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Mental Health Prevention, Education, Recovery

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1 Mental Health Prevention, Education, Recovery
The Association for Natural Psychology For Behavioral Health Services, Mental Health Professionals and Facilities 

2 Like tuning a violin… All photos in this presentation, with the exception of selected books, are courtesy of . Violin Head " by nuchylee

3 The brain is a delicate instrument
"Human Brain" by ddpavumba

4 Scope of mental health disorders in U.S. population
26.2% of U.S. population - approximately 1 in 4 According to the National Institute of Mental Health (NIMH), at any given year, An estimated 26.2 percent of Americans ages 18 and older — about one in four adults — suffer from a diagnosable mental disorder.1  When applied to the 2004 U.S. Census residential population estimate for ages 18 and older, this figure translates to 57.7 million people. 2  57.7 million people in U.S. The Numbers Count: Mental Disorders in America. National Institute of Mental Health (NIMH). Silhouette guys walking" by sattva

5 Serious Mental Illness
6 percent, or 1 in 17 — suffer from a serious mental illness.1 The leading cause of disability in the U.S. and Canada.3  Many suffer from more than one mental disorder at a given time. Nearly half (45 percent) of those with any mental disorder meet criteria for 2 or more disorders, with severity strongly related to comorbidity.1 The Numbers Count: Mental Disorders in America. National Institute of Mental Health (NIMH). "Human Pyramid" by digitalartt

6 The first part of this presentation is to demonstrate that
Education of the client/patient Self help Lifestyle changes Developing Coping Skills Bibliotherapy Prevention are key elements of success for long-term recovery. Section I Which can include bibliotherapy

7 Sections I - IV Part I Education, self help, lifestyle changes, developing coping skills, bibliotherapy, prevention – 54 slides Part II Models of Mental Health – 11 slides Part III Issues with Psychiatric Drugs – 19 slides Part IV Psychiatric Facilities and Professional Approaches Towards Reduced Emphasis on Pharmaceuticals – 9 slides

8 Lifestyle adjustments can positively affect mental health and that these need to be taught to the client/patient -synopsis Section I Education of the client/patient Self help Lifestyle changes Developing Coping Skills Bibliotherapy Prevention

9 Developing coping skills -synopsis
is an important element to prevent relapse and to improve mental health outcomes. Section I Education of the client/patient Self help Lifestyle changes Developing coping skills Bibliotherapy Prevention e.g. Journaling

10 Self Help, Education and Bibliotherapy - read a book
Self Help, Education and Bibliotherapy - read a book! In the UK, British mental health professionals prescribe “Bibliotherapy” for their patients. Patients are required to read up on their mental health disorders, learn about causes, practical measures and self help. Some mental health professionals in the U.S. also prescribe bibliotherapy. “A growing number of therapists are recommending something surprising for depressed and anxious patients: Read a book. The treatment is called bibliotherapy, and it is gaining force from a spate of research showing that some self-help books can measurably improve mental health. In May alone, the journal Behaviour Research and Therapy published two studies demonstrating the effectiveness of bibliotherapy in patients with depression or other mood disorders. The national health system in Britain this year is prescribing self-help books for tens of thousands of people seeking medical attention for mood disorders.” Kevin Helliker. Bibliotherapy: Reading Your Way To Mental Health. (2007). Wall Street Journal.

11 Education is one of the keys to learning how to recover from mental health disorders, both serious and less serious disorders. This can lead to… Lifestyle changes Developing coping skills Lifestyle changes and developing coping skills are essential elements of successful recovery. Attention to good nutrition and journaling are examples of 1). lifestyle changes – good nutrition and 2). Developing coping skills – journaling. Journaling Good nutrition

12 Mental Health America, a mainstream U. S
Mental Health America, a mainstream U.S. activist mental health non-profit recommends 9 strategies for better mental health 6. Keep a journal 7. Watch your negative self-talk 8. Get involved with spiritual activities 9. Write down 3 good things that happen to you each week. Connect with others Relax your mind Exercise Get enough rest

13 Focus on: Nutrition To select one area of lifestyle change – Nutrition
Many who suffer from a broad arena of mental health difficulties and disorders, including sleep disorders, depression and bipolar disorder, as well as serious mental health disorders such as symptoms associated with schizophrenia, do well to give serious consideration to nutrition. Poor nutrition can precipitate Major Depression and other mental disorders, and positive lifestyle changes can make a big difference towards improvement in mental health.

14 Exercise Lifestyle change and coping skill
Clinical studies indicate that exercise can be more effective than antidepressants for mild to moderate depression. (Duke University). Study: Exercise Has Long-Lasting Effects on Depression. September 22, Duke Today, (Duke University). Other studies and observational evidence indicate that exercise can be effective for Major Depression. See Keith Johnsgard’s book (right), Conquering Depression & Anxiety Through Exercise.

