It’s already starting…..including right here on the Tucson Citizen site……..the man, Major Nadil Malik Hasan was “crazy.”  If you have read any of my blogs before, you know how important it is to me to try and create a world where people living with mental illnesses do not feel stigmatized and one of the first steps is to stop using horribly discrimating terms like “crazy” or “crazed.”  Yes, I agree that someone who goes on a rampage killing 12 people and wounding at least 31 others is not of sound mind, but why don’t we take a look at why this happened? 

If you believe, as I do, that mental illnesses are illness just like any other, than why was this man, who supposedly treated other people with brain disorders, not receiving treatment himself?  Did  anyone not notice how he was struggling?  According to the “God Blogging” post on this site, NPR interviewed others at Walter Reed who said he was. 

Which brings us back to the same problem, the same issues that continue to plague people with mental illness and their families.  Because of the stigma, because of the inattention by our health care system that doesn’t think the mind is part of one’s physical health, because of an overburdened mental healthcare system, because people suffering from a mental illness can feel isoloated and abandoned by their support structure, people with diagnosable brain disorders are falling through the cracks.  One again, as President Obama called this tragedy, “a horrific” catastrophe has occured in this country.

Who knows what was going on in Hasan’s head……Certainly listening to war stories from our returning Veterans experiencing Post Traumatic Stress Disorder was not an easy thing to do, but why is it that no one saw the signs, especially when he was set to deploy at the end of the month? Maybe Major Hasan will be able to shed some light on our questions.

There are times when we have all thought if that person would just change, if that person would just see my point of view, if that person understood me, things would be better.  We would get along better.  We would be happier; he would be happier, etc. etc.

 But a quote from Gandhi says it all – “I can’t change the world, but I can change myself.”

When you really think about it, he is right.  We have no control over how someone else is, but we do have control over how we are.  I use the present tense, because the present is also what matters.

 In the Family to Family class taught at the local non-profit, NAMI of Southern Arizona, participants are first taught about the reality of mental illness and the biological basis of mental illness.  Then everyone learns what it means to be empathetic and to put themselves in their loved ones shoes. It can be an emotional realization for some who have come to the class trying to cope with what can be a day to day struggle.  Parents feel guilty, siblings feel anger and children of adults with mental illness can feel abandoned, or worse. Emotions vary and people can feel like they are experiencing never ending grief after their relative is diagnosed. The young man who was going to go to Harvard now struggles to comprehend a story in the newspaper, the high powered attorney who successfully represented clients in the courtroom no longer has the confidence to speak in public, or as in Daniel Ayers case (the man with schizophrenia in the move “The Soloist,”) an incredibly gifted musician is living on the streets.

 A person’s journey with mental illness can be heart-breaking.  We want so much to help them, advise them, and convince them to take medications.  But, in reality all we can do is support and encourage them and remind them there is hope.  Recovery is a reality and once we convince ourselves of that and acknowledge that today is a present and tomorrow is just a dream and we can’t and shouldn’t force our relative into anything the dynamic changes.

 People living with mental illness need emotional support.  They need to feel like someone genuinely cares.  People with mental illness tend to isolate, so it is incumbent upon us, as people that want the best for them to be there for them and be a much needed friend.

 If you are interested in being a friend to someone with mental illness, NAMI of Southern Arizona also has a “buddy” program.  It is called “Heart to Heart” and it pairs a compassionate volunteer with a person who truly appreciates the value of friendship.

For more information, call the local office at 520-622-5582 or visit the website www.namisa.org

Established by Congress and now in its 19^th year, MIAW takes place the first week of October each year, and recognizes the National Alliance on Mental Illness’ (NAMI) efforts to raise mental illness awareness through early detection and accurate diagnosis and to reduce the associated stigma and create awareness though outreach, support and educational programs focused on brain disorders. 

Several activities are scheduled for the week beginning with the Daniel Moreno Recovery Award Event at Skyline Country Club on Friday, October 2nd.  It’s open to the public and tickets may be purchased for $55 per person by calling NAMI Southern Arizona at 622-5582.

Sunday, October 4th

PBS Station KUAT Channel 6 will air the first in the Fred Friendly series on mental illness called “Minds on the Edge” (www.mindsontheedge.org) about current issues in the mental health care system. It will be aired four times that day at 5am, 11am, 6pm, and 10pm.

