, which insurance companies are accepted and religious orientation. While originally a directory of therapists, it has now expanded to include psychiatrists, group therapy and treatment centers. The profiles are also very thorough, including personal statements, cost of treatment, education, years in practice, etc.
If an insurance company will be paying for at least part of the treatment, it is a wise idea to actually call them up and insist on a complete list of professionals they are willing to work with. Usually the information packets and such only list some of the options. Cross-reference this with other directories with more information in order to get a better feel for the person.
RECOMMENDATIONS
The other route to finding a mental health professional is through asking for recommendations. While, for instance, a therapist cannot see a husband and wife separately due to conflict of interest, there are many other ways to find suggestions. Ask family and friends and have them check with theirs. Someone always knows someone. If a certain type of treatment is necessary, such as substance abuse or eating disorders, it might be worth mentioning in order to weed out the ones who mostly see clients with mild to moderate depression or anxiety.
It can be hard to admit that one needs help, though. Community organizations, religious groups, schools and the like will often have specific people they tend to work with and refer to. This is a more anonymous way of finding a practitioner. There will, however, likely be a bias based on what group is giving the suggestion.
After getting a list of names, there are still a few more things to check. It is worth seeing if each practitioner or clinic has their own website, as this can give a better feel for the options. Online reviews and ratings, if available, can be very valuable, too. I have found the best way to get these is to enter the name (in quotation marks) and state into the search engine, then adding the word "reviews" or "ratings." This should bring up any available results and saves the time of sifting through each site individually.
Another important thing to verify is licensure. This information will be available through the state itself. Searching the phrase license verification and the name of the state should bring up an option with ending in .gov. Check that the individual is actually licensed to practice. There might also be other useful information, like whether or not disciplinary action has been taken against the practitioner and when licenses expire. If working with someone who is not licensed, you have no guarantees of anything. This is how "life coaching" came about, but that is a different story.
At this point, the list should probably be fairly short. Choosing who to work with from the finalists has its own process, which will be posted on Thursday.
How did you find your therapist or one for someone else? Please share any tips on how to locate mental health professionals.
Following are two effective approaches to finding a mental health professional, although a combination of both is most likely to yield the best results. There are directories and there are recommendations.
DIRECTORIES
Short and simple: There's a list of people. Search for the ones nearby. Check specializations. Choose a few to look into further.
 |
| Stuart Miles/FreeDigitalPhotos.net |
In terms of professional organizations, these will not include every single counselor or social worker or anything else in an area. But it will list its members and being a part of a respected organization is a good sign, seeing as there are criteria that must be met and maintained, usually including continuing education. Because each specific sub-field has its own groups, it can be useful to look at several different sites to get a broader range of options.
An example would be the American Psychological Association (APA). This group might be the most respected professional organization in the field. (Well, there's also the American Psychiatric Association, who are also APA. For a reminder of how psychiatrists and psychologists are different, click here.) APA's psychologist locator allows the user to search by location, gender, specializations, cultural sensitivities and so on. This locator can be found here.
When it comes to non-professional listings, there is usually money involved. This limits the amount of results. I went to one of the larger sites and my only result when including every possible type of mental health professional or clinic in a 20 mile area gave me one option – and it only dealt with a very specific population. I don't live in an unpopulated area at all.
The best comprehensive search engine of this sort might actually be the one that Psychology Today runs, which can be found here. It has very specific search options and gives more results than anywhere else I have found. In addition to standard information like that APA have options for, they can also filter for specifications such as the type of treatment, which insurance companies are accepted and religious orientation. While originally a directory of therapists, it has now expanded to include psychiatrists, group therapy and treatment centers. The profiles are also very thorough, including personal statements, cost of treatment, education, years in practice, etc.
If an insurance company will be paying for at least part of the treatment, it is a wise idea to actually call them up and insist on a complete list of professionals they are willing to work with. Usually the information packets and such only list some of the options. Cross-reference this with other directories with more information in order to get a better feel for the person.
RECOMMENDATIONS
The other route to finding a mental health professional is through asking for recommendations. While, for instance, a therapist cannot see a husband and wife separately due to conflict of interest, there are many other ways to find suggestions. Ask family and friends and have them check with theirs. Someone always knows someone. If a certain type of treatment is necessary, such as substance abuse or eating disorders, it might be worth mentioning in order to weed out the ones who mostly see clients with mild to moderate depression or anxiety.
