mental health ISSUE 2
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He who has hope, has everything Arabian Proverb
a look inside ISSUE 2 5
topics featured in this issue 6 8 16 18 34 38 61 62 72 82 90 62 107 116
Welcome, from the Editor How we view mental health at BMH Mag Postnatal depression explained Keir Wells on personal worth and value Recreational drugs could help veterans Post-Traumatic Stress Disorder Suicide quick reference and links Worried about everything with GAD Anxiety Disorders explained Communities for refugee mental health Losing lives to stigma in migrant groups A snapshot of bipolar disorder Common Signs of Stress Waiting for procrastination
real people and real lives 5 22 38 40 52 66 96 108 112
Motherhood and postnatal depression Surviving childhood abuse with PTSD Anne Peterson shares her poetry Caring for Alzheimerâ&#x20AC;&#x2122;s Disease Living with physical and mental illness Managing the fear of flying The daily art project with Missy Douglas Melanieâ&#x20AC;&#x2122;s approach to mental health Changing habits to reduce stress
improve wellbeing every day 30 48 65 74 102
Writing for trauma recovery Sleepy facts across the globe The impact of anxiety on the body Eating well for mental health Health risks of the pursuit of happiness
82 40 66 better
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Better Mental Health Magazine Issue 2 5 February 2015 ISSN: 2204-1966 (print) ISSN: 2204-1974 (online) Better Mental Health Magazine is published by Aporia Media Pty Ltd, PO Box 1579, Strawberry Hills, NSW 2012, Australia. While every effort has been made to ensure that the information in this magazine is accurate and up to date, it should not take the place of medical advice from your doctors or other medical professionals. The purpose of this magazine is to offer information of a general nature. This may or may not apply to you or your situation. The publishers believe all material in this magazine to be correct at the time of publication. They cannot, however, provide guarantee of this and do not accept liability in the event of any information later proven to be inaccurate. Personal submissions do not necessarily reflect the opinions of the publishers. This magazine is copyright. No part may be reproduced by any process without written consent of the publishes, other than any fair dealings for the purpose of private study, research, criticism or review, as permitted under the Copyright Act. Magazine design concept by Cyan Loves Magenta BMH Mag App developed by GGA Digital Australia. Subscriptions available through http://www.bmhmag.com Copyright © Aporia Media 2015 ACN: 154 564 100 contact, engage and share with us through: w: www.bmhmag.com e: email@example.com fb: facebook.com/bmhmag g+: google.com/+bmhmag tw: twitter.com/bmhmag p: pintrest.com/bmhmag li: linkedin.com/company/bmhmag
the editorial Hello, and welcome to Issue 2 of Better Mental Health Magazine. This has been an exciting issue. The original concept for the magazine was for “themed” issues. These themes included particular disorders, grief or family – all sorts of things. We thought we should have a section of “feature” articles, about a mental illness topic, then related “wellness” topics and “personal” experiences. We used some of this well-defined (and traditional magazine) layout in Issue 1. But the more we worked on it, the more we realised that mental health just doesn’t fit neatly into a box. As more contributions came in, we had difficulty placing them those boxes. Like the symptoms of a disorder, an article touched on multiple topics. Like wellbeing practices, an article could relate to several of our carefully defined themed issues. Then we spoke with some of the Issue 1 readers. The feedback was that the mix of content – Issue 1 was always intended to be a broad stroke across multiple aspects of mental health – made the magazine more widely appealing. There was something for everyone. And we were told that the articles lead by personal experience with some supporting information were the more interesting. And then there are the submissions. We received a wonderfully touching account of mental health and told the contributor that it would have to wait until next October as it fit that theme well. We could hear her disappointing in a single sigh. She had bared her soul, collected all the courage she
had, and sent us her life story and was then told she’d have to wait until if fit our plan. We took a step back (caught our need for order and control) and realised that a more fluid approach was far more important. The contributors need to lead the content. It’s your lived experiences that help other understand mental health far better than any brochure or textbook. It’s the shared stories of the difficult experiences and the positive thoughts that make a difference. These encourage people to talk about their mental health, to seek greater understanding of mental illness and to believe that mental wellbeing is not only possible for everyone but a right. Topics around mental health can be challenging. We decided not to cover certain topics (such as politics, faith, or suicide), to ensure we don’t offend or upset anyone. That hard-line lasted for one issue; each of them is brushed against in Issue 2. I believe we’ve done so in context and respectfully. The magazine is not a soapbox, but when a topic relating to mental health is important and highlights particular aspects that need to be covered, they need to be covered.
having “face-to-face” conversations. Seeing the people behind the initial ‘I’d like to share my story’ email has been a wonderful experience. I’m incredibly grateful for the kind words I receive about the magazine. But it’s our readers and contributors, all of you who believe in better mental health, in reducing the stigma, in sharing often incredibly personal accounts (sometimes for the first time), who deserve thanks and appreciation. It has been, and continues to be, an amazingly moving experience every day. This issue introduces Keir Wells, a grassroots mental health advocate working with youth. He has joined the magazine as a regular contributor. So, we welcome Keir to the team and look forward to reading his insights. Thank you, all of you, our readers and contributors, for being such an important part of Better Mental Health Magazine. We exist because of you.
Taking that step back and looking at it, we’re pleased with the result. We like the look of Issue 2, and hope you do too. Please let us know what you think of the format, the contents, and what we could do better or differently. While putting this Issue together, I spoke with many of the contributors for future issues. I’ve spent several late nights and early mornings, grappling with international time zones and technology,
BMH Mag’s Mental Health what mental health means to us Mental health is a broad topic that can mean different things to different people. Our own understanding or context will impact what it means to each of us. At BMH Mag, it covers the topics of mental illness, mental health and mental wellbeing. Mental Illness includes the diagnosable disorders. We use the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the ICD-10 Classification of Mental and Behavioural Disorders for reference – sometimes one, sometimes both. Mental illnesses are the things that we’re trying to help people understand to reduce the stigma. These include disorders such as depression, bipolar, obsessive compulsive. They have been clinically defined. When we talk about Mental Health, we mean those things that affect everyone’s ability to thrive mentally, especially in the face of difficult events.
Having good mental health is the equivalent of staying fit and exercising regularly so that we can get through our day as best as possible. It includes topics such as resilience and mindfulness. We also include Mental Wellbeing which, for some, may be the same as mental health. For us, we use mental wellbeing to include all things that give us an overall, holistic, better body and mind to improve our mental health or reduce the impact of mental illness. Mental wellbeing means eating well, sleeping better, exercising, keeping our body healthy to ensure it can keep our brain – and our mind – performing well for a long as possible Better Mental Health Magazine is about all three. You may not have a disorder, but someone you know probably does. You might want to improve your general outlook and care about how you deal with stress or grief or trauma or just that annoying neighbour! You might want to ensure you keep your entire body and mind healthy. Your interest could be because you care about your family or friends or colleagues. We can’t include every mental health related topic in every issue, but we try to cover a broad range. Whatever your interest, Illness, Health, Wellbeing, we’ll try to cover it.
Mental Health Warnings
and why we don’t include them
Like many other topics, mental health media coverage is governed by a number of voluntary codes of practice. These include how mental health should be presented, the use of certain terms, the way to refer to conditions or people and the recommendation to include contact numbers for services, particularly help lines. Most countries have one, sometimes more, codes of practice with somewhat similar guidelines. While we support these guidelines, and add our own, we decided not to include “warnings” in each article. The entire magazine is about mental health. It is not a glossy fashion, news or entertainment magazine with a random article about an unfortunate or inspirational life event. To include references to the relevant services for all international readers would make little sense and add no value. Listing all services for all countries would be a magazine in itself.
In very practical terms, we considered that if a person is at an extreme point and needs immediate support, they probably won’t be picking up a magazine for a light but informative read. If we’re wrong, and you are considering harming yourself or someone else, or are in danger of being harmed, then stop reading now and contact your local support line, medical practitioner or emergency services. Where practical, or where it exists, we try to include a website that has a comprehensive list of support organisations or groups for a particular topic. This is not always possible. We hope you understand our decision to take this approach. If you have any questions or concerns, please contact us at firstname.lastname@example.org. Luke Myers Editor, BMH Magazine
Safety First If at any time you are concerned about your safety or wellbeing, or that of your children, a friend, or a loved one… you NEED help and assistance. Your first point of call is to phone your local emergency number. You can also call your local hospital and ask to speak with the Psychiatric Team. Often, this will open the door for an individual or family receiving help, support and understanding. It’s not about “getting locked into a system”. Rather, try to think of it as “unlocking” what may be a very difficult and scary situation. Receiving help will shift things. Remember: NO-ONE deserves to be in an unsafe situation.
Meeting my dark side on the mothering path Carlie Daley Nekrasov shares her early years as a new mother and her struggle with postnatal depression at a time when she expected to be at her happiest
Carlie Daley is a writer and mother of two living in the hills of Melbourne, Australia, trying to make sense of it all through words. She is currently working on a junior fiction story about a magical forest and a girl with synaesthesia. She has had fiction pieces published in a Swedish online journal, Frostwriting, and in various Australian anthologies. Writing has been her way to understand her life's journey. She believes it must be an adventure full of messy love and good coffee. better
‘Luna just threw up chicken and milk all over me. I can’t remember a day when I was bored. Life is full of vomit and love.’ Carlie Daley Nekrasov Facebook status update, June 2013 This is one of the many posts I have written about my children on social media for I am a timeline mama. The one who jubilantly pins photos of her children crafting in cute outfits. Who celebrates developmental milestones via uploads to Facebook. Who edits her life with children via photo selections that make her life appear more perfect and cute than it really is.
Months and years of little sleep took me to the edges of sanity and the darkest corners of my psyche. How to thrive along with the little people? Venus, the morning star, has been my constant companion as my feet hit the planks each day. I have coiled up inside my bed, pillows held desperately about my head, to stop the wails of my children.
Yet for all this disclosure, raw honesty rarely makes an appearance. In truth I have never dared to share the very darkest parts of my mothering journey in this sphere and I know few mothers who have. I often wonder how it would make our days less dark if we did share the dark as well as the light. If we started a revolution of raw and messy truth to balance out the way in which we glamorise parts of our personal lives to the world.
They have been chronically sleepless at times and sleep training failed to make a difference. Sometimes I banged my first angrily against the walls and swore at the injustice, cursed a god I didn’t believe in and felt the guilt bubble up to the surface soon after.
Like many parents, I have been on a roller coaster of emotions since my first born arrived via vacuum extraction. And five years, on I have no shortage of dark confessions to make. As I clocked up the sleepless nights, facial wrinkles bloomed like cracks on an icy lake.