October 6-8, 2009

10th Annual Community Mental Health Arts Show – Community Partnership of Southern Arizona – 2502 N. Dodge Blvd.         For information, call (520) 318-6994                   Website: www.cpsa-rbha.org

What are shame and guilt?
Shame and guilt are the:
* Feelings of embarrassment, blame and responsibility for negative circumstances that have befallen yourself or others.
* Feelings of regret for your real or imagined misdeeds, both past and present.
* Sense of remorse for thoughts, feelings or attitudes that were or are negative, uncomplimentary or non-accepting concerning yourself or others.
* Feelings of obligation for not pleasing, not helping or not placating another.
* Feelings of bewilderment and lack of balance for not responding to a situation in the “correct way.”
* Feelings of loss for not having done or said something to someone who is no longer available to you.
* Accepting of responsibility for someone else’s misfortune or problem because it bothers you to see that person suffer.
* Motivators to amend all real or perceived wrongs.
* Strong moral sense of right and wrong that inhibits you from choosing a “wrong” course of action.
* Driving forces or masks behind which irrational beliefs hide.

If you are a family member or loved one of someone who has a mental illness you undoubtedly have experienced one if not all of the feeling listed above.  I know I have.

When my son was first diagnosed with a serious mental illness I blamed everything from the flu I had while I was pregnant with him to the bug spray I used in the house when he was growing up.  Could it have been my parenting?   Was I too permissive or over-protective?  Did I spoil him, or not give him enough? Should I have re-married after his father died in a car accident? (one very cruel psychiatric nurse suggested that) Did I not handle the grief properly?  (Both my children went to grief counseling) What about the early signs?  Did I ignore them or was it that I was just ignorant of the symptoms?  Did I get him into treatment early enough? 

The questions can go on forever, but now I know something that anyone with a family member with a brain disorder should know……….IT IS NOT YOUR FAULT!!!  It never was and it never will be.  You certainly cannot blame yourself if mental illness runs in your family.  Yes, there is a genetic component, but who says that’s your fault?

All family members of those living with mental illness can do is support and love them.  Be encouraging, but don’t pressure.  Especially after a serious crisis……it will take your loved one time to heal – just like an injury to the physical body takes time. And, don’t feel guilty because you may have pressured  him, quarreled, or  not understood what was happening before.  Be empathetic and put yourselves in their shoes.  Imagine what it must be like to have the rug pulled out from under you and your reality.  And, then imagine what it will be like when a sense of balance returns. Your relative is in recovery and he’s able to feel your love and support and you’ve been there to assist him in his journey. 

If I’ve said it before, it needs to be repeated.  It’s important to educate yourself about mental illness.  It’s not an easy road to be on……actually it’s more like a roller coaster with the ups and downs and sometimes terrifying sense of no control.  So learn what you can and remember to take care of yourself as well!  If you are not doing well and your guilt is making you ill, you can’t be there for your loved one either. 

An article in the New York Times today motivated me to talk about housing.  A Federal Judge has ruled that the state has discriminated against people with mental illness.

http://www.nytimes.com/2009/09/09/nyregion/09mental.html

Above is the link to the New York Times article about discrimination against people with mental illness in poorly run adult “care” homes.  I put the word in quotes because I don’t think “care” is appropriate in many cases.  Evidently in New York privately run adult homes aren’t much better than many of the facilities in Tucson. The article states that the residents are essentially warehoused and in the case of New York, unlike some in  Arizona, their facilities are licensed!

My son spent less than 2 months in one 3 bedroom apartment that his provider had arranged for him.  It was a nightmare.  Without going into too many details, suffice it to say that street drugs are rampant, nutritional meals don’t exist, personal safety and privacy is not garanteed and in his case the house manager who was supposed to be on-site would disappear for days on end leaving the 6 residents to fend for themselves.

The Tucson Weekly reported in their article, “Slums or Salvation,” that the local unlicensed “necessary evils” are finally beginning to draw some attention and the Pima County Human Rights Committee are starting to make visits to some of these homes.

The annual state audit of the mental health system’s performance that was released this year found it fails nearly all of its patients on key measures.  Among other things,  placing them in stable housing is at the top of the list.  For those who have not been in jail or hospitalized for their illness, the system failed 86 percent of the time. 