15 Exercise for Depression
Harvard Mental Health Newsletter and Mayo Clinic similarly recommend exercise for depression. "Feet Of Runner In Evening Light" by Sura Nualpradid Exercise and Depression. August 3, Harvard Mental Health Letter. Depression (Major Depression) - Depression and anxiety: Exercise eases symptoms. (2011, October 1). Mayo Clinic.

16 Exercise can positively affect mental health of individuals with bipolar disorder
Dr. Gary Sachs, Director of the Bipolar Clinic and Research Program, Massachusetts General Hospital in Boston states that both exercise and lifestyle play a significant role in recover from bipolar disorder, though these are underutilized. How Can Exercise Or Lifestyle Help Bipolar Disorder? April 29, I ABC News. Interview with Gary Sachs, M.D., Director, Gary Sachs, M.D. Massachusetts General Hospital in Boston

17 Bipolar Disorder is proven to benefit from lifestyle changes.
Stanford University psychiatrist and professor Wes Burgess, M.D., Ph.D. notes that persons with bipolar disorder can experience up to a 30% decrease in symptoms by giving attention to… diet nutrition There is a high correlation between alcohol, past or present, abuse and bipolar disorder. New lifestyles need to be implemented for many. exercise quitting smoking abstaining from alcohol (from The Bipolar Handbook Wes Burgess, M.D., Ph.D.)

18 Answer to problems of bipolar disorder Gary Sachs, M. D
Answer to problems of bipolar disorder Gary Sachs, M.D., Director, Bipolar Clinic and Research Program, Massachusetts General Hospital “The answer to the problems that bipolar disorder causes are not all medication-related. A healthy lifestyle, adopting an exercise program, not only helps regulate your circadian rhythms but can help you reach your life goals.” “It's extremely important to set out for yourself a purpose in life apart from managing your symptoms - to use lifestyle interventions to help regulate your sleep and wake cycles, your diet, and promote wellness by adopting a healthy lifestyle.”

19 Recovery, Remission and Self-Help for Bipolar Disorder
Dr. Liz Miller is an occupational health physician in UK, with a background in neurosurgery. She developed mood mapping as a result of her own diagnosis of bipolar disorder, and her struggles to overcome it. Mood Mapping is one method of self help whereby individuals can gain insight and make needed adjustments.

20 “Cured of bipolar disorder”
"I consider myself cured of bipolar, [ Bipolar 1 ] which I had for ten years, including three mental health sections and industrial quantities of psychiatric medication. I have been completely well for the last twelve years and not taken so much as an aspirin. I am certain that nothing can happen to bring it back again. I know I will never be manic or seriously depressed again. I see these conditions as nothing more than states of mind, which I have learnt to manage..."  (quoted w/permission from Dr. Miller). U.K. Neurosurgeon Dr. Liz Miller

21 Bipolar Disorder I or II are not necessarily lifetime disorders and some do fully recover to see their disorder go into permanent remission. Dr. Miller’s experience is not unique. This idea is supported by clinical psychologist and university professor of psychology, Donald J. Kiesler, PhD, as well as by mental health service providers in Quebec, Canada. Similar experiences verify that Bipolar Disorder I and II are not necessarily lifetime disorders.

22 Television and Depression
Television may cause or contribute to depression in some individuals. American psychologist in Britain, Aric Sigman, links a television lifestyle with higher rates of depression. This is a reasonable conclusion, as the passive nature of television lends itself well to a depressed state.

23 ½ hour of watching television can contribute to depression for some who may be pre-disposed towards depression Life Coach, author and relationship expert Mel Robbins states that only ½ hour of television makes her feel depressed. When television is a lifestyle, then both the passivity, as well as the depressing nature of the news and some news magazine programs, can contribute to depression in individuals. For some women, soap opera or novella addiction might contribute towards depression, as they never can attain to the level of relationships developed in this fantasy world. Life Coach and media personality Mel Robbins

24 Living Without the Screen
For some, perhaps many, with mental health disorders, the lifestyle advocated by sociologist Marina Kromar is more conducive to good mental health. For those with any mental health disorder, the Association for Natural Psychology recommends a completely or relatively “screen-free” lifestyle, especially during the first six months to one year of recovery.