It can be hard to admit that one needs help, though. Community organizations, religious groups, schools and the like will often have specific people they tend to work with and refer to. This is a more anonymous way of finding a practitioner. There will, however, likely be a bias based on what group is giving the suggestion.
After getting a list of names, there are still a few more things to check. It is worth seeing if each practitioner or clinic has their own website, as this can give a better feel for the options. Online reviews and ratings, if available, can be very valuable, too. I have found the best way to get these is to enter the name (in quotation marks) and state into the search engine, then adding the word "reviews" or "ratings." This should bring up any available results and saves the time of sifting through each site individually.
Another important thing to verify is licensure. This information will be available through the state itself. Searching the phrase license verification and the name of the state should bring up an option with ending in .gov. Check that the individual is actually licensed to practice. There might also be other useful information, like whether or not disciplinary action has been taken against the practitioner and when licenses expire. If working with someone who is not licensed, you have no guarantees of anything. This is how "life coaching" came about, but that is a different story.
At this point, the list should probably be fairly short. Choosing who to work with from the finalists has its own process, which will be posted on Thursday.
How did you find your therapist or one for someone else? Please share any tips on how to locate mental health professionals.
Saturday, 26 January 2013
Psychologist, psychiatrist – what's the difference?
It seems to me that the most mixed up terms in the mental health field are actually two of the most fundamental ones: psychologist and psychiatrist.
There are a variety of types of mental health providers and they all have their purposes. Depending on the issue at hand, it is important to know which practitioner will be of the most help. So whether searching the Internet or checking the yellow pages for someone to help, it's important to know what, exactly, to look for.
There are, of course, other types of practitioners. Therapists, counselors, psychoanalysts, social workers, art therapists – there are a lot. There will be posts about these professionals in the future, but it seems that understanding the difference between psychiatry and psychology is the most pressing.
A psychiatrist is a medical doctor (MD). She will have gone through all of the same medical training as anyone else in medical school, but will have specialized in psychiatric disorders. Although they used to act more like traditional counselors, currently, the primary purpose of psychiatrists is to make diagnoses and prescribe medication. (It should be noted that regular physicians can also, to some degree, prescribe psych meds. This will be discussed in a later post.)
Pros: With a few rare exceptions, psychiatrists are the only mental health practitioners who can prescribe you medication. They also have medical training that might pick up on a physical ailment that is causing mental side effects instead of assuming it is a psychiatric condition. If you have a combination of physical and psychological symptoms, a consultation with a psychiatrist is worthwhile in order to understand the root of your problems.
Cons: Depending on who you're seeing, it is a very real possibility that she will spend ten minutes with you, hand you a prescription for the drug du jour and charge you $200. While a good psychiatrist will at least have an extended first consultation to understand your background and situation, they are usually paid per appointment, not per hour. Do not expect talk therapy.
A psychologist has a doctoral degree (either a Ph.D. or a Psy.D.) in psychology, has passed licensing exams and completed lots of supervised hours. Their training is more or less entirely focused on mental health and other psychological issues. This is the person you see in the movies: the man with diplomas on the wall, sitting in a comfy chair while hysterical clients pour their hearts out. Now, it doesn't always work like that, but it gets to the general idea. It's someone to talk to who has been trained in how to respond to a variety of issues.
Pros: Consulting a psychologist can be a good starting point for receiving treatment. He will be qualified to sort out what, exactly, you are experiencing and will have the academic background to suggest and utilize the optimal treatments. (This could include a referral to a psychiatrist if medication or other health complications should be considered.) Psychologists can also perform certain functions that other counselors cannot, such as administering certain psychological tests. All in all, psychologists are there to listen and to give you a lot more time and attention than a psychiatrist would.
Cons: The most obvious con is that psychologists cannot prescribe medication. (There are a few controversial programs in some states that grant psychologists prescription privileges, but don't count on it.) The field is also more diverse than psychiatry when it comes to treatment options. While a good thing, in practice it means that sometimes it can take a while to find the right practitioner. Additionally, psychologists are generally more expensive than other professionals with similar services, such as licensed counselors and social workers. (These will be discussed in another post.)
All right, there are the basics. Psychiatrists: medical doctors. Psychologists: talk therapists. Often it is a good idea to see both. A combination of antidepressants and counseling has been found to be more effective in treating moderate depression than either on its own.