Middle of the night feeds sometimes included lots of cursing in the dark of the night. Not at my children, but at the world itself. Sleep deprivation unhinged me, brought out my lowest self, made me see double, burnt my eyelids, caused me to despair of my life even if was essentially fantastic. The lingering financial insecurity sparked by the loss of my partner’s job 4 months after my son was born compounded it all. It was these factors
I witnessed a slow motion car crash of my own identity that created an ideal petri dish for postnatal depression and parenting despair during the early years. In parenting, my ideals collided with the worst parts of myself. I witnessed a slow motion car crash of my own identity. For a long time I kept ideals of myself vaulted in the ashes, refusing to let them go. A trophy vision, I was a beaming mother, who kept her own needs pushed down to endlessly serve her little people. Calm, giving and nurturing, I needed nothing for myself. I crafted contentedly all day and when disciplining I gave clear, explanations for why they couldnâ&#x20AC;&#x2122;t walk out onto roads or punch their baby sister in the face. This perfect fossil of a dream was my nemesis. It taunted me, as I fell dangerously short of this vision. Yelling about the house, in a rare moment after an extended solo parenting stint
punctuated by a string of sleepless nights, I held my sonâ&#x20AC;&#x2122;s arms tightly pushing him into the bed to enforce a time-out after he had thrown an object at my face. My teeth gritted together, neck tight, poised for aggression. Somehow I released him and avoided the next step from the first visceral impulse to lashing out physically, lathering him with kisses and hugs to make him believe he was safe. But, at times, only just. During my time as mother, I have scraped up against this aggressive side of me. This she-devil unleashed after my womb sprouted life. It left my ego and soul bruised and played on my mind repeatedly. FAILURE. It flashed above me in neon lights. It taunted me cruelly. Failing at motherhood loomed so viciously above me at times, I felt paralysed by the very thought of it. In the early days, I felt desperately overwhelmed. One sticky afternoon in the subtropics of Northern NSW in Australia I found myself passed out in our car in a bowling club carpark,
people vomit splayed all over my shirt, spittle congealing around my mouth as I slept away the few precious hours I had to myself away from my kids. I was spiritually, physically and mentally annihilated. Wrecked by five years of no sleep. Desperate to recapture a sense of adventure, of freedom, of autonomy that had been my modus operandi in my 20s. I felt like I was channelling Bukowski but there was no booze involved. Alcohol was risky business considering most days I felt hung-over. Instead I slept,
The first time I experienced postnatal depression was truly frightening the subtropical sun pounding down in the later afternoon, sweat plastering off my forehead, elderly men pulling up beside me to begin their afternoon drinking session. I didn’t even care if my spit dribbled all over my chin, such was my lack of shame. As I drifted in and out of sleep, I half nodded accordingly through my half unwound window to those old men that pulled up and away. All I cared about was falling in a heap, away from the screams of toddlers and babies. The blessed peace of this bowling club car park situated near a winding river had become my sanctuary. Sleep had become involuntary, something I slipped into as often and for as long as I could. One night, after months of not sleeping
since giving birth, I scratched my arm so hard in frustration I bear a scar to this day that I can trace with my fingers. The truth is, in these early years I often felt so ill and so ill-equipped to care for my kids and myself. I understood the essence of why people abandoned their children, although I couldn’t understand how people actually followed through with it. I was love locked as I adored my high-energy rascals, yet their sleeping habits and insatiable needs frequently left me feeling deeply inadequate as a mother. Truthfully I ached for them with all I had. I loved them wildly, ferociously, I cared about their wellbeing far more than my own. Perhaps if I had cared just a fraction less, if I had kept a sense of humour about it all just a little more, I would have been a softer mum. I would have had less to rage against when the vision of my own mamahood was foiled. It’s a raw, messy love affair having children. Easily the most intense kind of love you will ever experience. A procession of first moments watching shape-shifting clouds, velvet-skinned kisses, singing silly made-up songs together and the delicious sensuality of their impossibly soft skin. It’s so physical; the cuddles, the screaming, the bodily fluids. I witnessed many of my children’s first moments: an absolute privilege to see a young child blow bubbles for the first time or take their first wobbly steps into the world. To sleep with a newborn’s soft face up against your own skin. To hear them utter their first word tentatively. My son’s was ‘car, car’
and I remember my supreme pride and joy as he formed those words looking up at me for validation. While the joys are immense, I had to wrestle with so many demons to savour them. The first time I experienced postnatal depression was truly frightening, I thought death was knocking on my door after not sleeping properly for a whole month. The second time I wandered back into its badlands, its grip on me had loosened, feeling more like a shitty boyfriend I had returned to out of familiarity, but it still sucked. Throughout both these stints with postnatal depression I travelled to the centre of my own darkness. Kissed its lips and struck its face in disgust.
I felt so constrained by the cult of perfection
How to move into a kind of instinctive mothering where prescriptive scripts of how we should love, what we should say, how much of this or that they should eat terrorised our every move. I felt so constrained by the cult of perfection that loomed above me, and I often felt any disclosure of how dark I felt some days was such a deep taboo. I remained afraid and ashamed of revealing to myself and others my mothering shadow side and thereby utterly isolated.
I desperately needed advice on how to foster self-love and self-care at a time when I felt I was failing the most important job in my whole life. For in loving ourselves we love better, where self-kindness and care was wrought, happy babies would be.
After an accumulation of meltdowns, I experienced a breakthrough, a kind of satori. I knew in essence that surrender was my only option. That after meeting my dark side on this mothering path, self-compassion, selfforgiveness and self-kindness would be my only way through it. I couldn’t go around it, over or under it – I had to go through it. Otherwise my sense of inadequacy would pervade all the blissful, wonderful moments I had with my children. I had to forgive myself for harsh words, harsh actions at times as long as they were only a mere small per cent of my total mothering experience. I had to know that even if I wasn’t the gentle, selfless mother I aspired to be that the immense love I felt for my children would come up trumps.
Everywhere was the glamorisation of earth mothering and attachment
Well into my son’s second year I got the help that would see me exercise
There were books about mindfulness and Buddhism and motherhood that I loved but none of them truly spoke to me or helped me face and accept my demons, and most of them were child centric. Nowhere did I read something on Facebook or in parenting books that came close to how I was feeling on my dark days in the grip of this mother shock.
parenting and I felt mums were now existing behind a new curtain of guilt. We were enslaved by the pressure to be everything for our kids and the village setting described by attachment devotees was frequently hard to access.
I emerged from my hole of depression, anxiety and inadequacy more self-compassion, self-forgiveness and self-kindness. I found my saviour in therapy based on ancient mindfulness practices. This kind of therapy speaks of clean and dirty discomfort, suggesting that secondary emotions often do the most harm – not even the shameful action itself but the endless cycles of guilt. When I became crabby with my kids and husband, when I would yell, it would be my endless ruminations of this afterwards that would really kill my effectiveness as a mother. This mindfulness approach resonated with me strongly and helped me make peace with my negative emotions. After seeking help and embracing my
life as it was, I emerged from my hole of depression, anxiety and inadequacy to a place of acceptance and mindfulness. I had to let go of what I knew of myself, my children, my life. Whatever your therapy or belief system, getting the most out of the mothering experience only comes with acceptance. Life forces us to accept and integrate the darkness or grow bitter. Only then will the cracks of light start pouring through again. I learnt this the hard way. It took me many sleepless nights and crazy days forcing myself into a mould I could not fill. Now, with a two year old and a five year old, my overwhelming sense is supreme gratitude and a marvelling at the miracle of their sheer existence. It will always be tumultuous, dark and light at times, but I don’t fight the hard bits so much anymore. I also enjoy posting pictures of my chaotic house on Instagram and status updates that get to the guts of the visceral, raw journey that is parenting.
“There is no coming to consciousness without pain. People will do anything, no matter how absurd, in order to avoid facing their own Soul. One does not become enlightened by imagining figures of light, but by making the darkness conscious.” C.G. Jung.
th e w o rst t ime at t he best time Postnatal Depression is a depressive illness which can affect around 1 in 7 new mothers. It is sometimes also referred t as postparnum or puerperal depression. The DSM-5 and ICD-10 place postnatal depression within the category for other depressive conditions. The symptoms and treatments are typicallly also the same as other depression. The distinction is made becuase it (usually) occurs within weeks of childbirth. To be considered postparnum depression, the symptons would last at least two weeks. Symptoms of postnatal depression include feeling deep sadness or depression, irritability, tiredness, sleeplessness, appetite changes. social withdrawal, feelings of guilt over not loving the baby enough, low libido. Any, or all, of these might seem like typical responses to being a new mother. And they are. “This is an illness that takes away a women’s ability to access joy ... right at the time she needs it most” Dr. Katherine Wisner, director of Women’s Behavioral Healthcare at Western Psychiatric Institution and Clinic at the University of Pittsburgh
An estimated 10 – 15% of new mothers experience depression, feeling their worst at what should be one of the happiest times in a mother’s life. Many new mothers experience the baby blues, a milder level of similar symptoms. However, this should only occur for about two weeks. In fewer cases (around 1 in 1,000), a mother may exerience more severe symptoms of postparnum psychosis. This is a separate disorder and not depression. It is a serious condition and will not go away by itself. While the causes are not certain, it’s more common where a disorder was pre-existing – but not necessarily diagnosed previously. Many women don’t discuss it. A recent survey found that of the 26% of new mothers who experienced postnatal depression only 42% sought treatments. It can, but doesn’t have to, impact the mother-child relationship. As with any other condition, if you, or someone you know, is not feeling or acting well, speak up and seek the support that’s available. If you have any concerns, always speak to your doctor or neonatal nurse other community support. If you’re unsure, talk to your doctor, who will refer you to available services. For more information, visit Postpartum Support International at
Worth and Value “What do you love doing more than anything else?” By Keir Wells, regular contributor
“I have reactive depression, severe anxiety disorder, borderline personality disorder, skizophrenia and parapsychosis. I have been raped, beaten, kidnapped, the works and I’m still here...thank you so much for talking to me today, it means alot, I cant remember the last time somebody told me they believe in me.”
“Yeah, that’d be Jess” Those words are just part of a much longer SMS I received in November last year from a 16 year old girl. She was one of a group of young people with whom I met during one of my mental illness awareness and acceptance speaking tours of rural/regional Australia. She, like all the others in the group, attended an independent learning centre. Their shared goal was to gain the education that had eluded them in a traditional school environment. With the exception of only a few, all those young people admitted to having being
diagnosed with some form(s) of mental illness. At school they had been the ‘psychos’, ‘tards’ and general misfits. Their worth and value were little in comparison to those of their fellow students who were better able to deal with the day-to-day pressures of life and school. But Jess can sing. As I had sat down in the room where we were to gather, I heard singing coming from one of the rooms down a hallway. After we had spoken for quite a while I asked the group whose voice it was I had heard. “Yeah, that’d be Jess,” volunteered one of them.
It took just a little bit of encouragement, but Jess eventually started singing; and it was one of the most beautiful voices I have ever heard. We all sat there totally entranced as Jess gave voice to a particularly moving song. It was truly amazing and I believe - hope that it will stay with me forever. She confessed to us that her goal in life was to be a professional singer and that she had put forward her name to audition for a talent show in Sydney. I asked all the young people in turn what they felt made them unique. What it was in their lives that
particularly excited and motivated them. It was an elevating and revealing exercise. Within that group of mentally ill misfits was: • regional basketball championship player who aspires to be in the professional league; • a particularly beautiful and stylish young lady who has ambitions to become a model; • a very shy boy whose knowledge of modern history staggered me; • ...well, the list goes on. Without exception, every single one of those young people has skill, passion and drive that demonstrates so clearly their worth and value in society. When I challenged them to imagine any other group that could be drawn at random from the community and demonstrate such an incredible range of talents, they seemed proud of themselves; and so they should. I received the SMS from Jess as I made the 100 kilometre drive to my next speaking engagement. As I sat in a park in the centre of a small country town, reading that message I marvelled at her obvious strength. Despite everything she has endured, her commitment to realising her own value and worth remains an inspiration.
“I feel so meaningless” In another town during that same tour, I met Susan. She is 21 years old and the massively long scars of self-harm on her arms and legs will be with her forever. Throughout my presentation she had sat with her carer, listening quietly yet with her head bowed slightly. Half-way through the open forum part of the presentation, Susan tentatively raised her hand and spoke. I did something a professional speaker isn’t really meant to do - I walked off the stage and gave her a hug. After the event I had a short chat with Susan and asked about what she enjoyed doing in her spare time. She pulled out her smartphone and showed me some of her poetry and art. They were wonderful. Several days later after I had returned home, she sent me a link to a video she had placed on the internet. It was a video she had recorded herself singing. Like Jess, she sang beautifully. Susan doesn’t have a job. She lives on a pension and receives personal support from governmentfunded carers. She confided in me recently by email that “...I feel so meaningless.” Despite her talents as a singer, artist and poet, she believed herself to be meaningless. I couldn’t help but think of the times when a person’s value and worth
featur e were not measured solely by position in society, their job, house and bank balance. They were measured also by their innate skills and commitment. Their personal worth and value. One simple question We can delude ourselves into thinking that we have become a compassionate society. One in which those with mental illness are fully accepted. But it is a delusion right now. For Jess, Susan and far too many others, there is no celebrity
status on which they can stand. First and foremost they are still widely recognised as mentally ill. Yet we all, without exception and despite mental health conditions, have value and worth in society. For those of us with mental illness, that value and worth is often hidden. In many cases, though, unlocking the passion and drive, requires one simple question to be asked: “What do you love doing more than anything else?”