25 Pornography and Mental Health Disorders
Pornography addiction and/or excessive masturbation might also be a factor in depression or bipolar disorder for some. The absence of emotional bonding with daily sexual stimulation can create a vacuum of loneliness which leads to depression or emotional, behavioral, or psychological instability. Real relationship might become more difficult to manage in view of solitary sexual stimulation. University of Texas study links female masturbation to depression. Sexual Functioning and Self-Reported Depressive Symptoms Among College Women. Penny Frolich, Cindy Meston, University of Texas, Austin (2003)

26 Self-Help Overcoming Pornography Addiction
University of Texas at Dallas How would you know if your pornography use is harmful to you? The use feels like it is out of your control. You make unsuccessful efforts to quit or limit your use. Your use of pornography is incompatible with your beliefs and values. You feel guilt, shame, depression, and/or remorse after using pornography. (it/bold added) Ideas for Changing Pornography Usage Change routines and environments that lead to pornography usage. Avoid high risk situations. Make a list of the positive and negative consequences of using versus not using pornography. Spend less time alone. Review the status of your friendships and relationships. Are they meaningful and satisfying? If not, what would make them more fulfilling? Learn new ways of coping with strong feelings like anxiety, loneliness, anger, depression, and boredom. Identify activities that can help you relax, enjoy yourself, and feel refreshed. The following self-help web resources…

27 Psychotherapy, Talk and Cognitive Behavioral Therapy
Various psychological therapies can also be as effective as psychiatric drugs in the short and long-term for many. Therapy" by Ambro courtesy of

28 Cognitive Behavioral Therapy as Self-Help
Cognitive behavioral therapy can be employed as a self-help tool and mental health strategy. Learning to recognize and correct common faulty reasoning or cognitive errors can help some out of depression, including depression associated with bipolar disorder. There are many books similar to this self-help book.

29 Coaching Life Coaching can be helpful for many high-functioning adults experiencing mental health difficulties or disorders. Coaching for ADHD is totally mainstream and well-developed, supported by professional organizations. Coaching for mental health, with its emphasis on practicality and sticking to treatment plans and goals, is an excellent tool which some have found as effective or even “more effective” than therapy. Coaching for Bipolar Disorder, is not as well- developed, however, there are experienced coaches who specialize in bipolar disorder, who have helped many towards the goal of managing bipolar disorder, and some to full recovery.

30 Coaching for Bipolar Disorder
“I see it as my job to help balance the individual and encourage him to change some of his habits. For instance if he isn’t exercising or sleeping properly, I focus on those core habits then work on fine tuning other habits. I find people with bipolar disorder inherently unbalanced. I have to teach it to them.” Bipolar disorder coach, specialist, Bradley Foster.

31 Art as a Professional Therapy and as Self Help
Professional Art Therapy can be a form of therapy that is very effective for many individuals for a wide variety of mental health disorders. It can help people to open up when they might be reticent. Art as self help can be very effective for most psychiatric disorders. It soothes the mind, helps individuals recover from stress trauma and is a natural aid for anxiety. Creating art can contribute to feelings of self worth and self esteem, as well as to inner peace.

32 Art Therapy is not an alternative treatment
Art therapists are board licensed, and therefore art therapy is not an alternative, but mainstream psychological treatment. Art Therapy Photo: Creative Commons license

33 Art as self help for mental health disorders or difficulties
In Brazil, a Rio De Janeiran middle aged woman went to her doctor for help with anxiety. Rather than prescribe drugs, he encouraged her to take up art. She began taking lessons, and discovered she had a hidden talent. The art helped to relieve the stress and anxiety she was experiencing, and to get through a particularly difficult period of time in her life. She was 50 years old when she took up art. These are some of her works.

34 Music, Music Therapy and Mental Health
Music can have a positive influence on mental health when the music is positive, individuals listen to music moderately. A wide variety of music can have positive affect on mood. Stevie Wonder, as an example, is known for quite a bit of positive, catchy music. More recently, Alicia Keys has some popular positive music.

35 Music Therapy can be effective when administered in clinical settings or in outpatient settings.
From: American Music Therapy Association, Inc. How Does Music Therapy Make a Difference for Persons with Mental Health Needs? Music therapy is an efficacious and valid treatment for persons who have psychosocial, affective, cognitive and communicative needs. Research results and clinical experiences attest to the viability of music therapy even in those who are resistive to other treatment approaches. Music is a form of sensory stimulation that provokes responses due to the familiarity, predictability and feelings of security associated with it. Music therapy for clients with mental health concerns uses musical interaction as a means of communication and expression. The aim of therapy is to help individuals develop relationships and address issues they may not be able to address using words alone. Music therapy sessions include the use of active music making, music listening, and discussion.

36 Type of music is a factor
A Netherlands study indicates that the type of music adolescents choose can affect behavior. Some behaviors are symptoms of mental health disorders. Indirectly, then, type of music can be a factor contributing to a mental health diagnosis or label. Early Adolescent Music Preferences and Minor Delinquency. (2012, October 1). Tom F.M. ter Bogt, PhD, Loes Keijsers, PhDb, Wim H.J. Meeus, PhD. Pediatrics. Choices in Music

37 When music is Too intense Negative
Or the listener listens to immoderate amounts of music It can contribute to depression, destabilization, anger problems, symptoms associated with bipolar disorder and other mental health difficulties. Early Adolescent Music Preferences and Minor Delinquency. Tom F.M. ter Bogt, PhD, Loes Keijsers, PhD, Wim H.J. Meeus, PhD. Oct 1, Pediatrics. Bizkit - Break Stuff