What has your experience been like with psychologists and psychiatrists? There are so many interesting stories out there.
There are a variety of types of mental health providers and they all have their purposes. Depending on the issue at hand, it is important to know which practitioner will be of the most help. So whether searching the Internet or checking the yellow pages for someone to help, it's important to know what, exactly, to look for.
There are, of course, other types of practitioners. Therapists, counselors, psychoanalysts, social workers, art therapists – there are a lot. There will be posts about these professionals in the future, but it seems that understanding the difference between psychiatry and psychology is the most pressing.
A psychiatrist is a medical doctor (MD). She will have gone through all of the same medical training as anyone else in medical school, but will have specialized in psychiatric disorders. Although they used to act more like traditional counselors, currently, the primary purpose of psychiatrists is to make diagnoses and prescribe medication. (It should be noted that regular physicians can also, to some degree, prescribe psych meds. This will be discussed in a later post.)
Pros: With a few rare exceptions, psychiatrists are the only mental health practitioners who can prescribe you medication. They also have medical training that might pick up on a physical ailment that is causing mental side effects instead of assuming it is a psychiatric condition. If you have a combination of physical and psychological symptoms, a consultation with a psychiatrist is worthwhile in order to understand the root of your problems.
Cons: Depending on who you're seeing, it is a very real possibility that she will spend ten minutes with you, hand you a prescription for the drug du jour and charge you $200. While a good psychiatrist will at least have an extended first consultation to understand your background and situation, they are usually paid per appointment, not per hour. Do not expect talk therapy.
A psychologist has a doctoral degree (either a Ph.D. or a Psy.D.) in psychology, has passed licensing exams and completed lots of supervised hours. Their training is more or less entirely focused on mental health and other psychological issues. This is the person you see in the movies: the man with diplomas on the wall, sitting in a comfy chair while hysterical clients pour their hearts out. Now, it doesn't always work like that, but it gets to the general idea. It's someone to talk to who has been trained in how to respond to a variety of issues.
Pros: Consulting a psychologist can be a good starting point for receiving treatment. He will be qualified to sort out what, exactly, you are experiencing and will have the academic background to suggest and utilize the optimal treatments. (This could include a referral to a psychiatrist if medication or other health complications should be considered.) Psychologists can also perform certain functions that other counselors cannot, such as administering certain psychological tests. All in all, psychologists are there to listen and to give you a lot more time and attention than a psychiatrist would.
Cons: The most obvious con is that psychologists cannot prescribe medication. (There are a few controversial programs in some states that grant psychologists prescription privileges, but don't count on it.) The field is also more diverse than psychiatry when it comes to treatment options. While a good thing, in practice it means that sometimes it can take a while to find the right practitioner. Additionally, psychologists are generally more expensive than other professionals with similar services, such as licensed counselors and social workers. (These will be discussed in another post.)
All right, there are the basics. Psychiatrists: medical doctors. Psychologists: talk therapists. Often it is a good idea to see both. A combination of antidepressants and counseling has been found to be more effective in treating moderate depression than either on its own.
What has your experience been like with psychologists and psychiatrists? There are so many interesting stories out there.
Tuesday, 22 January 2013
When it's time
One of the necessary limitations of being a living creature is that one only has access to one own's experiences and perspectives. (Perhaps this is why so many find the idea of reincarnation appealing.) The problem with this is that, by default, people tend to start out with the assumption that others are like them before gradually working out the differences.
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| Photo courtesy of @norwigger on Instagram. |
Just like one has to evaluate whether a cut is infected enough to seek medical attention, there is a necessity to evaluate when professional help might be needed in terms of mental health issues. The difference is that the scabs and infections are visible and documented, giving a guide as to when something becomes diseased.
- When does a fear become a phobia?
- When does sadness become depression?
- When does quirkiness become psychopathology?
The symptoms cause clinically significant distress or impairment is social, occupational, or other important areas of functioning.
Basically, if it's interfering with the ability to act within or experience a major aspect of normal life, it probably demands attention. As an analogy, a twisted ankle from a misstep will likely go away on its own within a few days. It's an inconvenience. Breaking a leg, on the other hand, can seriously affect someone's ability to go through their basic routines. In some fields, it eliminates the capacity to perform one's work altogether.