“What do you love doing more than anything else?”
Keir Wells is a mental illness awareness and acceptance speaker and writer. He has carried manicdepression (never call him bipolar) since childhood and speaks openly of his lived experiences. He can be contacted by email: email@example.com or via his website: www.wells.com.au
a war without guns Anne Peterson, author, poet and public speaker shares her very personal account as a survivor of childhood physical abuse. She has overcome many experiences of loss and grief and lives with Post Traumatic Stress Disorder
I freeze. Tears run down my reddened face. I have to get out of here. PTSD. Post Traumatic Stress Disorder. It’s funny how real struggles can be reduced to letters. Remember the television show, Quantum Leap? One moment Samuel Beckett would be living his regular life, when in an instant he was thrust to another time and place either in the past or the future. A place he didn’t choose. That’s kind of what PTSD is like. Except when buttons better
get pressed your mind travels back in time while your body stays here. When PTSD first came on the scene it was associated with wartime soldiers and the horrific things they experienced. I’m here to tell you there are different wars. Some wars are fought without guns. People will often tell others, “Forget your past.” And some people are able to do that. Those with PTSD try to, but their past keeps finding them. And then holds on tight.
Looking Back Having grown up in an abusive home, my radar is always on. We never knew what would happen next as children. Who would get it. Our older brother Gus was often the first target when Dad slipped off his belt. It was brutal. The rest of us cringed in our rooms, knowing we were next.
people We’d plead, “Dad stop.” “Put your hands down or you’re gonna get it even worse!” he’d yell. And when we lowered our hands from our faces, we still got it.
Haircuts I hated when Dad cut my brothers’ hair. Towering over them, he’d slap them if they moved the tiniest bit. “Stupid idiot! I said don’t move!” If the electric trimmer cut too close, their flinching earned them another slap. I don’t remember one tearless haircut. As far as my buttons. Well, most of them are tied to authority. No surprise there. I grew up scared to death. A stern look was enough to make me crumple up. Add a belt and you get the picture. I spent most of my life afraid and when I left home, my memories of abuse followed. Even years after my Dad’s death, buttons still get pressed.
Authority still equals fear Rushing to an appointment I forgot the speed limit on Main Street had been lowered. The police didn’t. Seeing the flashing lights in my rearview mirror I froze. As the officer approached my car, No longer was I an adult who takes responsibility for her mistakes. Instead I was a little girl who knew she was in trouble. And trouble meant pain. Hearing the fine would be $200.00, my tears were unstoppable.
My day in court Then came my court date, an opportunity to explain my actions, maybe get a lesser fine. I had to try. I sat on the edge of my seat waiting for my turn. I was on high alert. I scrutinized each person’s actions as they were called, so I knew what to do.
Hearing my name, I shot up like a bullet. The man in the suit talked too fast, or was I hearing in slow motion? After a few questions, he directed me to a clerk to pay my fine. What happened to seeing a judge? I couldn’t ask, my words were being held hostage in my mind. And I couldn’t risk looking stupid. Not anymore. I paid the fine with money earmarked for my electric bill. Once inside my car, tears cascaded down my face. Asking about Driving Safety Class, I decided to take it. Maybe it would lower my fine. But though I wasn’t sure, I couldn’t ask because... Well you know why.
Driving class A week later I drove to the driving class, held at the community college. Though I never received directions, I assumed it would be easy to find. Looking at the five buildings I started shaking inside. Walking through the empty hall of the first building I remembered being tardy to grammar school as a little girl. My heart started beating faster. Not now. I need to stay in the present. A kind gentleman in the parking lot made a call and located my class. Running inside, I said to a woman behind the counter, “I need to get to room 101. I’m here for the Driving class.” “No,” she stated, “It’s already started, you can’t go in.” “Can’t I just talk to the instructor?” I pleaded. “No,” she repeated. “But if you like, you can sign up here for another class. But you’ll have to pay again.” Smiling weakly, I thanked her and left. Maybe my Dad was right, maybe I was stupid. Once in my car, more tears. I drove home defeated. I had wasted not only my energy but also more money.
Uncertain days People who live with PTSD never know what their days will be like because they never know when those buttons will go off. better
people I once asked a counselor, “Can I stop the buttons from going off?” “No,” he explained. “But you can learn how to deal with them more effectively. So I watch what I tell myself: You’re gonna be okay.
Just relax. Before I knew about PTSD, I wondered why things affected me in such a big way? I discovered the more powerless, the younger I was when I was traumatized. I’m thankful for the help I’ve received through the years. Thankful for greater understanding about something that used to cripple me. That still tries to. There is help for people who suffer with PTSD. And you can learn to self-soothe. That makes all the difference in the world. The next time you see someone dissolve in tears. Be patient. The truth is, you never know what buttons just went off. You just never know.
Reflections My mirror not my image, my image still, not me. But my reflection is the one! that you reflect,
Isolation Every day I took another step back and then I wondered where everyone went.
Wrong You thought that I forgave you from all the things you heard, For I recited things I knew, but didn’t mean a word. Inside my heart I stuffed my pain; I did it all along, You thought that I forgave you; but I’m afraid, you’re wrong.
Angry Tears I wasn’t one to fight at all I couldn’t do it well And when I did get angry I couldn’t even yell The anger lived inside me All locked away for years The only way it got away Was through my many tears.
Regret in the quiet of the night thoughts awaken me screaming what I should have done beating up on me.
Identity Would you step a little closer just to let me see, my own reflection in your eyes To see there is a me?
Anne Peterson is well acquainted with grief and PTSD, having sustained multiple losses in her life in addition to suffering physical abuse as a child. Anne is a poet, speaker, a published author of four books and 42 published Bible Studies and 27 articles with christianbiblestudies.com/ Today’s Christian Woman. Her poetry is available 23 countries, and gift stores throughout the U.S. Her favorite title is still “Grandma”. To find out more about Anne you can visit her at: w:www.annepeterson.com f:www.facebook.com/annepetersonwrites t: https://twitter.com/annepeterson g:plus.google.com/+AnnePeterson/ p:http://www.pinterest.com/annepeterson2/
The Healing Power of Writing Jan Marquart, lcsw , cas , and
author discusses the benefits of writing creatively as part of the process of healing from trauma
Most of us have experienced some type of trauma in our lives. We no longer hold the paradigm that experiencing trauma is a shell-shock experience limited to war veterans. Trauma is an experience that fragments the self so that the individual must struggle to find a way to cope with internal changes that have been altered because of it. Clients ask me why it is so difficult to heal from trauma. I tell them this: when we experience something good that we enjoy our internal energy is flowing. Perhaps we are laughing and smiling and breathing easily. When we experience something shocking, unwanted, or life-changing, our nervous system tightens, our breath becomes extremely shallow and our bodies are trying to clamp shut as a means to physically protect as from external harm. When our nervous system clamps down on the energy, like a camera snapping a picture, it has been captured by our nervous system. We need a way to allow the energy to flow again. So the first thing the body needs to do is get the physical impact of trauma discharged. Then it needs to engage its consciousness and transform the pain and suffering experience through some act of creative expression. We cannot ‘get rid’ of trauma. We cannot ‘get rid’ of any experience. As creative beings we must use trauma to create something else with it.
Writing is a powerful and effective way to transform trauma into healing. Anything artistic will work but here is why I find writing an amazing tool: we can each do it. No one needs to know how to paint or mold clay. If you went to school, you already know how to put words on a piece of paper. Those words are from our inner voice and it is the inner voice that speaks experiences that our outer voices may not touch as deeply. When we write we are silent and an listen to the internal voice that is screaming at the top of our lungs. There is a six-step writing process that has proven to be successful. I have used these steps with people suffering from trauma around the world. I have used it myself. Here are the steps: 1. write what happened, 2. write how you experienced what happened, 3. describe the wound, externally and internally, 4. how does this wound effect your life, 5. what is your healing vision, and 6. what steps do you need to take to create this vision. These steps have varied components to them that take you deeper into your traumatic experience. I recommend that you have help through this process
because it will surface what needs to be discharged and transformed. You might think that an enormous amount of writing must take place to change from fragmented to whole but that is not the case. Most writing pieces have been no more than five doublespaced pages but there must be an honest and brutal telling of the details. Once people have written on the sixth step there is no going back to the person before the trauma. No one can go back to the past. Instead, they have become new, transformed, a combination of experiences now imbedded with wisdom, realizations, enlightenments, and necessary changes. Don’t we all want to evolve in such ways and don’t we all gain wisdom through our experiences no matter what they are? Aren’t those who have suffered greatly and found a way to overcome and heal offer the most to the world?
Jan Marquart has been a psychotherapist for the last thirty plus years. She has written daily since 1972 and used the power of writing to heal and triumph over great obstacles both in her own life and those of her clients.
Jan has also written 11 books, had articles, stories, essays, poems published continuing to learn from the power of the written voice. One of Jan’s books is a basic primer for writing and healing titled, Write to Heal, which can be purchased at http://www.JanMarquart.com
Working with Wo r k b o o k s While the act of writing can certainly have therapeutic benefits for many people, it’s not always the best approach for everyone. For some people, the mere thought of putting pen to a blank sheet of paper can be daunting – even for seasoned writers.
The workbook opens into a double page on a particular topic. The left side is a brief description of the topic and the right side asks specific questions for you to answer. We found it to be a very simple and straightforward approach to journaling.
An alternative is the use of workbooks. These have defined sections, instructions and guidance on making notes about specific topics. They can be a great starting point before moving onto further creative endeavours.
Even for those not in recovery, it would still be a useful tool for putting life into perspective. Questions such as ‘What are two things you do in your life that have meaning for you?’, seem easy enough, until you stop to take the time for honest self-reflection.
We had a look at the The Better Days Recovery Workbook, by Craig Lewis. Craig designed the workbook based on his personal experience of recovery. His is an incredibly interesting story, which we hope to include in a future issue.
The workbook is 8½" X 11", 82 pages and published by Better Days Recovery Press. For more information or to buy a copy, visit: http://www.betterdaysrecovery.com
The Battle of PTSD Medication Veterans may be losing the Post-Traumatic Stress Disorder battle, but psychedelic reinforcements may be coming. MDMA may offer an alternative treatment for those with PTSD. By Kevin Sterne
Even though they are back home, many of the bravest men and women are still fighting an enemy as formidable as any terrorist or foreign army. Over twenty US military veterans commit suicide every day according to the Department of Veterans Affairs, and, in many instances, combatrelated Post-Traumatic Stress Disorder (PTSD) is at the heart of the problem. “It [PTSD] takes over your life. The anxiety, the obsession, you’re not doing it on purpose — you just have this irrational fear that makes no sense,” said Don Place, a 64 year-old Vietnam Veteran from Durant Iowa, better
takes over “ It [PTSD] your life ” who has suffered from PTSD since he was twenty. What’s most disturbing is the lack of medical breakthroughs available to the people coping with these demons. “I’m not aware of any new methods for treating individuals,” said Christine Daniels, a Clinical Nurse Specialist for Presence Saint Joseph Medical Center in Joliet, Illinois. She has worked with PTSD patients for 25 years yet admits she follows no protocol — a familiar story for veterans like Place. “They point-blank told me and my dad that there was nothing they
Essentially, MDMA may open what Burge calls a “window of tolerance” in patients undergoing psychotherapy, and hold it open long enough for them to pass through.
could do with me,” Place recalled of his experience as a returning soldier after the war, “so I started drinking to overcome the nightmares, the anxiety.” That was in 1969. As of 2008, nearly half the veterans with PTSD did not bother seeking any treatment; for those that did, only half of them received what a RAND study called, “minimally adequate.” Only recently have researchers began testing alternative treatments. At the forefront is the Multidisciplinary Association for Psychedelic Studies (MAPS), which has focused its research on Methylenedioxymethamphetamine (MDMA, or the street drug Ecstasy), and early trials have proved fairly successful in long-term follow-ups. “MDMA appears to make it easier for patients to be comfortable between the extremes of fear and avoidance, and may increase the effectiveness of psychotherapy by strengthening the alliance between therapist and patient,” said Brad Burge, Director of communications and Marketing for MAPS. It also helps the body release oxytocin and prolactin, hormones associated with trust and bonding. better
Most patients that have crossed to the other side have not gone back. In one of the first clinical trials for MDMA-assisted psychotherapy authored by Mark Wagner, professor of Neurology at the Medical University of South Carolina, twenty men and women underwent MDMA-assisted psychotherapy during two 8-hour sessions scheduled a month apart with non-drug sessions in between. Of the 16 people who completed long-term follow-ups after 17-74 months, 14 reported significant symptom relief.