38 Influence of Type of Music on Mood and Behaviors
The study states: “early fans of different types of rock (eg, rock, heavy metal, gothic, punk), African American music (rhythm and blues, hip-hop), and electronic dance music (trance, techno/hardhouse) showed elevated minor delinquency concurrently and longitudinally. Preferring conventional pop (chart pop) or highbrow music (classic music, jazz), in contrast, was not related to or was negatively related to minor delinquency.” Rock Heavy Metal Gothic Punk R & B Hip-Hop Electronic dance Because musical taste often follows into one’s adult years, the emotions and behaviors acquired or influenced by certain types of music, for some, can be a factor in mental health disorders as adults or young adults (18 and older).

39 Natural Prozac Clinical psychologist Joel Robertson establishes such a connection with music and depression, where the positive and negative effects of music on the listener are highlighted.

40 Amount of Time Listening to Popular Music Correlated with Major Depressive Disorder
Time Listening to Popular Music Correlated with Major Depression - Major Depressive Disorder (MDD) - in Adolescents - Researchers at the University of Pittsburgh concluded that there is a correlation between Major Depression and the amount of time an adolescent spends with popular music. Conversely, Major Depression is negatively, or reversely correlated with reading print media such as books. Though the study focused on adolescents, there are many adults, especially those 18 through 25, for whom this might also be true. Using Ecological Momentary Assessment to Determine Media Use by Individuals With and Without Major Depressive Disorder. April 04, 2011. Brian A. Primack, MD, EdM, MS; Jennifer S. Silk, PhD; Christian R. DeLozier, BS; William G. Shadel, PhD; Francesca R. Dillman Carpentier, PhD; Ronald E. Dahl, MD; Galen E. Switzer, PhD. JAMA Pediatrics. Constant artificial stimulation is exciting. But when the music turns off, there can be a corresponding low.

41 Positive adjustments in music
Making adjustments in music habits from intense to less intense. and listening to music in moderate amounts rather than constantly – allowing for quiet time w/o external stimulation. And by choosing positive rather than negative, anti-social, dark or angry music. "Shouting Woman Listening Music" by imagerymajestic "Piano" by healingdream

42 As noted, the brain is a delicate instrument
In the same way a little bit of sand can ruin a car’s engine, there are many external factors which can cause the brain to malfunction or not perform optimally. "Human Brain" by ddpavumba "Close Up Of Car Engine" by Stoonn“ Psychedelic Guitar" by dan

43 Sensory Overload The Manual of Nursing Diagnosis lists “sensory overload” as a real condition, where “environmental stimuli” is above normal levels. This can resulting in… Decreased cognitive capability Reduction in reasoning ability Sleep disturbances, nightmares Disorientation Short attention span Decreased stress tolerance Restlessness Fatigue Increased anxiety Irritability Loss of control

44 Mental overstimulation through excessive media channels such as
Movies Television Music can be adjusted to more moderate levels, or even therapeutic levels, and this can have a positive mental health affect. However, the client/patient needs to be taught new life habits or adjust their lifestyle outside the clinical setting in order to benefit from a lifestyle that is more conducive to better mental health. “Front View Of Screaming Young Woman Listening Music" by imagerymajestic "Satellite Dish" by renjith krishnan

45 Thoughts do not originate with chemistry but with electrical charges.
Thoughts are sparked through electrical, rather than chemical charges. It is only after the fact, between the synapses of the neurons, from thoughts already originating electrically, that the gap between synapses is crossed by chemical impulses in the form of neurotransmitters. The source of the errant thinking must be considered, the brain chemistry is often an after-fact, or may have a source that is controllable or modifiable. Mental disorders then, might more appropriately be referred to in terms of electro-chemical rather than as chemical imbalances. Neuron" by renjith krishnan

46 Addressing faulty thinking and external stimuli, we come closer to the source.
By addressing thought and mood at its source, the electrical charge, rather than concentrating on the chemical neurotransmitter, we come closer to the source of faulty thinking, mental health or mood disorder. Image, Synapse, courtesy of Synapse Sheelam Ohan Some professionals consider referring to mental health disorders as a “chemical imbalance,” as inaccurate.

47 Differentiating between cause and effect
There are some 23 different types of neurotransmitters in the brain. Thoughts start with electrical impulses that run through the individual neuron, nerve or, in this case, brain cell. The gap between neurons is referred to as the synapse. The electrical signal is converted to a chemical signal, as it bridges the synapse. The thought is then converted back into an electrical signal as it runs through the next neuron. The process is repeated through millions of neurons, to complete the thought, and possibly action of the body. The most well-known neurotransmitters are serotonin and dopamine.. Effect Depression, chemical imbalance of neurotransmitters

48 SSRI antidepressants SSRI antidepressants block the reuptake of serotonin into the nerve cell, by “plugging up” reabsorption points or “holes,” thus leaving more serotonin in the gap between the neurons.