In mental health, the examples might look somewhere along this line:
- A broken-hearted man secludes himself and won't see his friends at all for months after his girlfriend breaks up with him.
- A student regularly cannot complete a quiz in the given time because her mind is highly distracted.
- A grieving widow experiences a complete and continuing lack of appetite for a full year after the unexpected loss of her husband.
- A worker loses his job because he becomes obsessively focused on certain trivial aspects of his duties instead of tackling what he is supposed to be doing.
- A teenager’s life becomes erratic because she comes to in a strange situation with no recollection of how she got there or why, especially if substance use was not involved.
If there is still uncertainty after considering this guideline, many mental health practitioners offer a free initial consultation either by phone or in person. While they want clients and will generally be able to claim to help, take care to ask about what she thinks she had to offer. If it seems valuable, it might be worth trying treatment. It's also perfectly okay to consult with more than one practitioner and see which one is the best fit.
It’s often hard to seek help when at this point, so look out for this disturbance in the lives of loved ones. A sudden, huge personality/habit change or a continuing impairment should at least cause consideration for professional help.
If you are/have been in treatment or have helped someone else get it, how did you know it was time to take that step?
Sunday, 20 January 2013
Why should I listen to you?
While this blog is not about me, I can understand why some readers might want to know what exactly qualifies me to write about this topic. In order to justify my endeavor, here is a summary of the relevant aspects of my experience for those who are interested.
Like many high school students, I felt depressed. Unfortunately, it's a relatively common phenomenon. Being a teenager includes moodiness, right? I had some other major factors in my life that could easily be seen as contributors, so I partially wrote it off. I was told that high school was not the best environment for me and that in college, I'd thrive and be happy. Even crushing suicidality was another thing that just happens.
My first semester of college, I was excited to be in a setting where I would finally fit in and succeed. That's not what happened. I had always gotten top grades, but I couldn't finish – or even start – easy assignments. It was not that I was not prepared for university-level work. It was the ever-growing melancholia that was taking over every aspect of my life.
At the time, I had started dating a doctoral student who was going into counseling psychology. Seeing me deteriorate, he told me that my experience was not just a normal phase and that I needed to get help. He referred me to the campus counseling center and that is how I entered therapy.
I have read countless memoirs concerning mental illness, looking for answers. They generally seem to end along the lines of, "And then I took Prozac/got an awesome therapist/met my significant other/moved/found the meaning of life/grew out of it – and lived happily ever after." This is not one of those stories. While taking that first step of reaching out to get help is a vital step in growing, there won't always be a magic pill, brilliant counselor or lifestyle change that will solve everything.
You will stumble along the way. There is no "intro to handling your mental illness" orientation meeting. No one will sit you down and explain how exactly you go about "getting better." I thought that a few weeks of therapy would cure me. Over six years later, that depression is still a part of my life.
While that sounds discouraging, it's actually amazing. I have a chronic condition, but I can function. I still struggle, but I know what my resources are. I continue to feel broken, but I don't feel despondent. Well, I have my days. I always will.
But reaching this point has been a hard-won battle. I went from thinking I was a sulking teenager to believing I had a depressive episode to a journey that, at times, is much stranger than fiction. I have met all sorts of characters who all had their own "interesting" takes on what was going on with me. There were times when I was being hurt more than helped by mental health professionals. During a particularly painful experience, I made a promise to do my best to make it so others would not have to endure that kind of suffering. It's hard enough to struggle with yourself; having the people who are getting paid to support you do damage of their own can be crushing.
Looking back, I could have many "if-only" wishes. If only someone had told me how to find a therapist that is a good fit. If only someone had explained psychiatric pharmacology better. If only those close to me understood the warning signs and intervened. If only someone had even told me how to properly ask for help… well, things would be different. But I don't regret it.
I did end up dropping out of college, then going back and forth for a while. That actually is normal young adult behavior. I diligently tried to improve myself through whatever means I could find. I found a few that help. Now I am working on a combined degree in psychology and communication in order to have the skill set necessary to guide others through a confusing world that, in and of itself, could drive someone "crazy."
I knew it was worth it when I got a 2 a.m. phone call from a distressed friend I hadn't heard from in a long time. Her younger sister had been admitted to a psychiatric unit and my friend was the only family member anywhere close enough to be of use. What was she supposed to do? How should she talk to her sister? Should she try to get her out of there? What could she expect? What would she need to do after discharge?