MDMA“ legal assisted
“The treatment effect seems to be huge, but it's really expensive and we are definitely very small potatoes compared to the vast sums of money and resources big pharmaceuticals or even startups have to spend,” said Wagner. But aren’t big pharmaceutical companies at least a little interested in what MDMA can offer? Not at all. “Rather than resist psychedelic and medical cannabis research, large pharmaceutical companies have chosen to ignore it. This emphasizes
featur e how uninterested Big Pharma is in developing treatments that only need to be taken a few times,” added Burge. With little money in MDMA therapy — it is generic — research is on a very tight shoestring. It’s also illegal (criminalized in 1985), forcing researchers to walk a tight rope of red tape and restrictions. Current FDA regulations limit MDMA trials to only twenty test subjects, and the stigma attached makes even public conversations difficult for someone like Burge. The goal for MAPS is legal MDMA-assisted psychotherapy and prescription treatment with therapist training, but this is still a decade away. Alternative treatments for PTSD are not without sceptics, namely veterans like Place. “No matter what medication they give you, it won’t do any good. Everyone’s kind of climbing on marijuana but there is no cure. Same with MDMA. It might
relieve symptoms like having a couple of drinks—you won’t have intrusive thoughts. But you still have to deal with it later. You won’t be able to walk to the grave without it.” Burge admits MDMA-assisted psychotherapy is not for everyone. “For some people, it won’t work or it will be too difficult,” he said. And this is the reality for Vietnam, Afghanistan, and Iraq veterans. “In the end, what ever happens to us, we’re on our own, dealing with it ourselves without expecting help from anyone else. Expectations turn out to be just as bad as PTSD,” said Place. A push for new, effective treatments is still critical according to Daniels. “Whatever it takes to help these people. Twenty suicides [per day] is absolutely unacceptable in my book.” Small steps in the right directions help, but the war on combat-related PTSD is far from over.
Kevin is a freelance writer and graduate student at DePaul University working on an M.A. in writing and publishing, with extensive experience writing about mental health. As a person with ADHD, depression, and anxiety, he understands first-hand the stigma mental health garners from the general public. He can be contacted through his website http://kevinsterne.com/ or follow him on twitter @kevinsterne. And he asked us to mention that he loves his dog!
What is PostTraumatic Stress Disorder?
Post-Traumatic Stress Disorder (or PTSD) is a severe type of anxiety disorder. It is brought on by a single or ongoing traumatic experience. Post-traumatic stress is a natural form of coping and should only last up to two weeks before learning to accept and understand the situation. However, when the symptoms last for more than a month, it would be considered a disorder and require professional support from your doctor or other health professional.
Post-Traumatic Stress Disorder What causes PTSD?
PTSD affects some people after experiencing a traumatic event. This could include: • War as a soldier, aid worker or victim • Sexual or physical abuse • Rape, kidnapping or assault • Sudden death of family or friend • Natural disasters • Car, plane or train crash, or similar accident • Terrorist attacks • Childhood trauma or abuse.
What are the symptoms?
Post-Traumatic Stress Disorder symptoms are placed in the following groups:
• Re-experiencing through flashbacks of the event as unwanted memories or nightmares. This could cause increased stress or panic attacks. • Losing interest and avoiding triggers such as situations, places or conversations or other reminders. This could cause isolation from enjoyable activities, family and friends. • Hyperarousal such as increased awareness of potentially dangerous situations, poor sleep, low concentration, irritability and feeling anxious. Someone who has experienced a traumatic event may sometimes feel that they have ‘got over’ it, until they are confronted with a reminder that triggers the
featur e symptoms again. Those affected may also develop other anxiety disorders (such as phobias or social anxiety), depression, or problems with alcohol and drug use. These conditions can be present at the same time as the PTSD, and require additional treatment.
Who else is impacted?
PTSD also affects family members and friends. When a person responds to PTSD by ‘pulling back’ emotionally, or becoming irritable, angry or even violent, close relationships are impacted. Care-givers can also be emotionally and psychologically affected and may need to seek support as well.
Can it be treated?
Most people with PTSD are able to recover or lean to manage and live normal lives. Usual approaches to treating PTSD are: • Counselling and psychotherapy with the person directly affected and sometimes those indirectly impacted. • Medications can also be used to assist while attending counselling. • Meditation and mindfulness techniques can also help some people, particularly as an ongoing long-term method of managing triggers.
If you are concerned about the impact of trauma on you or someone you care about, speak to your doctor or other health care professional.
Alzheimer’s Most people understand Alzheimer’s disease as a problem of “forgetting” – a memory problem. But it is much more than that; it is a thinking disorder, one that disrupts the usual patterns of thought conception, storage, retrieval and utility. As such, it may rob the person of a skill that was,
up until today, an everyday action, taken for granted until now. This is something I would want to know if I myself had Alzheimer’s disease but, I don’t; my husband, Jay, does. Learning about the disease is different for each of us. He lives with Alzheimer’s; I walk beside it.
Paula S. Forté is a Registered Nurse and PhD with nearly 40 years of experience in nursing practice, education and administration. All of which will serve her well as dementia care has become the focus of her own household. Paula has published several articles in her field but now also writes about every-day life issues in the hope of reaching a broader audience. She continues to work as an education specialist in long-term care and manage the changing landscape of every-day things with the love of her life, and husband of twelve years, who is 20+ years older than she and was diagnosed with Alzheimer’s disease in September of 2013. His symptoms began several years before his diagnosis. He is currently in stage four and while the direction of his health trajectory is clear, the velocity is not. They live together in the suburbs of Minneapolis, MN.
Almost every week, there is something I discover that Jay can no longer accomplish. It moves from his to-do list over to mine and, over time my list will become overwhelming, that is a predictable truth. There is no way to determine the trajectory for this disease, so Jay’s accumulation of inabilities may be slow or fast, and will likely be a fluctuating tendency rather than a straight line progression. That said the challenges that his diagnosis presents in our lives are significant.
every week, “ Almost there is something I
discover that Jay can no longer accomplish
Jay is 83 and only at the early stages of the illness, there is much more disruption to come, should he live into the later stages of Alzheimer’s. But this is an essay about me, his partner, living with him through the horrifying reality that his brain is deteriorating, right in front of us. Little pieces of it are missing and, on any given day, it is unknown what he will or will not be able to do, say, think or manage.
First Signs My first indications that something was wrong came several years ago, long before his formal diagnosis. I better
began to see behaviors that were inconsistent with the man my husband is and has been all his life. We’ve been married only since 2002, but we’ve been in each other’s lives since 1983 and the friendship we forged long before we were formally a family has given us a profoundly solid foundation for the earthquakes that are everyday occurrences in the lives of those with Alzheimer’s disease. My earliest journal notations about a change in Jay’s behavior come from 2011 when I wrote in my journal, “He has not closed a business deal since before his heart surgery in November. Essentially, he’s retired – but he can’t bring himself to let anyone know – he still talks about being in business. He’d have to pass two certification tests if he wanted to keep the business open, but that just isn’t going to happen”! Later, I would make notations like, “We visited Jay’s son’s family last week. Jay drove to their house and totally missed the turn off of Highway 5; I drove home” and “His ability focus is gone. I see him spending his time making lists – sometimes lists of lists. Each time he picks up the newspaper, he is essentially starting over as if he’d not read any of it earlier that day.” The deficits were painfully obvious but still, there was no diagnosis. Jay had been diligent about seeking periodic neuropsychiatric testing on his own since the mid-1990s if only to
people assure himself that he was not going the way of his mother, who died with Alzheimer’s disease. Needless to say, the tests (that took hours at a time) all came back negative – to the experts he showed no clear deficits uncommon for a man his age.
Choosing a Worldview In everyday conversation we can see the reflections of common worldviews; this is even more obvious when we humans encounter difficulties. Then, the volume is dialed up on our vocal descriptions of how unfair the world has been to us. The lenses we use to see our circumstances can color or cloud what is genuinely happening. Too often we “awfulize” about life in general, focusing on the dreadful, the terrible and the awful things we find or that find us. Illness brings huge opportunities for “awfulizing.”
Some assume it is simple optimism but I believe it is richer than that. I see it as an approach to life that reinforces values that Jay and I share. If we believe that our lives are significant and purposeful, we can share personal growth experiences even in the middle of negative events and circumstances usually seen only through the lenses of scarcity, failure or shame. We do this by transforming, not the events and circumstances themselves, but how we think about them each day. This enables us to see them as amazing bearers of creative energy and optimistic possibility. This is the platform from which we can thrive even through Alzheimer’s disease.
For me, the possibility of thriving with this disruptive disease in our lives emerges from a concept that Norman Vincent Peal popularized in the middle of the 20th century under the title “The Power of Positive Thinking.” It was reiterated a few decades later by the televangelist, Robert A. Schuller in his works on “Possibility Thinking.” Most recently, this concept shows up as Positive Psychology in the popular writings of Shawn Achor who authored The Happiness Advantage (2010) and Before Happiness (2013).
How can we be Happy? I firmly believe that happiness is a choice. I try to tell my grandson that whenever I catch him sulking over things he can’t change and can’t control. I don’t think I have convinced him yet. I often ask myself, “What do we have to be unhappy about”? And, under ordinary circumstances, the voice in my head might urge me to complain. Certainly there are bills that go missing because Jay has tucked them away somewhere, the wallet that was “stolen” only to turn up two days later in the lost-and-found at the fitness center and the taxes that went unpaid because I didn’t know we owed them, since the bill came in his name only. One could certainly be unhappy about such things. But these are, in the big scheme of things, really just inconveniences, annoyances, trivialities.
We haven’t hit the BIG markers of brain disease yet – wandering outside on a dangerously cold night, losing the names of those he loves or forgetting exactly how or when to use the restroom, but those events are likely coming. Whenever we hit a snag, I try to remind myself, “he’s doing the best he can, and so am I.” Adding that last part is the hardest thing to do because like most spouses, I am quick to recriminate myself when I lose patience with the situation or with Jay.
Health Amidst Disease If the diagnosis were to disappear, would we find ourselves healthier as individuals or a couple? I think not because the absence of disease is not health and most of us are looking for health. Health is also very much a state of mind. The lenses we choose to view the world can allow us to be positive as well as negative and modern neuropsychology is telling us that every aspect of the brain functions better when those chemicals of positivity (dopamine, serotonin) are flowing in our neural soup than when we’re in a negative state. The key to health is finding ways to urge those endorphins out into the open so that health, or a positive worldview, is possible even in the middle of other, more typically negative circumstances like illness or disease.
every week, “ Almost there is something I
discover that Jay can no longer accomplish
great benefit from changing their mindset.