49 Cognitive Behavioral Therapy
Is more successful in treating depression and other mental health disorders for some people, because it addresses depression at the cause, and targets faulty thinking. It is assumed that the faulty thinking causes the depression, or causes the ultimate chemical imbalance of neurotransmitters, and that the chemical imbalance is not the ultimate cause of the depression. The positive affect, then, can be more long-term, as thinking and associated behaviors are corrected or adjusted. Cause Faulty thinking Effect Depression, chemical imbalance of neurotransmitters

50 Pharmaceutical drugs address symptoms rather than causes of mental health disorders
To illustrate: You can provide medicine to individuals with malaria, and they will experience relief. However, the cause of the malaria is not a blood or organ imbalance, but a parasite. The parasite is transmitted by a mosquito. By killing the mosquitoes, you are closer to the source of the problem. Mosquito In Nature" by SweetCrisis

51 Cause Effect Model of Malaria
Proliferation of mosquitoes infected w/parasites Cause Stagnant waters Effect/Cause Proliferation of infected mosquitoes Effect Spread of malaria

52 Prevention in Mental Health
By removing sources of stagnant water, you address the cause, and have come closer to a permanent solution for the mosquito problem which is leading to proliferation of mosquitoes, which contribute to widespread malaria. It is similar with mental health. Prevention is an important element of both health, and mental health. Stagnant Water Photo by Evelyn Simak

53 Cause and Effect, continued
Controllable biological causes of depression Cause Poor nutrition Skipping meals such as breakfast and lunch Effect Poorly nourished brain Effect Depression Cause Need for exercise Effect Shortage of certain neurotransmitters Effect Depression

54 Naturally and gently adjusting brain chemistry
In Natural Prozac, clinical psychologist Joel Robertson suggests numerous natural ways to adjust the brain chemistry at the source level, the causal level. This includes nutrition, exercise, as well as by adjusting the level of stimulus through controllable environmental stimuli, such as music input type, intensity and amount.

55 Green Therapy Regular periods of time spent with nature has positive affect on: Depression ADHD Bipolar Disorder OCD Other mental health disorders A Potential Natural Treatment for Attention-Deficit/Hyperactivity Disorder: Evidence From a National Study. Frances E. Kuo, PhD, and Andrea Faber Taylor, PhD Exercise and Depression. (Retrieved August 3, 2009). Harvard Mental Health Letter. Mind Launches Green Agenda for Mental Health. Ecotherapy vs. retail therapy. (2007). From Heliq database:

56 Sleep Mayo Clinic states: “If you have chronic insomnia, a better
Rather than classifying problems with sleep or a sleep disorder as a symptom of a larger disorder, such as bipolar disorder, Addressing the issue itself provides a more practical way of dealing with issues having to do with sleep. Mayo Clinic states: “If you have chronic insomnia, a better approach may be to remove the cause by changing your lifestyle.”

57 Sleep Sleep can be like the head pin, when addressed, negate other symptoms that are caused by the issues dealing with sleep. For example, better sleep results in: -better focus -less anger -less irritability -mood stability -better judgment Woman Asleep" by Danilo Rizzuti Bowling" by Salvatore Vuono

58 Addressing sleep issues
Is an example of how focusing on solving the problem rather than assigning a label results in a better solution towards improvement in mental health. "Sleepless And Thoughtful" by David Castillo Dominici

59 Positive Lifestyle Changes
can result in lasting improvement in mental health and can remedy symptoms of even very serious mental health disorders. Awareness Incentive Education Self-Monitoring can provide impetus for positive lifestyle changes and a long-term solution.

60 Counseling and help with practical areas of life such as
Handling finances Debt Self-sufficiency and Employment are also of importance for stability and good mental health.

61 Studies indicate that Spirituality
can positively affect mental health and even physical health. “Across all five [major] faiths, a greater degree of spirituality was related to better mental health, specifically lower levels of neuroticism and greater extraversion.” In this study, “forgiveness” was the spiritual trait most predictive of good mental health, after personality variables were considered. Science Daily. Aug 20, Referring to University of Missouri researchers’ clinical study. Man Keep His Hands On Head" by photostock

62 Rest and Relaxation, Balance
For some, taking a break from a hectic schedule, daily, restful vacation periods, and developing more balance can be preventive and therapeutic in terms of mental health disorders and good mental health.