I didn't know all the answers. I still don't. But I knew where to point her. I knew which local agencies might be of use, as well as a few people she should avoid. Through both personal experience (including that of those around me), intense research and formal education, I have figured out a thing or two.
My aim here is to fulfill that promise I made to myself when I was at my worst. I can't fix your problems, but I can tell you how to get started.
So whether you are concerned for a loved one or feeling like you need some help yourself, welcome. It's a difficult but worthwhile journey you are embarking on. Let me show you the ropes and give you a map. I'm here as a friend. If I don't know the answer to your question, I will do my best to find it. I may not be the one who has the skills to ease your pain, but I have walked this path. I know the ditches and the shortcuts, as well as some beautiful places of reprieve.
I am here because I understand how confusing and overwhelming mental health issues can be. Let's figure this out together.
Like many high school students, I felt depressed. Unfortunately, it's a relatively common phenomenon. Being a teenager includes moodiness, right? I had some other major factors in my life that could easily be seen as contributors, so I partially wrote it off. I was told that high school was not the best environment for me and that in college, I'd thrive and be happy. Even crushing suicidality was another thing that just happens. My first semester of college, I was excited to be in a setting where I would finally fit in and succeed. That's not what happened. I had always gotten top grades, but I couldn't finish – or even start – easy assignments. It was not that I was not prepared for university-level work. It was the ever-growing melancholia that was taking over every aspect of my life.
At the time, I had started dating a doctoral student who was going into counseling psychology. Seeing me deteriorate, he told me that my experience was not just a normal phase and that I needed to get help. He referred me to the campus counseling center and that is how I entered therapy.
I have read countless memoirs concerning mental illness, looking for answers. They generally seem to end along the lines of, "And then I took Prozac/got an awesome therapist/met my significant other/moved/found the meaning of life/grew out of it – and lived happily ever after." This is not one of those stories. While taking that first step of reaching out to get help is a vital step in growing, there won't always be a magic pill, brilliant counselor or lifestyle change that will solve everything.
You will stumble along the way. There is no "intro to handling your mental illness" orientation meeting. No one will sit you down and explain how exactly you go about "getting better." I thought that a few weeks of therapy would cure me. Over six years later, that depression is still a part of my life.
While that sounds discouraging, it's actually amazing. I have a chronic condition, but I can function. I still struggle, but I know what my resources are. I continue to feel broken, but I don't feel despondent. Well, I have my days. I always will.
But reaching this point has been a hard-won battle. I went from thinking I was a sulking teenager to believing I had a depressive episode to a journey that, at times, is much stranger than fiction. I have met all sorts of characters who all had their own "interesting" takes on what was going on with me. There were times when I was being hurt more than helped by mental health professionals. During a particularly painful experience, I made a promise to do my best to make it so others would not have to endure that kind of suffering. It's hard enough to struggle with yourself; having the people who are getting paid to support you do damage of their own can be crushing.
Looking back, I could have many "if-only" wishes. If only someone had told me how to find a therapist that is a good fit. If only someone had explained psychiatric pharmacology better. If only those close to me understood the warning signs and intervened. If only someone had even told me how to properly ask for help… well, things would be different. But I don't regret it.
I did end up dropping out of college, then going back and forth for a while. That actually is normal young adult behavior. I diligently tried to improve myself through whatever means I could find. I found a few that help. Now I am working on a combined degree in psychology and communication in order to have the skill set necessary to guide others through a confusing world that, in and of itself, could drive someone "crazy."
I knew it was worth it when I got a 2 a.m. phone call from a distressed friend I hadn't heard from in a long time. Her younger sister had been admitted to a psychiatric unit and my friend was the only family member anywhere close enough to be of use. What was she supposed to do? How should she talk to her sister? Should she try to get her out of there? What could she expect? What would she need to do after discharge? I didn't know all the answers. I still don't. But I knew where to point her. I knew which local agencies might be of use, as well as a few people she should avoid. Through both personal experience (including that of those around me), intense research and formal education, I have figured out a thing or two.
My aim here is to fulfill that promise I made to myself when I was at my worst. I can't fix your problems, but I can tell you how to get started.