Crum, Slaovey and Achor (2013), traced the work of Becca R. Levy, an epidemiologist who has published with several teams of colleagues. In summarizing Levy’s findings they noted:
Individuals who hold onto negative mindsets regarding their own aging are much less likely to engage in self-care measures like healthy eating, taking time for exercise, and keeping primary care appointments (B. R. Levy & Myers, 2004). People with negative mindsets, when reminded of common negative stereotypes of aging, also experienced a sense of hopelessness and measurably reduced cardiac function (B. R. Levy, Slade, Kunkel, & Kasl, 2002). Subjects with a negative mindset also die earlier than their counterparts with a positive mindset (B. R. Levy, Hausdorff, Hencke, & Wei, 2000). Levy is clearly onto something, and Crum and colleagues (2013) make the case that to fare well in the midst of difficulties “people may not need to focus single-mindedly on reducing their stress” but instead if they focus on the “enhancing aspects of stress (as opposed to merely preventing the debilitating ones)” they may discover
That is what we are determined to do, focus on the “enhancing aspects of the stress” that Alzheimer’s disease imposes on our lives and our lifestyle, thereby seeking out the best consequences of our lot, better overall health and a happier life in spite of Alzheimer’s intrusion.
The Road Less Traveled To that end, we have actively begun to do some things we might never have gotten around to if Alzheimer’s disease had not insinuated itself in our lives. We do these things because they help – they make the sadness of the losses more palatable and the recognition of the disease’s progression less painful. Our simple formula for life well-lived is this: We exercise Jay more than I because he has more time and because he derives pure joy from the strengthtraining exercises he does for hours two or three times each week. We reminisce Mine often takes the form of journaling; Jay’s comes out in conversation especially as we look at the many pieces of art in our home that tell the story of places we’ve visited, interests we’ve shared and people we’ve been privileged to know. We meditate Jay is more religious than I, so his quiet time takes the
form of prayer. Mine is the more traditional meditation with a focus on breathing and quieting the mind. Either way, the effect is calming and beneficial. We spend time together Sometimes, just in each other’s presence, but often we intentionally do things together that could be done separately because it is beneficial to actively look after each other, and yes that action still goes both ways! We express gratitude Especially to each other (people frequently comment that rarely do they hear “please and thank you” as much as when listening to us banter in the kitchen), we really do try to be courteous to each other and to everyone, acknowledging that sometimes even we miss the opportunity to be gracious. We enjoy doing random acts of kindness This has become a little “game” between us. Jay will spot a neighbor walking her dog on a hot summer’s night and invite her to join us for a beer on our porch. I might see a colleague at work suffering the effects of a newly emptied nest and invite her to join us for dinner. It is random, but always intentional.
Our Future It isn’t rocket science. This disease will inevitably make our lives harder. It will rob him of his memories, his capabilities and his dignity should he live that long and ultimately it will take better
his life. It has already robbed me of my partner, the man I trusted to pay the bills, manage the taxes and care for the car. He can’t do those things any more but we’re intent on focusing on the CANs in life, not the CAN’Ts. This is the road to happiness, the path to peacefulness and the only way I know to thrive, even with Alzheimer’s in our lives.
References mentioned by Paula Editor: We don’t often include references in an article as this isn’t a journal. In this case, however, we decided to include them as they will be of interest if you interesting in reading them. Achor, Shawn (2010). The Happiness Advantage. Random House. New York, NY. Achor, Shawn. (2013). Before Happiness. Crown Publishing Group. New York, NY. Crum, A. J., Salovey, P., & Achor, S. (2013). Rethinking stress: The role of mindsets in determining the stress response. Journal of personality and social psychology, 104(4), 716. Peale, N. V. (1996). The power of positive thinking. Ballantine Books; Reissue edition (August 1, 1996).Random House. Scheier, M. F., Carver, C. S., & Bridges, M. W. (2001). Optimism, pessimism, and psychological well-being. In Chang, Edward C. (Ed), (2001). Optimism & pessimism: Implications for theory, research, and practice. , (pp. 189216). Washington, DC, US: American Psychological Association, xxi, 395 pp. doi: 10.1037/10385-009 Schuller, R. H. (1986). Move Ahead with Possibility Thinking. Jove.
DEMENTIA IN BRIEF neurocognitive disorders Neurocognitive disorders are a range of disorders that result in a decline of a person’s memory and thinking skills severely enough to reduce a their ability to perform usual activities. It is more commonly called dementia. They are caused by damage to the nerve cells in the brain.
a group of disorders Alzeheimer’s disease, while the most common, is not the only form of dementia. It accounts for 60 – 80% of cases. Vascula dementia, which is caused by a stroke, is the second most common. Rare causes only make up around 5% of cases. Huntington’s disease, Parkinson’s disease, CreutzfeldtJakob disease, Multiple Sclerosis, and HIV-related cognitive impairment are some rarer causes of dementia.
quick facts • More than 30 million people worldwide, 5 million in the US, nearly 1 million in the UK, 40,000 of those are young people. • Two-thirds are women. • One in six people over 60 have dementia. • Alzheimer’s is the 6th leading cause death in the US.
an old person’s disorder It is not an “old person’s disease”. Less common,early onset dementia, refers to persons who develops dementia while younger than 65.
more information For more information, you can visit http://www.alzheimers.org.uk http://fightdementia.org.au http://www.alz.org http://www.alzheimer.ca
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shares with us an intimate account of her own life with mental health and the tragic legacy mental health can leave behind Delali Norvor was born in Accra, Ghana on October 29, 1995. Being diagnosed with mild Cerebral Palsy did not stop her from living life and earning a lot of rare accomplishments for people her age. Delali is a published poet/ author with three books available online. She has been recognized by several publications who excitedly praise her and has her future referred to as â&#x20AC;&#x153;bright, and promising.â&#x20AC;? Delali is a college freshman, who has aspirations to go to law school. better
My name is Delali, and I suffered from depression. Her name was Ayo, and she, too, suffered from depression. I have Cerebral Palsy, while she had Autism. What triggered my depression was the presence of my disability. I walk a bit differently, I talk differently, and I have mild hearing loss. I possess intelligence, so I was sent to mainstream schools that mean I was the only disabled person in my class. From PreK to second grade, I didn’t know I was different. My parents did an excellent job of making my disability invisible and letting my abilities come to the light. My family never treated me differently; they treated me the same way the children were treated. For that, I’m thankful because their inclusive treatment allowed me to be fearless and confident. My mom called me a diva when I was growing up. She said that even though I couldn’t talk (I didn’t
start talking until I was five and half years old), I still “argued” with her and let my opinion be known. For an example, she will dress me in an outfit I didn’t like; and I will shake my head no and use my body expressions to tell her I did not like the outfit she picked for me. Since then, she allowed me to choose my own outfits by letting me point the one I wanted to wear. So yes, I wasn’t treated differently in my home, and that allowed me to gain confidence whenever I was not home.
I started getting the “you’re different” treatment in First Grade When I started talking, they took me to a mainstream school where I was the only disabled student, but I didn’t know that, because everyone treated me just the same. I made some friends, and I grew up with them till 5th grade before going to another school to middle school. From PreK to second grade, I had a close group of friends, and I always thought we were going to be friends forever until we graduated from high school. Unfortunately, that bond of closeness dissolved for me in second grade. My friends pushed me out of the group then. I was being treated differently by them, and I didn’t know why. I was so confused, because the same group of friends that I grew up with were treating me differently as we entered elementary school together. I still didn’t know I was “disabled”. You may be reading this article and think to yourself, “well, what if you weren’t treated differently because of your disability?” I would tell you to wait and allow me to get my points across. I started getting the “you’re different” treatment in First Grade. In P.E., for instance, I was slow and not so athletic. I ran better
people differently and, in a race, I never finished first, or whatsoever. Because of that, I was always the last one to be picked. It hurt my feelings because my friends never picked me to join their team, and they were supposed to be my friends. It didn’t make sense, since some of their peers that were selected to join their team weren’t even that fast or athletic, but they tried their best. That’s the point. I tried my best too. I started observing how people walked and ran, and how I walked and ran. I started noticing that I was different, and it threw me in a temporary loophole. I started wondering why I was different, and so on. I kept waiting for my parents to give me an answer, but I never asked and I don’t know why. I think that was the early stages of
depression for me. Being treated differently and not knowing exactly why you’re different. On the first day of third grade, I was waiting outside for the bell to ring so we could enter the classroom. I noticed a girl my age sitting in front of the classroom, just crying hysterically. I felt bad for her. Even though she was being comforted by her mother, she was still crying so I thought to myself that maybe she will stop crying if she met someone her age who befriended her. So I walked up to her and greeted her; she was still crying. My attempted plan to make her stop crying still didn’t work. So I just sat beside her and comforted her, alongside with the mother. Later in the day, she stopped crying, and she introduced herself to me and the rest is history. She was so fresh, spunky, amazing, funny, and just warm. After third grade, she and her family moved to another country, so we stayed in touch via email. After a while, she stopped emailing me, and I never understood why. Five years later, I was on Facebook and had the urge to search her name and there she was. I quickly added her, and she accepted.
do not ever refer a disabled person as a retard or dumb However, we still didn’t talk much, and I wondered why again. A year later in 2013, she hit me up, and I was overjoyed. She explained to me the reason she stopped staying in touch with me was because she was suffering from autism and depression, so she was being treated for it. She had a rare form of autism, and there was a lack of successful treatment for it. It took me back to the time I was diagnosed with Fibromyalgia during my sophomore year of high school. When I was a sophomore diagnosed with Fibromyalgia, that is when my depression exploded. better
people Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, and tenderness in localized areas. Before I was diagnosed, I didn’t know it was fibromyalgia. I just thought it was my disability that was worsening, and it made me even more depressed.
I had created a vision board of all things I wanted to accomplish The reason I was more depressed, was because I couldn’t go to school anymore. I was paralyzed with pain from head to toe, and it affected my mobility. I thought my life was over. That thought made me angry and sad because I had a lot of plans for my future. I wanted to go to law school and start my own practice. With the thought that my life was over, I became suicidal. Life wasn’t worth living anymore, because school was the only thing that kept me happy and distracted me from my 16-year-old mind which was filled with thoughts regarding my insecurity with my body and disability. I was being bullied for having a disability. I had people call me a retard and referred to me as dumb. School was the only thing that told myself that I wasn’t a retard, and I wasn’t dumb. But first of all, do not ever refer a disabled person as a retard or dumb. The problem with society is that persons with disabilities are seen as disabled first and human second. I honestly feel like people with disabilities are treated by “normal” people as reminders that the disabled person’s life is harder than the “average” person’s life. Stella Young, an advocate for disability equality who recently passed away, said the disabled population is treated as “inspiration porn.” She
pointed out that persons with disabilities are used as “objects of inspiration.” We have only experienced disabled people inspiring you, and that is it. Ms. Young also pointed out that the majority of society hasn’t experienced disabled people as your teachers, doctors, or your manicurists. Society has just experienced disabled people as “objects of inspiration.” I’m also going to point out that while society treats me as inspiration porn, insecure society treat disabled people inferior to feel better about themselves. This can explain my bullying and the negative experience of people looking down on me, just because I have a disability. While you might say “I was bullied too, even though I don’t have a disability,” you were probably bullied for something you had control over. For instance, people may be bullied for being smart or not being “physically attractive” enough. However, they were able to heal from it timely because being smart gets rewarded, and puberty or finding a loving partner (or even surgery) restored the bullying victims’ confidence and self-esteem. I got bullied for having a disability, I can’t have surgery to remove it, and puberty didn’t do anything to it. I have no control over my disability, and it’s going to be a part of my body till I die, just like the color of your skin is going to be with you till you die. The thing here is once I realized I couldn’t change my disability, I started wishing that the bullies would tease me for being smart and not the other way around. They should bully me for being smart because I know my intelligence will pay off in the end when I get into college and get a degree and go to law school afterward. However being bullied for something I don’t have control over, led me to being insecure and depressed. On top of all of that, I was battling Fibromyalgia that I thought was part of my disability. I feel sorry better
Delali contacted us only to tell us her story and that of her friend. She didn’t mention or ask us to discuss her books or other aspects of her amazing achievements. But we will anyway.
people for my family because they had to deal with me and my suicidal tendencies. I would cry every day and scream those words of “I want to die!” repeatedly. I couldn’t get a doctor’s appointment because the Children’s Hospital was overbooked, and I had to wait for three months. Imagine three months of constant, unbearable pain that leaves you bedridden and puts your life on hiatus. Talking to Ayo that year reminded me of my experience, so I tried my best to tell her she can overcome depression and unhappiness. She had always had mood swings, but it got worse as she grew up. It hurts me that she was going through that because she was such a bright star who could shine your dark nights. We had a hearty laughter every time we chatted and gave each other advice whenever we complained about our miserable teenage years that we were experiencing. We were concerned about each other, and that’s true friendship. The National Eyes of an Urban Pariah and Baptised in GXLD are collections of wonderful and thoughtful poetry. Look for them on Amazon.