And, now with budget cuts who knows how much worse this system is going to get.  For some, living on the streets may be a better choice, but a stable environment is key to mental health recovery and I’m not sure the wash under a bridge qualifies.

Every year as part of Mental Illness Awareness Week the first part of October The National Alliance on Mental Illness of Southern Arizona  sponsors the Annual Daniel Moreno Recovery Award.  This year marks the third anniversary for the event.  Daniel Moreno was living with schizophrenia before his tragic passing in December of 2005 and his family has established this recognition event in his memory.  The Recovery Awards will recognize individuals that exemplify the current reality of recovery for those who have lived with serious mental illness. 

 According to the President’s New Freedom Commission Report, the word “recovery” refers to the process in which people are able to live, work, learn, and participate fully in their communities.  For some individuals, recovery is the ability to live a fulfilling and productive life despite a disability.  For others, recovery implies the reduction or complete remission of symptoms.  The Recovery Award Event provides positive recognition of a person’s struggle, progress and of the courage needed to overcome often overwhelming adversity and stresses. Publicity surrounding the event has assisted in building awareness about brain disorders and encourages anti-stigma.

 If you know someone who fits the criteria you are encouraged to nominate the individual(s) who has courageously faced their illness and recovered.  The Award will be presented at a Reception and Silent Auction on October 2nd, 2009 at the Skyline Country Club. Tickets for the dinner event can be purchased in advance for $50.00.

 To R.S.V.P. for the event or for a Nomination Form call the office at 520 622-5582 or visit the website at www.namisa.org and submit to NAMI of Southern Arizona by September 15, 2009.  A short narrative (not to exceed 500 words) should be attached describing how the nominee(s) meets the criteria above. Points to consider include obstacles overcome, age of onset and duration, degree of improvement, ability to advocate for ones self and others as well as ability to speak publicly about his/her journey. In addition, please ask your nominee to describe in 250 words or less their recovery journey. Submit by mail, email or fax to NAMI Southern Arizona.

 The Moreno Family will make the selection by September 25th at which time the Nominators and Award Recipients will be notified.  If a nominee is not selected, please consider resubmission next year.

If you’re like me, you’re really anxious to get some rain here in the Old Pueblo. I was so excited when I saw that huge hurricane south of the Baja last week. I thought “this time we’ll definitely get some good rain.” Well, as of 4:30 pm Saturday the clouds have come and gone, come and gone, and now the skies are partly cloudy and I feel like they (the clouds) are just teasing me! What I want is a big, bank to bank, Rillito River filler! I want the news feeds on the bottom of the television screen to say, “Stay Home……heavy rain advisory, rivers and streams are overflowing, hundreds of lighting strikes, avoid downed power lines, etc.”

I don’t suffer from Seasonal Affective Disorder, a form of depression that occurs in relation to the seasons, most commonly in winter. Light therapy, one of the hallmark treatments of S.A.D. certainly isn’t needed in this case…..with almost 365 days of yearly sunshine in Tucson, we definitely don’t have the cloudy days that Seattle has! But, what I wonder is…….Is there such a thing as ” too much sunshine and not enought rain” depresssion? One of the symptoms of depression can be irritability…….hummm, I may be on to something. I JUST WISH IT WOULD RAIN!!!!

Below is the list of Seasonal Affective Disorder symptoms:
•Afternoon slumps with decreased energy and concentration
•Carbohydrate cravings
•Decreased interest in work or other activities
•Depression that starts in fall or winter
•Increased appetite with weight gain
•Increased sleep and excessive daytime sleepiness
•Lack of energy
•Slow, sluggish, lethargic movement
•Social withdrawal

Except for the depression that starts in fall or winter, seems like many of us can feel this way at the end of a long hot summer.  But, unlike people that do have this diagnosis, I think I’ll be able to get through it. Seasonal Affective Disorder is nothing to make fun of and is very serious for those living with it, but it responds well to treatment.  As for me…….I can’t wait for November!!

Did you know that 50% more people die by suicide each year than by homicide? Most experts believe that people that do complete this horrible last act don’t really want to die, they just want to end the pain they are experiencing. But, it is preventable, when suicidal risk or intent is detected, lives can be saved.

The Community Partnership of Southern Arizona, (www.cpsa-rbha.org) the regional behavioral health agency, offers classes on suicide prevention.  Obviously, depression plays a big role in someone contemplating suicide – about 2/3 of the people that complete suicide are depressed at the time of death. I believe for my son, it was most certainly his schizophrenia.  As I have said…..I believe it was the mental illness that took his life. 