63 Character Development Developing qualities such as
Integrity Honesty High ethics Contributes to good mental health. Someone in the habit of lying to escape consequences or criticism, for example, can create mental battles with in his or her own, adding to anxiety, stress and depression. A minister noted, “There is no pillow so soft as a clean conscience.” "Pointing Truth On Blackboard" by Stuart Miles -

64 Giving and receiving of love is an important element of good mental health
Love has been described as “the best prescription. Social factors can play a major role in mental health. Love is a universal psychological need. "Smiling Teenage Girls" by Ambro

65 Models of Mental Health
Part II Models of Mental Health

66 Medical Model The modern “medical model” of psychiatry with emphasis on genetics and biology stresses… Identifying mental health disorders with a label which matches a list of symptoms. 2. Prescribing pharmaceutical drugs deemed appropriate for that specific mental health disorder.

67 Psychiatric Labeling Child psychiatrist Scott Shannon, who sometimes uses psychiatric medication in his treatment of children, states that he often finds he gets better results by addressing the specific issues and problems of the individual child, rather than assigning a label. The result is that fewer children need to be prescribed a psychiatric drug, and more are helped to recovery and stability. The same approach can be beneficial in addressing mental health disorders with adults.

68 Other viable models of mental health include
Urie Bronfenbrenner's Bioecological Model Engel’s Biopsychosocial Model Zubin’s Vulnerability-Stress Model Positive Psychology (Penn State) Strengths Model Aspects of these models provide a more complete foundation on which to build, as opposed to the medical model, with its emphasis on genetics and non-controllable biological functions with corresponding pharmaceutical treatment.

69 Engel’s Biopsychosocial Model
Engel’s biopsychosocial model of mental health, as an example, places equal emphasis on Biological Psychological Social factors "Open Mind" by Idea got

70 Biological Factors not, and are controllable.
Some biological factors may be genetic, what can be referred to as a “genetic predisposition,” but some are not, and are controllable. e.g. Diet, including three balanced, healthful meals a day, is both behavioral, biological and modifiable. It can also have psychological roots, when individuals do not eat regular meals out of fear of weight gain, or from anxiety rooted in social isolation. Obviously, we can’t do anything about our genetics, but we can do something about our diet. "Fresh Vegetable Salad" by dusky

71 Psychological Factors of mental health disorders
One individual, male, who suffered from seasonal debilitating depression experienced permanent relief after talking to a minister, openly, for the first time, about child abuse he experienced in his formative years. "Dad Scolding His Son" by David Castillo Dominici

72 Social Factors Verbal or emotional abuse Isolation
Marital discord, for example, a social factor, may result in anxiety or depression. Family therapy of marital counseling, then, can provide a more permanent and practical solution to what, in this case, is really a symptom, depression. Verbal or emotional abuse Isolation Need for emotionally-bonding relationships Need for fulfilling secular work or More fulfilling life purpose "Young Couple" by imagerymajestic

73 Loneliness Can precipitate depression as another example. There can be practical solutions for the problem of loneliness. "Sad Woman Sitting Alone In Room" by FrameAngel

74 A “Multi-Causal” Approach to Mental Health Disorders
Clinical psychologist and university professor of psychology, Donald J. Kiesler, PhD, develops the theme that the “biological” or “medical model” of mental health needs to be abandoned, in favor of a “multi-causal” approach, which includes both biological, social and psychological factors, logically developing this idea in the book, Beyond the Disease Model of Mental Disorders.

75 Psychiatric facilities should consider
Placing less emphasis on the medical model of mental health and pharmaceutical treatments And more emphasis on helping the client/patient to develop skills, work through problems and develop better lifestyles which are more conducive to mental health. While genetics cannot be controlled Lifestyle can be controlled

76 Issues with Psychiatric Drugs
Part III Issues with Psychiatric Drugs

77 Issues with Psychiatric Drugs While there are potential many “issues” with psychiatric drugs, this section touches on only three: Side Effects Risks Drug Cocktails

78 Side Effects One of the most common complaints about pharmaceutical drugs prescribed for mental health disorders is side effects, some of which can be serious.

79 Serious Side Effects All prescription drugs prescribed for psychiatric disorders have side effects. Some of these range from “not feeling myself” to lethargy and fatigue, sleepiness and sleeping long hours, being unable to work, to a host of other side effects, including some which can be life threatening in the long-term, such as diabetes from pharmaceuticals prescribed for bipolar disorder.