During Christmas of 2013, she wrote me “Merry Christmas. This was the year we got in touch again It was good to know good friends always stay friends even if you don’t see or talk to them for a very long time. It felt like if I never stopped talking to you and I feel honored to have such an amazing friend.” We talked more during 2014 and became closer than ever. However, when I entered college in the fall, I didn’t have time to chat with her. I was always buried with studying and homework. Whenever I was free, she was sleeping. The time difference was a hurdle because she was in Holland while I was in the USA. Each time we chatted in the Fall, she expressed her feelings of frustration. She felt like her life was on hold because she was getting treated for her depression in a mental health hospital while I was in school, preparing for my future. Ayo finished high school a year early and to me, I think she felt even emptier because she said she had nothing to do and better
she was bored. At the same time she was bored, she was still feeling unhappy and felt like life didn’t have anything to offer her. I reminded her that I was in her shoes before and even though I wasn’t in a hospital, I was treated for it, and I got better. She asked me “how?” and I told her “by thinking positively.” I told her that I started planning my future. I had created a vision board of all things I wanted to accomplish. I told her that my dreams gave me hope, and asked her “what is your dream?” She said she wanted to design costumes for Broadway or design buildings and travel all over the world while hosting the travel show. I want to be an hotelier and own hotels all over the world, so she said “when you become a global hotelier, I’m going to stay in your hotel for free.” I told her that dreams distracted me from the dark chapter I was in, so she shouldn’t give up because her dreams were beautiful and she could accomplish it if she just believed her life was worthy and the world was her oyster. Later, in the summer of 2014, she got this cool tattoo of a feather with Dutch words inscribed around it. The words were “Catch your dreams and follow.” Sadly, that wasn’t enough because depression beat the motivation she was getting from me and others. Depression killed her in November 2014. I love you; I miss you. Rest in peace, Ayo.
Editor: This article very nearly didn’t happen. As we were preparing to lay it out, we received an email from Ms Norvor retracting it, explaining that Ayo’s parents were not yet ready. We were disappointed, but understood. We later received another message from Ms Norvor, allowing us to print her story. We are grateful to Ms Norvor for sharing this story with us, and to Ayo’s parents for allowing her to do so. Thank you.
Suicide Snapshot While laying out this issue, we spoke with four people who were directly or indirectly impacted by suicide. While there are many impacts to mental health, the loss of life is final, it ends a life and impacts the lives of others forever. Suicide statistics vary widely across the globe, but other aspects are reasonably consistent. The Numbers 800,000 people die by suicide each year globally, that’s 1 every 40 seconds Rate is around 11 per 100,000 people For every completed suicide, an estimated 30 people attempt Men: 4 times more likely to suicide Women: 3 times more likely to attempt One in four suicide deaths are males Some Risk Factors Existing mental illness Past or current trauma or abuse History of alcoholism or drug abuse Previous suicide attempts Family history of suicide Terminal illness or chronic pain A recent loss or stressful life event Social isolation and loneliness
Youth 3rd leading cause of death Around 30% of all youth deaths under 25 8% of students attempt Warning Signs Social and family withdrawal Sense of hopelessness/worthlessness Mood changes, especially sad or angry Talking or writing about it Acts of self-harm Sudden calm after periods of depression Unexpected and unusual calls or visits Existing mental health conditions Prevention Take it seriously Talk openly and honestly Be supportive and seek support
For lists of local suicide resources, visit The International Suicide Prevention wiki: http://suicideprevention.wikia.com/ and the International Association for Suicide Prevention: http://www.iasp.info/resources/Crisis_Centres/ and Sucide.org at http://www.suicide.org/international-suicide-hotlines.html. Go now, and find your local services for when someone you know needs it!
Perish The Thought on G eneralized A nxiety D isorder By Dr Nitsa Stylianou, Clinical Psychologist
Generalized Anxiety Disorder (GAD) is the most prevalent anxiety disorder. So much so that it has been described as “the common cold of mental illness”. While GAD is indeed prevalent, there is nothing benign about it. It usually involves a long-standing, if not constant state of tension and worry. Realistic worries do not mean you have GAD. If you are worried about your health and you have just been diagnosed with a chronic illness, that’s not GAD. But if you constantly worry about your health even after receiving a clean bill of health, you just may have GAD. better
worry and gad
Worry is central to the problem of GAD and individuals presenting with this disorder often state that they have been worriers for much of their lives.
featur e GAD is fairly common among children and even more common among older children. Most people who worry constantly do so about any number of events or activities and find it difficult to control the worry. cognitive-behavioural therapy
It has been well established that thoughts have a strong impact on emotional and psychological wellbeing. In Cognitive-Behavioural theories (CBT), the content of thoughts has been given paramount importance in determining the presence of a disorder. Psychologists are beginning to refer in addition to the metacognitive model of GAD (Wells, 2009). Metacognitive theory proposes that people with GAD use worrying as their main means of anticipating future problems and generating ways of coping. For example “I am worried about my term paper and anticipate problems as a result. If I start worrying about it now, it might reverse the bad outcome and help me cope until my results are finally in”. Worriers belong to a “club” that have converted worrying from an adjective
to a working noun. Common beliefs can include: • “If I worry enough, nothing bad will happen” but • “I could go mad with all this worry and have a mental breakdown” Most worriers do indeed appear to be in two minds about worry as illustrated above. On the one hand, they believe that worry is beneficial, but on the other hand they believe it is harmful and uncontrollable. metacognitive therapy
Metacognitive Therapy (MCT) would tackle the above problem by asking the individual some of the following questions in order to highlight their ambivalence about worry: • “How can you stop worrying if you are constantly in two minds about it?” • “If you believe that worrying is harmful, how can you also believe that it helps you cope?” • “Have you ever considered that worry might not be useful or harmful, but that it is neither useful nor harmful”
has a repetitive, “ Itbrooding quality
that is difficult to bring under control
Worriers often discover that their behaviour (substance use for example) is not effective in managing their anxiety. In therapy, the above act of discovery allows the therapist to ask a number of useful, exploratory type questions, such as: “What happens to your worry when you are drinking in excess and you have to do something important like answer your mobile phone? Does it stay uncontrollable or can it be switched on and off? The above types of questions help sufferers identify their ambivalence about worry in therapy and how this keeps them “tethered to the worry post”. It also helps them realize that the tendency to worry is not altogether uncontrollable, it can be switched on and off.
worry is not stress
The ultimate realization is that worry is a coping strategy in response to stress. Worry is not equivalent to stress. There is limited evidence that psychological stress is directly damaging. The book The Truth About Stress (Patmore, 2006) is a good resource for those who wish to explore the stress myth further. From my personal experience as a therapist, I have discovered that there is something significant about the patterns of thinking as seen in GAD. It has a repetitive, brooding quality that is difficult to bring under control. Focusing on the content of thoughts is only a small feature of cognition and might even be of limited importance. We must also address the tendency to worry or ruminate, which leads to sustained thinking about danger and a persistence of symptoms, including physical complaints such as muscle tension, fatigue and irritable bowel syndrome (IBS). There is hope of course. Worry is often a process involving future events and ways of coping with them. The aim is to lessen or stop worry-based thinking in response to intrusive thoughts and professional help in this regard may be necessary.
the impact of anxiety on the body dizzines, irritability
sweating increased blood pressure
rapid breathing, breathlessness
reduced libido fatigue
Dr Nitsa Stylianou is a clinical psychologist with 20 years experience in this field of psychology. She has worked predominantly in private practice, currently at the Live Well Centre in Crows Nest, Australia. Since 2014, she has specialized in working exclusively with adults suffering from anxiety and depression. She can be contacted through firstname.lastname@example.org
The In-Flight Conference Ramblings on Life, Death, and the Absurd.
Recently, my partner and I had to travel overseas for business. The flight was pretty typical for me.
be carried on board, unconscious after a few dozen preflight martinis. I can do it – and I do it, all the time.
Like many high‑functioning persons with anxiety or panic disorders, certain modes of transportation require a certain amount of concentration for me. I can do it. I don’t run up and down the aisle, shrieking like a maniac when the plane lifts off. I don’t need to
It is necessary that I continue to be capable of doing it, as I am stable and holding down a job these days. On good days, I can do it with just a little concentration. On other days, it requires a bit more effort to keep myself together.
By L.S. Hope
I am extraordinarily lucky. Over the years, upon being diagnosed with manic‑depressive disorder and anxiety problems, I was quickly surrounded by family, friends, medical care, and a loving partner who were ready to help me. They know that I have good days and that I have bad days. They know that, being forgetful by nature, I need to be reminded to take my medication. And they know that on High days, when I am suddenly at one with the universe and cant recall ever having been low, I need to reminded of why I need to keep taking it. They have been patient and supportive, and gone to great pains to convince me that these issues are nothing to be embarrassed about. I have slowly come to believe them, but anyone who suffers from anxiety knows that it can feel a bit embarrassing sometimes. Admitting to a fear of flying, for example, sounds
so silly, and invariably invites the usual well‑meaning, hackneyed phrases – that you are more likely to be killed in a car crash on the way to the airport, etc. This is an interesting statistic, but usually of little consolation when you are sitting in your seat and mild turbulence hits. Flying is simply one situation among many that somehow started getting progressively more difficult over the last few years. As a small child, I flew extremely frequently with my family for my father’s occupation. I thoroughly enjoyed it. As a young adult, constantly travelling, I was on planes more frequently than buses. But these days, it can make my stomach tighten and my mind race to a painful speed. It’s extremely difficult to turn off the internal commentary. Notions like engine failure, collision with another plane in the fog, lightening strikes, birds flying into the
jets at 30,000', the chance that one of the ground crew had a bad day and forget to close the door properly, etc., start running around in circles in my brain. To say nothing of the recent news headlines telling tales of various airlines near where I live in Asia. Sometimes I think I must experience more forebodings of imminent death in a single day than any other human alive. When things build up too far, it feels like being stabbed by an icicle of sheer panic. Any other people who are high‑functioning and battle with anxiety issues, but also happen to be in a loving relationship with a wonderful, normal, adventurous go‑getter of a person will also understand another side of this predicament. Why is it that we go to such great lengths to appear entirely at ease, in the moments when we are not? We are aware that the people who live
with us and love us, know us pretty well. We are also aware that after this many years of being together, they are probably pretty clued‑in to the parts of us that can be difficult to live with. But the instinct to smile brightly and keep you eyes shining, even when you feel like you are falling apart – to be fun, happy, easy‑to‑live‑with and a sparkling companion at all times, remains strong. Albeit somewhat comical at times. Perhaps this instinct is so strong in high functioning people with manic depressive or anxiety disorders because we are pretty keenly aware of all the times that we have been precisely the opposite of this – no fun, direly unhappy, and extremely difficult to live with. Perhaps we secretly hope we can erase the memory of our bad days in the eyes of our lovers by over‑compensating. Whatever the reason, I always try to place superhuman control over my mind and emotions when I am flying. Sometimes it works. The flight we were to take was long, and we had already been travelling for some time. Upon boarding the plane, I glanced again at the number and letter on my pass, took my seat and arranged my possessions – a large sweater to wear on the absurdly cold flights, at least one book to read, gum, iPod, and a pen, to be well prepared for any forms to fill in. I chatted idly with my partner for a short while, arranged my sweater, gazed peacefully over the rows in front of us. I drank
Oh God, I think, I am not ready to die right now some water, smiled at the drooling infant across the row, and made a general show of being light‑hearted. Then, with a serene smile on my face, I turned my head towards the window and softly closed my eyes. Oh God, I think, I am not ready to die right now. I know it sounds ridiculous, but once the idea of imminent death starts plaguing a brain like mine, it’s hard to shake. I have developed a means of controlling this feeling on a plane, a routine that I fall into. Its not a mantra or a role‑play script from my therapist, it just makes me feel better. I calmly assemble the inner voices in my head to a conference and we all have a rational conversation together about the fact that we are probably about to die. At this point, the voices are all so excited and convinced that the flight will crash or be shot down, that the only sensible and soothing topic we can discuss is death. It might sounds morbid, but it’s not – it is simply a translation of all the panicked voices in my head into a room full of manageable, suit‑and‑tie wearing entities at a conference table. I just tell everyone to be quiet and sit down, and we can begin. After a little while, the mood can get kind of festive.