So whether you are concerned for a loved one or feeling like you need some help yourself, welcome. It's a difficult but worthwhile journey you are embarking on. Let me show you the ropes and give you a map. I'm here as a friend. If I don't know the answer to your question, I will do my best to find it. I may not be the one who has the skills to ease your pain, but I have walked this path. I know the ditches and the shortcuts, as well as some beautiful places of reprieve.
I am here because I understand how confusing and overwhelming mental health issues can be. Let's figure this out together.
Saturday, 19 January 2013
An incomplete education
There are certain challenges every adult is expected to know how to respond to:
How do I do laundry?
Where do I take my car for an oil change?
How do I fill out taxes?
Which stores have pants that fit me?
What do I do if my kid breaks her arm?
But then there are the ones that the average person is ill-prepared for:
What do I say to a friend who has suddenly lost interest in all his friends and hobbies?
Where do I go if I can't remember significant stretches of time?
Who can help me when I'm afraid to even leave the house?
Is there a supplement or medication that can make me focus better?
When do I seek treatment for my father's increasing disconnect with reality?
Mental health topics are given a cursory nod in high school health class and suicide hotlines are a small news item – sometimes – because of underfunding. There's always the crazy aunt, but no one really cares to get involved because what can you do? A broken bone is met with sympathy while a diagnosis of
schizophrenia is unmentionable.
And yet the general population has a fascination with the functions (and dysfunctions) of the mind. There are movies about escaping mental institutions, TV characters with personality disorders and songs on the radio about bipolar lovers. Although cases of mental illness usually do not involve violence (at least not towards others), it suddenly becomes a temporarily real issue when a school shooting or suicide from bullying occurs. College students live on Ritalin and at any given workplace, you can be sure that there is someone on anti-depressants.
People manage their weight, check their blood pressure, get mammograms and visit doctors with complaints of the common cold. Is something hurting? Get it checked out. While you're at it, it's a good idea to get preventative care. Yearly physicals are a standard recommendation.
But when it comes to matters of the mind, hurting actually impedes getting help. How is someone bedridden with depression supposed to seek treatment when he doesn't even have the motivation to shower and get dressed? How is a student supposed to confront her roommate when she is becoming dangerously thin?
There are so many questions. There are also so many answers. So consider this blog the orientation you never got. The mental health system is complex, but a little street savvy advice and dissection of jargon can go a long way.
Health care – including that of the mind – is a business. Become an informed consumer.
 |
| Photo courtesy of @norwigger on Instagram. |
Where do I take my car for an oil change?
How do I fill out taxes?
Which stores have pants that fit me?
What do I do if my kid breaks her arm?
But then there are the ones that the average person is ill-prepared for:
What do I say to a friend who has suddenly lost interest in all his friends and hobbies?
Where do I go if I can't remember significant stretches of time?
Who can help me when I'm afraid to even leave the house?
Is there a supplement or medication that can make me focus better?
When do I seek treatment for my father's increasing disconnect with reality?
Mental health topics are given a cursory nod in high school health class and suicide hotlines are a small news item – sometimes – because of underfunding. There's always the crazy aunt, but no one really cares to get involved because what can you do? A broken bone is met with sympathy while a diagnosis of
schizophrenia is unmentionable.
And yet the general population has a fascination with the functions (and dysfunctions) of the mind. There are movies about escaping mental institutions, TV characters with personality disorders and songs on the radio about bipolar lovers. Although cases of mental illness usually do not involve violence (at least not towards others), it suddenly becomes a temporarily real issue when a school shooting or suicide from bullying occurs. College students live on Ritalin and at any given workplace, you can be sure that there is someone on anti-depressants.
People manage their weight, check their blood pressure, get mammograms and visit doctors with complaints of the common cold. Is something hurting? Get it checked out. While you're at it, it's a good idea to get preventative care. Yearly physicals are a standard recommendation.
But when it comes to matters of the mind, hurting actually impedes getting help. How is someone bedridden with depression supposed to seek treatment when he doesn't even have the motivation to shower and get dressed? How is a student supposed to confront her roommate when she is becoming dangerously thin?
There are so many questions. There are also so many answers. So consider this blog the orientation you never got. The mental health system is complex, but a little street savvy advice and dissection of jargon can go a long way.
Health care – including that of the mind – is a business. Become an informed consumer.