80 There are benefits vs. risks in the decision to take psychiatric drugs

81 Antidepressants example of risks vs benefits
“Many of the two-thirds of those with depression who do not respond fully to antidepressants are three times more likely to improve with cognitive behavioral therapy, the researchers report.” MedLine Plus. 2012 Antidepressants example of risks vs benefits Carry benefits and risks Benefits: Can help relieve depression in 33% to 50% of individuals who take antidepressants. Risks: 1). Do not provide relief for up to 50% to 67% of those who take antidepressants. (Medline Plus. Dec 7, 2012). 2). Can cause sexual dysfunction in up to 70% who take antidepressants (most common reason for discontinuation). (Primary Psychiatry). 3). Antidepressants can stop working in a short or long period of time. (Mayo Clinic). 4). Can double risk of suicidal ideation from 2% to 4%, among certain age groups (under 25 years old). 5). Can contribute to development of bipolar disorder in some individuals. (University of Maryland. 2011)

82 SSRI Antidepressants examples of risks
1. SSRI antidepressants, for example, can result in a greater propensity (double, from 2% to 4%) towards suicidal ideation for certain age groups (under 25 years of age). For this reason, the FDA requires black box warnings on most SSRIs clearly stating this risk. (BMJ Group. 2009). 2. Antidepressants also can result in sexual dysfunction, with up to 70% of those who take them. Many quit taking antidepressants as a result. (Primary Psychiatry. 2003) 3. Antidepressant use can contribute to the development of bipolar disorder. (University of Maryland. 2011) “Many studies indicate that antidepressants may cause patients to “switch” to a manic state. Any patient with bipolar disorder who takes antidepressants and who develops symptoms of hypomania should stop taking these drugs, because hypomania is often a sign of impending mania.” University of Maryland Medical Center

83 SSRI Antidepressants and Sexual Dysfunction – 59% (Mean age 40 – 1,022 surveyed. Primary Psychiatry – Peer reviewed). “Because antidepressant-associated sexual dysfunction is considerably underestimated by physicians, greater recognition and education are imperative when prescribing antidepressant treatment.” Prevalence of sexual dysfunction among newer antidepressants. Clayton AH, Pradko JF, Croft HA, Montano CB, Leadbetter RA, Bolden-Watson C, Bass KI, Donahue RM, Jamerson BD, Metz A. Department of Psychiatric Medicine, University of Virginia. Journal of Clinical Psychiatry Apr;63(4): “Sexual dysfunction can adversely affect quality of life, self-esteem, and interpersonal relationships. These effects are of particular concern among patients with depression, in whom these issues may already be compromised. Moreover, antidepressant-associated sexual dysfunction may lead to medication noncompliance and premature discontinuation and thereby may increase the risk of relapse or recurrence of depression.10,11 In an open-label study of 1,022 patients with a mean 40 years of age, 59.1% reported antidepressant-associated sexual dysfunction  Montejo AL, Llorca G, Izquierdo JA, et al. Incidence of sexual dysfunction associated with antidepressant agents: a prospective multicenter study of 1022 outpatients. J Clin Psychiatry.2001;62(suppl 3):10-21. Sexual dysfunction can contribute to marital problems, further exacerbating causes of depression or other mental health disorders.

84 Suicide risk is lessened with intervention
Standard treatment involves use of antidepressants. However, intervention and support in itself, may be the greatest reason for lessened risk of suicide, rather than use of psychiatric drugs, for many. In other words, not all positive affect of mental health treatment is attributable to medication. There are usually many other interventions taking place at the same time.

85 Patients should be Fully Informed
Psychiatric patients should be fully informed of the benefits vs. risks, both long and short-term, of specific psychiatric drugs as well as those of non-drug complementary or optional treatments. A realistic view of psychiatric drugs needs to be communicated between mental health professionals and patients, rather than an idealistic view. Self-determination is not a challenge to the psychiatric establishment, but is a right of each individual, a core human right. vs Illustrations by Stuart Miles

86 Vigorous marketing by pharmaceutical corporations
In Blaming the Brain, by Michigan State University professor of psychology, Elliot Valenstein, PhD, evidence is provided that the current emphasis on prescribing psychiatric drugs, is, in part, due to vigorous and continuous marketing on many levels, from pharmaceutical corporations, from the 1960s through the present. Marketing practices are sometimes unethical or misleading. Big Pharma by Jacky Law. Creative Commons License

87 Drug Cocktails Drug cocktails, when a patient is prescribed 3 to 10 different types of medications, can leave a person largely incapacitated and feeling groggy most of the day. Photo: RayNata – Creative Commons

88 Effects of “Drug Cocktails”
One middle aged woman who had been diagnosed with bipolar disorder, found herself on a vigorous drug regimen within several years of her diagnosis. She was prescribed 9 different drugs to the point that she began to lose her memory and coherence. Her husband said, “I am losing my wife,” not due to the mental illness, but due to the serious side effects of the “drug cocktails” that she was being prescribed. He felt constrained by his health insurance to pursue other options.