OK – the point is, we are all going to die. If I die on this flight, it will be quick. Quick? Yes well, relatively quick, a few minutes maybe. That’s much better than days of torturous pain, isn’t it? Or years! Exactly! I bet I can think of far worse deaths. Burning. Cancer. Firing squad. Being trapped in a cave. If something happens here, the plane will lose control, plummet towards the earth, and it will all be over in a matter of minutes; easy and simple, like falling asleep. That’s True. It will be quick. Exactly! If it happens now, it happens now – its not the end of the world. Right. Plus it will probably involve fast falling, and you know what happens when you fall, you wont be able to breathe, and asphyxiation will probably knock you out before the plane even — “Whatcha thinking about?” I open my eyes to find my partner’s face inches from my own, blinking at me lovingly. He seems bored. The flight attendants are still strolling down the aisle, closing compartments and checking seatbelts. I indulge myself for a moment in wondering what he would think if he knew about the absurd conference that was taking place right now. I smile brightly and try not to let my voice come out too high pitched.
we go to such great lengths to appear entirely at ease, in the moments when we are not “Nothing! I am really looking forward to this!” He raises and eyebrow and looks at me incredulously. “Your looking forward to this...” “No, no, I mean, you know...” I fumble, and giggle sheepishly. “I mean, to arriving.” “Yeah, me too” he yawns, exhausted from days of travel, and turns to the in‑flight magazine. I continue to smile brightly, and stare ahead of me until I’m certain he is fully engrossed in the magazine article. And then return to my inner conference. Plus, if I do die now its all ok, right? Think of the list. The list, that’s right! The list is a series of things I have done it my life that I carry around in my mind for moments such as these. No‑one will ever convince me that it is not natural, and entirely a part of the human condition, to fear death. We all have our antidote to this fear, be it religion or simply a pointed avoidance of ever thinking about it. My own antidote is probably silly to some, but it calms me. Perhaps the illusions we better
spin to comfort ourselves are absurd but that does not make them wrong. Absurd is all I can manage on some days, but that is still managing. The list accounts for every beautiful thing I have ever seen, experienced or done; a conscious remembering of everything meaningful that has ever taken place in my life. Some of the items may seem mundane when set on paper – like driving through the Appalachian mountains in fall, surrounded on every side by glorious, riotous gold and red, and how I felt on that day, in that moment. Some of the items are more considerable accomplishments for me, like swimming with whales in the pacific ocean, or riding an elephant bareback in the Indonesian jungle. It is kind of like flashing my own life before my eyes, albeit selectively – every sublime, beautiful or meaningful moment in this fleeting existence. The list has a calming effect on me. The voices in my head, dressed as conference attendees, become calm too, and soon most of them fall asleep in their chairs, like overtired children. I am soon officially and happily lulled into that most comforting of ridiculous delusion – that, I Am Ready! The plane may be about to crash, but I am calm! I glance over at the drooling, gurgling infant across the row, playing happily with an empty plastic cup. I glance at my partner from the corner of my eye, happily absorbed in an article about scuba diving. The plane lifts off
people the run‑way, and I take a deep breath, privately congratulating myself on how my demeanour appears just as calm as everyone else’s on the plane. The attendees to the mental voices conference stir slightly, then nestle back down and continue slumbering in their office chairs. Maybe its not proper or best practice, but it works for me, and I have come to cling to things that work for me, regardless of what other people say, now that I am older, steadier, and know myself better. Everyone has to find their own way of keeping it together. The effects of the conference may linger well into the flight for me – or at least up until the advent of any minor turbulence. At which point the calm slumber of the mental conference attendees is shattered and all of them bolt upright and starts running around with their hair on fire. The plane trembles, my senses jolt into gear, my
eyes narrow and widen, and two hands automatically grip the arm rests on either side of my chair. “What’s wrong?” My partner looks at me quizzically. I lick my lips and smile brightly, and with eyes as wide as saucers, I squeak in reply. “Nothing!” At which point, he usually looks at me for a moment or two, and then chuckles. I love that he doesn’t make me say it. “Nothing” I say again, quieter. He shakes his head, and kisses me on the shoulder. He slips his hand into mine until the seat rest is released from my vice‑like grip. As I said – almost always, the inner conference works for me when I fly. And when it fails, other people are usually there to help fill in the gaps and carry me through.
ANXIETY Fear or Anxiety
Types of Anxiety
Separation Anxiety Selective Mutism Specific Phobia Social Anxiety Panic Disorder Agoraphobia Generalized Anxiety
eating well for better mental health
What we eat has a significant impact on our brain functioning and mental health. It may affect our moods, concentration, memory and cognitive processes in many different ways. This impact can be right now and and in the future. Understanding what we eat, and the impact on our mental wellbeing can help us make the right food choices. by Jayne Tancred
cause or effect? The links between diet and mental health are made more complex for many people affected by a mental health condition or low mental wellbeing. Too often, when you’re at your mental peak, your diet is impacted. Someone with severe depression may skips meals and you may eat more snacks when stressed, for instance. So it’s not always clear whether a poor diet is a contributing factor to poor mental health, or one of the consequences of it. In general though, having a poor quality diet, low in nutritional value, increases your likelihood of
experiencing mental health problems such as depression and anxiety, and having a nutritious diet may help you avoid or manage these issues.
nutrition for mental health The basic principles of eating for good health apply equally to eating for good mental health. If you stick to a diet that’s good for your heart, blood sugar and body weight, you’ll also likely be doing your mental health a favour. Foods to avoid or cut back on are those rich in saturated fats (such as those found in meat and dairy foods), added sugars, and refined carbohydrates, all of which may be
wellbeing detrimental to mental functioning. In animal studies, diets containing large amounts of these types of foods have been shown to lead to declines in cognitive performance in as little as three weeks. On the other hand, foods to consume in abundance for optimal mental health include fresh fruit and vegetables, healthy sources of fat, and wholegrain carbohydrates. Additionally, a number of foods and nutrients are considered to have specific benefits for brain function and mental health.
fish and omega-3 fatty acids Fish are our most important dietary source of omega-3 fatty acids, a group of ‘good fats’ that help to make up our cell membranes and play a vital role in brain function. One of the omega-3 fats, docosahexaenoic acid (DHA), is particularly important; low levels of it have been associated with increased risk of Alzheimer’s disease, attention deficit-hyperactivity disorder (ADHD), dementia, depression, bipolar disorder and schizophrenia. Oily types of fish such as tuna, sardines and salmon are ideal to include in your diet to top up your omega-3
folate is essential “ for brain function in adults ”
levels. Some (but not all) people with diagnosed depressive disorders may also benefit from taking omega-3 supplements; talk to your doctor for more information.
leafy greens and folate Spinach and other leafy green vegetables are good sources of folate (sometimes referred to as folic acid). This B-group vitamin is best known for its role in preventing spina bifida and other neurological birth defects in unborn children, but is also essential for brain function in adults. Dietary deficiency of folate may contribute to depression and agerelated cognitive decline. Clinical studies suggest that taking folic acid supplements (either alone or in combination with other B-group vitamins) may help to prevent these conditions, and may even enhance the effects of prescribed antidepressant medications in some people. However, folic supplements are not suitable for everyone, so talk to your
The brain is highly susceptible to oxidative damage
doctor or other healthcare professional before taking folic acid, especially if you’re being treated for a mental health disorder.
iron and B12 Without red meat or high iron plant based foods in your diet, you may not be consuming the recommended dietary intake (RDI) of iron. Women are particularly susceptible to iron deficiency and anaemia, which may contribute to mental and emotional symptoms such as depressed moods and apathy, as well as physical symptoms such as fatigue and pale skin. Red meat is also an important dietary source of vitamin B12. We don’t need much of this vitamin, but as we get older our ability to absorb it declines and we become increasingly susceptible to deficiency. In the elderly, signs of vitamin B12 deficiency may include a range of psychological symptoms, including memory problems, depression, personality changes, irritability and dementia. better
Adolescents whose vitamin B12 levels are low may also experience cognitive changes. Including a few moderately sized portions of red meat in your diet each week will help to ensure that your dietary intake of iron and vitamin B12 is adequate (although some people may still need to take supplements to top their levels up). Make sure you’re not increasing your consumption of those nasty saturated fats at the same time though – either trim all the fat from the meat before you cook it, or choose a very lean cut.
other B-group vitamins In addition to folic acid and vitamin B12, other B-group vitamins may also have positive effects on moods. In a recent clinical trial conducted by scientists at Swinburne University of Technology in Melbourne, people affected by chronic work stress took either a high-potency vitamin B-complex formula or a placebo for three months. At the end of that time, those who had taken the vitamin B supplement reported that they were feeling less personal strain and confusion, and that their depressed and dejected moods had improved.
antioxidant-rich fruit and veg
The brain is highly susceptible to oxidative damage (sometimes referred to as free radical damage), which may be partially offset by consuming plenty of foods that are rich in antioxidants.
Here in Australia we’re more likely to reach for a cup of black tea or coffee than we are to drink green tea, but perhaps that should change. Research in Japan has shown that compared to those who drink little or none, older people who drink large quantities of green tea (four or more cups per day) enjoy a degree of protection against depressive symptoms.
This is believed to be a key reason that people whose diets include plenty of fruit and vegetables are less susceptible to age-related conditions such as Alzheimer’s disease. Many fruits and vegetables are rich in antioxidants, but those that are particularly vibrant or intense in colour tend to be especially good sources of these vitamins and other antioxidant nutrients. (Think carrots, red capsicum, blueberries, tomatoes and citrus fruit, just for starters).
This may be partly because green tea contains high levels of an amino acid called theanine, which has calming effects on the brain, helping to lower stress levels. The presence of a compound called EGCG, which is famously believed responsible for green tea’s cardiovascular protective properties, may also contribute to the effects of green tea on mood.
Jayne Tancr ed is a natu ropath, he and nutritio rbalist nist. She is fr eelance na health write tural r and busin ess consult whose wri ant ting on na tural healt wellbeing h a n d has been w idely publis Australia a h e d in nd interna tionally. Ja be contact yn e can ed through http://www .jaynetancr ed.com.au http://www or .facebook. com/Jayne Tancred
better blood sugar, better moods? It’s been known for a long time that for diabetes and depression go hand-in-hand for many people. Now, emerging research suggests that eating a low glycaemic index (low-GI) diet that aims to stabilise blood sugar fluctuations by minimising carbohydrates that are quickly converted into glucose in the body and prioritising those that are converted more slowly may also help to improve moods and cognitive processes – even in people who don’t have diabetes. In one study, children’s moods and
cognitive performance were measured after they’d consumed either a lowor high-GI breakfast. Over the next couple of hours, those who’d had the low-GI breakfast were more alert, happier, and less nervous, and also demonstrated improvements in some aspects of memory and learning. A low-GI diet has other health benefits too (for example, it may help you lose weight and reduce your risk of diabetes and heart disease), so it’s something we should all be moving towards. To start lowering the GI of your diet, cut back on rapidly absorbed forms of carbohydrate like sugar, white bread, white rice and potatoes, and increase your consumption of wholegrain cereals and legumes.
Enjoy the little things, for one day you may look back and realize they were the big things If you enjoy reading this issue, buy it in print at
From Killing Fields to Mansion Gardens A once neglected plot of land in Werribee has seen the germination of a bold and innovative program to help settle refugees and build cross-cultural communities.