Choline Supplements During Pregnancy May Prevent Schizophrenia
Research shows that the use of choline supplements during pregnancy may prevent schizophrenia. Specifically, lower rates of physiological schizophrenic risk factors in infants 33 days old has been noted when the dietary supplement is given during the second and third trimesters of pregnancy and early infancy.
Choline is a water-soluble essential nutrient, typically grouped within the B-complex vitamins. It can be found naturally in foods such as liver, muscle meats, fish, nuts and eggs. According to the American Institute of Medicine, pregnant women require between 450 and 3500 milligrams of choline each day and 550 to 3500 milligrams while lactating. Infants aged 0-6 months need a minimum daily dose of 125 milligrams of choline and 150 milligrams from 7-12 months of age.
“Choline is also being studied for potential benefits in liver disease, including chronic hepatitis and cirrhosis, depression, memory loss, Alzheimer's disease and dementia, and certain types of seizures.”
“Half the healthy pregnant women in this study took 3,600 milligrams of phosphatidylcholine each morning and 2,700 milligrams each evening; the other half took placebo. After delivery, their infants received 100 milligrams of phosphatidylcholine per day or placebo. Eighty-six percent of infants exposed to pre- and postnatal choline supplementation, compared to 43% of unexposed infants, inhibited the response to repeated sounds, as measured with EEG sensors placed on the baby's head during sleep.”
These results could not only assist in early detection of schizophrenia, but may even help in preventing the illness or developing more effective treatments.
Some examples of choline found in different food sources:
Type of Food | mg of choline |
5 ounces (142 g) raw beef liver | 473 |
Large hardboiled egg | 113 |
Half a pound (227 g) cod fish | 190 |
Half a pound of chicken | 150 |
Quart of milk, 1% fat | 173 |
A gram soy lecithin | 30 |
100 grams of Soybeans dry | 116 |
A pound (454 grams) of cauliflower | 177 |
A pound of spinach | 113 |
A cup of wheat germ | 202 |
Two cups (0.47 liters) firm tofu | 142 |
Two cups of cooked kidney beans | 108 |
A cup of uncooked quinoa | 119 |
A cup of uncooked amaranth | 135 |
A grapefruit | 19 |
Three cups (710 cc) cooked brown rice | 54 |
A cup (146 g) of peanuts | 77 |
A cup (143 g) of almonds | 74 |
Choline Supplementation DuringPregnancy Presents a New Approach to Schizophrenia Prevention
Choline
Saturday, 12 January 2013
Driving the Therapy Bus
College mental health work is a very rewarding profession. I feel privileged to walk alongside a young person and witness or assist their blooming into an authentic adulthood, facing fears and challenges along the way. I also feel blessed to have wonderful colleagues in student affairs who toil along with me. It is a joy to learn from them, and I like to think that I am able to assist them by interpreting and communicating the mental health needs of students, and by offering a perspective which is incorporated into campus life.
But there are also frustrations, and here's one. On one hand, campus communities are now more educated and sensitive to students in need; faculty, staff and parents now routinely spot and refer a troubled student for counseling and other services. This is a good thing. Many students have obtained assistance in just this way. On the other hand, sometimes it is the third party that wants help for students, but not the students themselves. When issues of safety are involved, this is not so much a predicament. College mental health professionals are trained to creatively find ways to provide help in that scenario, up to and including the invocation of law relating to involuntary treatment.
The frustration emerges when the student's situation falls short of this safety mark, and often very, very short. Disconcerting though it may be, students who, say, stare off into space in class may need help but one cannot force it upon them. A student in grief over the loss of a family member is deserving of attention but they do have the right to refuse it. The same is true about students who are homesick, partying too much, not doing well in class, angry at parents, not eating or sleeping well, sick of a roommate, and so on. Sometimes third parties, be they parents or university personnel, literally trip all over themselves trying to arrange for care, making multiple telephone calls, writing many an email, even visiting the campus counseling service, trying their best to shoe-horn in a student to treatment. There are occasions when days and even weeks pass while well-intentioned individuals engage in this frenetic activity. The labor involved here can really add up, for everyone. This occurs even when no one has asked the student if they would like some help. There are even times, sadly and maddeningly, when someone resorts to trickery and coercion to get a student into therapy, such as posing as a student on the phone in order to set an appointment, or threatening them with undue harsh consequences if they don't. Come on people. This last scenario is a surefire way to make a student hate me, and I don't even know them!