89 Drunk or “high” on psychiatric drugs
Some have said that they “feel drunk” on pharmaceutical drug treatments. One who was treated in a psychiatric facility in Newark, NJ stated that the psychiatric drugs made him “high”. "Girl Drinking Wine" by Dundee Photographics –

90 Side Effects and Complications from psychiatric drug treatment warrant
1. Education of the client/patient and their family 2. Freedom of choice in treatment and 3. Vigorous attention to effective non-pharmaceutical approaches This presentation does not provide details on all of the serious side effects or deleterious effects of psychiatric medications, which are researchable, but side effects are serious enough to warrant freedom of choice in treatment, and vigorous attention to effective non-pharmaceutical approaches. Sleeping Businessman At His Desk" by imagerymajesti

91 Two Doctors Two Approaches
A man comes to the doctor with a back problem. One doctor recommends Surgery The other doctor recommends a less invasive measure involving exercise and massage before considering surgery. Surgery photo courtesy of arztsamui. Fitness Men Stretches His Leg" by photostock - Free Digital

92 The less invasive measure works
Within 6 weeks the back problem has largely been relieved and surgery is avoided (true experience) Back Pose Of Male Doing Exercise" by imagerymajestic- Free Digital

93 Similar with mental health
By focusing on non-pharmaceutical solutions involving positive lifestyle adjustments, developing coping skills, developing social relationships and practical areas of life, the “more invasive” pharmaceutical approach can often be circumvented. A better long-term outcome is the result. A better short-term outcome often often results as well. “Teach Skills Not Pills”

94 Part IV Psychiatric Facilities and Professional Approaches Towards Reduced Emphasis on Pharmaceuticals

95 Gaining Autonomy with Medication (GAM)
In Quebec Canada this movement, (GAM), in association with mainstream psychiatric services, is giving adults with mental health disorders a measure of self-determination over their treatment, with good results. Many in the program have recovered from their serious mental health disorders and have been able to manage their mental health disorder without medication, or experience their mental health disorder go into remission. Regroupement des ressources alternatives em sante mentale du Quebec

96 Some patients desire to reduce or eliminate their psychiatric drug regimen.
As an example, using this method, one professional with bipolar disorder was able to successfully cut back her lithium dosage to a non-therapeutic level, about 1/3 of the dosage recommended by her doctor, and remain stable. Thus, it eliminated many of the greivious side effects she was experiencing. Against her doctor’s advice, but she insisted. Telephone conversation, January Sacramento, CA. Taking Back Control (GAM method). Acknowledging that some may feel totally comfortable with their current psychiatric drug treatment, and do not wish to make any changes, others might strongly desire to cut down on, and others may desire to cut out completely taking psychiatric drugs. All three personal choices are valid and possible.

97 Others with Bipolar I, Bipolar II and Schizophrenia
Have reduced Or come off completely psychiatric drugs maintaining stability and good mental health, according to the lead social worker of the Quebec GAM program. Taking Back Control: My Self Management Guide to Psychiatric Drugs is used as a guide in this process.

98 The book Taking back control: My Self management Guide to Psychiatric Medication, used in conjunction with Gaining Autonomy with Medication (GAM) serves as a balanced guidebook for those who wish to reduce the amount of psychiatric medication they are on, or who wish to try to cut out psychiatric medication from their treatment. It is being used successfully and safely by adjunctive professional mental health service providers in Quebec in conjunction with mainstream psychiatric treatment.

99 This publication was funded by the Quebec Ministry of Health and Social Services (MSSS)

100 Benefits. Better Quality of Life. Greater Short-Term Success
Benefits * Better Quality of Life * Greater Short-Term Success * Better Long-Term Outcomes * Lower Relapse Rate Professional mental health facilities which address the issues discussed in this presentation such as is being accomplished in the Quebec, Canada mental health system, are of value and in the patient’s best interests, contributing to a better quality of life for the client and their family. Mother And Children" by photostock

101 Medical needs associated with psychiatric drugs that psychiatric hospitals can address
Some need to safely detoxify from prescription drug over-prescription. Many who have addressed core issues contributing to a mental health disorders would like to try coming off psychiatric drugs, but are afraid to.

102 Cutting down on and coming off psychiatric drugs
While most psychiatric hospitals are designed to prescribe treatment, professional facilities are also needed to assist some to cut down, manage or come off of treatment, in a balanced and professional, orderly and safe way.

103 Effective Mental Health Treatment includes
Self help Lifestyle changes Developing Coping Skills Education Bibliotherapy Prevention

104 Recovery and education
Patients/clients should be aware that there are balanced and helpful sites and books, which provide suggestions and resources that can help many to improve, and some to fully recover from a wide range of mental health difficulties and disorders.

105 Good Self Help Resources
There are many excellent self help resources online for depression and bipolar disorder, as well many excellent self help books. Depression and Bipolar Support Alliance This is one that has good information on Healthy Lifestyles, including reducing stress, though the organization is geared towards typical medical model treatment and theory.

106 Self help webpages, sites
The AYCNP features pages on self help for depression, bipolar disorder and other mental health disorders.

107 HELPGUIDE.ORG Has excellent information on effective
bipolar disorder self-help

108 Books from the Association for Natural Psychology

109 Thank you for considering this information
The Association for Natural Psychology is pleased to provide you with a small library of self help books for your staff and patients.

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