Most people that do attempt or complete suicide have some sort of mental illness.  It’s an act of desperation for someone that doesn’t see the alternatives.

Individuals who are depressed and exhibit the following symptoms are at particular risk of suicide.

• Extreme hopelessnessIf you or anyone you know if thinking about suicide…..please get help.  Speaking from experience, the survivors never get over it.
• A lack of interest in activities that were previously pleasurable
• Heightened anxiety and/or panic attacks
• Insomnia
• Talk about suicide or have a prior history of attempts
• Irritability and agitation

IF YOU ARE IN CRISIS AND
NEED IMMEDIATE HELP,
please call 1-800-273-TALK (8255).

www.sostucson.org

Suicide Prevention Week is September 6th -  12th 

Any pet owner knows this already……we have all heard the saying ” a dog is man’s best friend.”  But, is it really true?

As an owner of a wonderfully perfect (in my view) mutt that is some cross of terrier, German Sheppard and who knows what else, I know that she loves me unconditionally. I know that when I’m feeling a little lonely or blue, she can make me smile  if I let her and she’ll leave me alone when I want her to. Maybe they do have some kind of sixth sense. She follows me around the house, even when I have guests and she doesn’t complain when I forget to give her her morning “treat.”  Of course, I eventually remember and apologize as I rush to the pantry to complete our morning ritual. My dog is so special, she’s even killed a scorpion or two! (we won’t talk about the birds she’s caught and brought in through her dogie door in the middle of the night.)

Studies have shown that pets absolutely have a positive impact on our mental health. They can even help to lower blood pressure and cholesterol levels! Just the act of petting your dog can have a soothing effect. Gazing at fish in an aquarium can also have a calming effect. Taking care of a horse has proven to be therapeutic……it’s just not easy to care for one in your living room! Better to get a cat…..

When my son was inpatient at the National Institutes of Mental Health his favorite part of the week was when a couple of dogs were able to visit the unit. They call it “Animal Assisted Therapy.” In the last photo I have of him he is petting a beautiful black lab – they both look very content.

Daniel (my son) had an aquatic turtle that his sister now cares for. (they can live 30 – 40 years). He used to always tell me how he related to his turtle. I thought it was a delusion, but now I know. That funny little reptile, “Thumper” is his name, does have a personality and he has brought joy to the entire family!

Pets never judge or complain. When we are sick, they know whether they should  leave us alone or snuggle up. When we’re excited, you can bet your pet is, too.

Professionally trained dogs have proven to be a wonderful support for people with physical as well as mental handicaps.

So, the next time you’re feeling blue, why not take your dog for a walk? If you don’t have one, ask your neighbor to borrow their pooch for thirty minutes. Pets are natural attitude adjusters.

 I just read an article in Psychology Today http://psychcentral.com/news/2009/08/20/physicians-avoid-mental-health-care/7875.html

It talks about a study done in the UK about doctors avoiding seeking advise for mental health issues.  A few different reasons are  cited…….most importantly were “career implications”,   ” personal integrity”  and STIGMA!”  That dirty little word that continues to pop up!  Almost half the doctors surveyed would seek informal advise, a small percentage would “self-medicate,” but almost 80% would seek inpatient treatment in either a private or distant facility rather than use the local NHS system because of the lack of confidence in the confidentiality of that system. (not, by the way, because of the quality of care)

Not having confidence in the confidentiality of the system is something that we can all relate to, but I want to talk about the impact of stigma for even those in the medical field!  According to the article doctors suffer depression and substance abuse as well as higher suicide rates than the general population.  And, these are the people that should understand that mental illnesses are  disorders of the brain………..just like diabetes can be caused by a disorder of the pancreas!

So, while we know that people do get better 80% of the time with proper treatment for brain disorders, even people that understand how medical  treatment can help someone may shy away from it.

I can’t wait for the new season of “House” on the Fox Network.  At the end of last season, Dr. House  checked himself into a psychiatric facility without telling any one. In the real world I’m sure he would be feeling stigmatized.  It will be interesting to see how it’s handled and if that dirty little word is addressed in any of the episodes. 

My sense is there are many medical doctors out there that are successfully living with mental illness……I know of a few, but don’t tell anyone!