In quiet moments, which are few, counselors lean back and scratch their heads over these phenomena. Folks sure are anxious about something when they carry out such behavior. From past experiences they surmise this anxiety may result from fear of being blamed if something goes wrong, for lack of clairvoyance in identifying a "potential shooter" (a reflection of unfortunate times we live in), of facing the wrath of a powerful or "VIP" parent, or even a lack of skill in managing cheap bullying behavior.
Not that we don't understand these anxieties. We do. These are all too human reactions in difficult circumstances. Sometimes we may be victim to them too. But let's all raise our game a bit. It is the student who needs to drive the therapy bus, not us. Short of life and death matters, many times a problem needs to percolate for a while before someone feels motivated to get help. Humans, for the most part, don't take their hands off the stove until they feel some heat. We're just built that way, especially when we are young and not fully formed. It can be painful to watch a student twist in the wind before change happens, but this is a necessary stage many of us go through prior to our transcendence. In fact, we can contaminate the whole process by needling in it carelessly, thus unwittingly prolonging healing or enabling the continuation of disorder. I know in my heart no rational person wants this.
So, here's the deal. Tell the student about your concern. Encourage them to use resources. You can even be a benign pest by checking in with them repeatedly when you are really concerned. But, by all means communicate your respect for their autonomy and agency by allowing them room to make their own choices and to be responsible for them. This course provides the fertilizer for their continued growth, which is what we all want. Including students themselves.
But there are also frustrations, and here's one. On one hand, campus communities are now more educated and sensitive to students in need; faculty, staff and parents now routinely spot and refer a troubled student for counseling and other services. This is a good thing. Many students have obtained assistance in just this way. On the other hand, sometimes it is the third party that wants help for students, but not the students themselves. When issues of safety are involved, this is not so much a predicament. College mental health professionals are trained to creatively find ways to provide help in that scenario, up to and including the invocation of law relating to involuntary treatment.
The frustration emerges when the student's situation falls short of this safety mark, and often very, very short. Disconcerting though it may be, students who, say, stare off into space in class may need help but one cannot force it upon them. A student in grief over the loss of a family member is deserving of attention but they do have the right to refuse it. The same is true about students who are homesick, partying too much, not doing well in class, angry at parents, not eating or sleeping well, sick of a roommate, and so on. Sometimes third parties, be they parents or university personnel, literally trip all over themselves trying to arrange for care, making multiple telephone calls, writing many an email, even visiting the campus counseling service, trying their best to shoe-horn in a student to treatment. There are occasions when days and even weeks pass while well-intentioned individuals engage in this frenetic activity. The labor involved here can really add up, for everyone. This occurs even when no one has asked the student if they would like some help. There are even times, sadly and maddeningly, when someone resorts to trickery and coercion to get a student into therapy, such as posing as a student on the phone in order to set an appointment, or threatening them with undue harsh consequences if they don't. Come on people. This last scenario is a surefire way to make a student hate me, and I don't even know them!
In quiet moments, which are few, counselors lean back and scratch their heads over these phenomena. Folks sure are anxious about something when they carry out such behavior. From past experiences they surmise this anxiety may result from fear of being blamed if something goes wrong, for lack of clairvoyance in identifying a "potential shooter" (a reflection of unfortunate times we live in), of facing the wrath of a powerful or "VIP" parent, or even a lack of skill in managing cheap bullying behavior.
Not that we don't understand these anxieties. We do. These are all too human reactions in difficult circumstances. Sometimes we may be victim to them too. But let's all raise our game a bit. It is the student who needs to drive the therapy bus, not us. Short of life and death matters, many times a problem needs to percolate for a while before someone feels motivated to get help. Humans, for the most part, don't take their hands off the stove until they feel some heat. We're just built that way, especially when we are young and not fully formed. It can be painful to watch a student twist in the wind before change happens, but this is a necessary stage many of us go through prior to our transcendence. In fact, we can contaminate the whole process by needling in it carelessly, thus unwittingly prolonging healing or enabling the continuation of disorder. I know in my heart no rational person wants this.
So, here's the deal. Tell the student about your concern. Encourage them to use resources. You can even be a benign pest by checking in with them repeatedly when you are really concerned. But, by all means communicate your respect for their autonomy and agency by allowing them room to make their own choices and to be responsible for them. This course provides the fertilizer for their continued growth, which is what we all want. Including students themselves.
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