James Brincat calls it his “build it and they will come” moment. As the Ranger in Charge at Werribee Park, he has witnessed the regeneration of an historic garden and, in a remarkable example of cultural cross-pollination, the blossoming of local refugee communities. What started as a call for volunteers to better
help rebuild the gardens at Werribee turned into a therapy session for dislocated and isolated refugee families. “It has been amazing to watch what has happened here,” James said, his passion and irrepressible nature evident in his voice. “What started out as a community project to rebuild the old kitchen
garden here at Werribee Mansion has turned out to be an incredibly successful social experiment and a model for other community engagement projects,” he said. “Everyone involved in this is blown away by what we’ve achieved and the inspirational outcomes that have come from putting some seeds in the ground and seeing what happens – both literally and figuratively,” James said. Like baseball fan Ray Kinsella in the Kevin Costner film ‘Field of Dreams’, James built his garden to attract dislocated people from another time and place. And like the protagonist in the film, he built it and they came. “We started with a working bee and we had a few of the local Karen people turn up to do some weeding in the mansion gardens. A few of them said they’d like to come back,” James said. “The Karen came back with some of their friends and family members and soon we had a small workforce,” said With so much labour on hand, James decided in June 2012 to recreate the Mansion’s historic kitchen garden which was first established by the
Chirnside family as owners of the mansion in 1875. The Chirnsides were one of Australia’s wealthiest squatter families who created a pastoral empire in western Victoria and built the 60-room Italianate Werribee Mansion between 1872 and 1877. As new laws and taxes were introduced into Australia and with the decline of the wool industry, the Chirnsides’ fortunes waned and as a result the kitchen garden fell into disrepair. The family sold Werribee Park in 1922 and for many years the house served as a Catholic seminary. In 1875 the garden produced fresh vegetables for the Chirnsides’ table; now it supplies Werribee Mansion’s upscale restaurant with a stunning array of crops – from mustard greens to Vietnamese mint and from capsicum to chard. The garden is the result of a program called ‘Working Beyond the Boundaries’, a partnership between Parks Victoria, AMES and Werribee Mansion Hotel. AMES Program Manager Dr Melika Yassin Sheikh-Eldin says that people from several emerging communities
have been attracted to the park’s volunteer program. “Many of them have come from difficult circumstance or have spent years in refugee camps,” she said. “Members of these communities, who are striving to adjust to a new country, are encouraged to join the program so that as well as garden they can learn new skills, develop social networks and gain an understanding of a new culture. “The program has helped many people overcome health or social issues and it can offer a pathway to meaningful employment,” Dr Sheikh-Eldin said. She said the project was born out of a community consultation that identified needs in the local refugee communities.
“We identified issues of isolation and depression among the elderly and a lack of employment opportunities among the younger people. A lot of the youth had no clear idea of what the future would look like for them. “Many of the kids had had little schooling in the camps and little English and yet they were expected to compete with children in mainstream schools. A lot of them dropped out and ended up with no job prospects,” Dr Sheikh-Eldin said. A partnership between AMES and Parks Victoria threw up the possibility of refugees volunteering in some of Melbourne’s parks. “We talked to Parks Victoria about the possibility of refugees volunteering and we organised an excursion to Werribee. We had 15 Karen women register initially and it grew from there,” Dr Sheikh-Eldin said. “The grandparents asked to bring the kids along. Then, the teenagers and young adults - those with nothing much to do - started to turn up.
A Karen refugee camp on the Thailand border better
She said extensive consultations with the local communities were a key aspect of the
program’s success. “We engaged them from the very beginning which gave them a sense of ownership of the project. They developed a deep sense of pride in the contribution they are making,” Dr SheikhEldin said. Now, similar projects are being planned for other parks on Melbourne’s fringes. “We are looking at developing partnerships with Parks Victoria in other locations. There is the potential for a similar project at Brimbank Park,” Dr Sheikh-Eldin said.
lesson we’ve learned over time is that we have to work on reinforcing these communities’ innate strengths,” Dr Sheikh-Eldin said.
“There is also a group of Bhutanese refuges in Sunshine and Broadmeadows who traditionally are farmers and in Dandenong we have a group of Afghans interested in establishing a community vegetable garden,” she said.
The Karen people gravitated to the Werribee area after the first of them who arrived in Victoria as refugees were settled there.
“What we have found is that the more we give these communities a say in their own circumstances the more likely they are to come up with solutions to their own issues. The
The ethnic minority Karen have been targeted by the Burmese government for 30 years. There are an estimated 150,000 Karen living in refugee camps in or on the Thai border.
The Burmese army has systematically demolished Karen villages in operations described by human rights groups as ethnic cleansing. A largely agrarian and village-based people, Karen refugees have often encountered difficulties when settled
in urban locations around the world. Traditionally, they are gardeners and cultivators and living in an urban environment has left many of them dislocated and suffering depression. But being able to volunteer in the gardens of Werribee Park has had a remarkable effect on them. James Brincat says that many of the local refugee communities have suffered clinical depression and that their health has improved because of the program. “What we’ve seen is that people find a sense of selfworth being able to come here and do something constructive,” he said. “What was a big surprise was to see the kids turn up – teenagers also – who want to come and garden. They’re here during the school holidays and weekends, they just
love being with their mums,” James said.
the conflict there and has suffered depression and dislocation.
One of the mums who played a key role in the success of the program is Evelyn Kunoo, who grew up in southern Burma with a large lush garden where her parents grew mangoes, bananas, pineapples and a cornucopia of vegetables.
Several months ago ‘Bee See’ was without work and suffering severe depression.
From the age of 17 and for 22 years Evelyn lived in a refugee camp on the Thai-Burma border. She and her husband Kert, whom she married in the camp, have been living in Hoppers Crossing for seven years. James says Evelyn has been responsible for bringing people from the local refugee communities into the garden and inspiring them to contribute. “Evelyn is a leader in her community and she has become the heart and soul of the garden. “She has recruited and organised the community members to work in the gardens and is a driving force behind the whole thing,” he said. Another key figure in the garden community, and one of its great success stories, is another Karen refugee Bee See Maw Kay. He spent many traumatic years in refugee camps in Thailand, lost his father and some of his family in
Now, thanks to the garden project at Werribee, BeeSee is an intern park ranger who hopes to become a fullyfledged Parks Victoria Ranger. “At first Bee See was timid and almost afraid,” James said. “But we’ve watched him blossom into a real leader in his community.” “He’s gone from pulling up weeds to learning about machinery and he’s studying horticulture,” James said. The program has seen the establishment of a private horticultural college at Werribee to provide training opportunities for members of local refugee communities to help them find paid work in the local market garden and nursery industries. “Giving people from the communities skills they can translate into jobs is one of the more rewarding aspects of being involved in the program,” he said. James said the knowledge and skills exchange has been reciprocal. “Our rangers say that having the Karen people work alongside them has been as much of a learning experience for them as for the volunteers,” he said.
“And the Karen are now renewing the collections in the gardens. They have begun a project on propagating plants for the gardens. They have already produced about a thousand plants. This is big as it will potentially save us thousands of dollars,” James said. The local refugee communities in Wyndham, particularly the Karen, have taken to the job of managing the gardens in significant numbers and in doing so have found themselves reengaged, with a new sense of purpose and have reconnected with their traditional pursuits of gardening and food cultivation. The project has become a model for both sustainable community gardens and engagement strategies for marginal communities; and, in the heart of one of Australia’s rapidly developing urban districts, the Karen have rediscovered their links with the land. Following the success of the kitchen garden, volunteers from local communities are now at work in the park’s orchard and river park area. The orchard is home to hundreds of varieties of fruit and volunteers are involved in pruning, grafting and
propagation work. They are also working to help to stabilise river banks, reforest areas of woodland and humanely eradicate pests. ‘Field of Dreams’ is the story of an Iowa corn farmer who hears voices commanding him to build a baseball diamond in his fields. When he does, what appears is a ghostly team of long lost baseball players none of whom ever reached their full potential. Anyone who has seen the film will know that the underlying theme is that for those prepared to open their hearts and minds, anything is possible. James Brincat and the volunteer gardeners of Werribee Park are proof of this. The gardens at Werribee have become a field of dreams for many people in local refugee communities. But unlike Ray Kinsella’s ‘Field of Dreams’, James’ garden is not a figment of imaginary Hollywood fancy, but a living, breathing, productive garden; and perhaps more importantly the cultural and spiritual focus for a group of people lost in time and space.
This article was provided by Laurie Nowell, Senior Journalist/Writer at AMES. AMES is Australia’s largest provider of humanitarian settlement, education, training and employment services for refugees and newly arrived migrants (http://www.ames.net.au/). While Better Mental Health Magazine does not have take political affiliation or position, more information about the Karen refugees can be found at Karen Human Rights Group. More information about the mental health of refugees can be found at the Refugee Health Technical Assistance Centre (http://refugeehealthta.org/).
mental health of refugees The United Nations High Commissioner and for Refugees (UNHCR) estimates as at 31 asylum December 2012, the seekers number of people
displaced by persecution and conflict at 45.2 million; 28.8 million internally displaced persons, 15.4 million refugees and 937,000 asylum seekers. Typical mental health issues affecting refugees and asylum seekers include anxiety, depression, distress, PTSD, substance or alcohol use, depression or impulsivity, feelings
of hopelessness, social isolation, loss and chronic grief. The impact is staggering. Suicide rates amongst the general population is around 11 per 100,000. It can be three times as high for refugees, many of whom who have suffered hunger, persecution, torture, and other atrocities. Providing a safe environment for refugees extends far beyond housing, to critical and ongoing mental health care and support. Luke Myers Editor
Lotshampa (Bhutanese) refugees in a Beldangi camp
Losing Lives to Stigma What the cases of Pallavi Dhawan and Saiqa Akhter can teach Communities about immigration, integration and the Social Stigmas of the Developmentally Disabled By Furqan Sunny Azhar
Pallavi Dhawan, her husband, and their child left India and came to the US in 2012 partly (or primarily) because they wanted better treatment options for their son, Arnav. He suffered from a brain cyst and microcephaly, a condition characterized by a small head circumference. Their time in the US was short and tragic, as the three of them are now dead, and the motives regarding the deaths are still under investigation. What we do know, though, is that the death of her child and her husband have been ruled a homicide, and her death has been ruled a suicide.
More is known about the tragic case of Saiqa Akhter who, in 2010, strangled her 2 children because they were autistic. She wanted â&#x20AC;&#x153;normal kids,â&#x20AC;? as she stated in her 9-11 call. Various media outlets revealed that she was suffering from depression in the days leading up to the childrenâ&#x20AC;&#x2122;s murders. In my own practice as an immigration attorney, I have handled asylum cases for South Asian clients who have a developmentally disabled child. Their stories, which are fully corroborated by country condition reports, reveal that not only are the disabled children discriminated against in their home country, but there exists a hostility towards parents of developmentally disabled children as well. Parents of disabled children are also discriminated against, vilified and demonized. The often prevailing thought is that God has punished them, so they must deserve the burden (or blessing depending on how you
think about the way in which developmentally disabled children are treated in our communities
view it) of caring for a developmentally disabled child. The other common perception is that the parent’s genetic makeup was in some way responsible for the child’s condition, and usually the mother unfairly bears the brunt of this blame, since she bore the child. Both Pallavi Dhawan and Saiqa Akhter were immigrants to the US. They had opportunities to leave their home countries, and they took advantage of those opportunities. It is certainly true that with respect to the issue of treatment for developmentally disabled children, the US is far and away more progressive, inclusive and tolerant as a society, particularly in relation to South Asian countries. However, immigration to the US is not always a seamless transition. Families in South Asia are structured differently than in the US. In the US, the child may leave the house at 18 in order to ‘find their own way,’ whereas South Asian communities often times live in “joint family systems” in which there exists an extended family arrangement where several families live in the same home. The benefit of a joint family system is that children and their parents have support of their immediate family, both emotionally and in terms of rearing children. This can be particularly important since caring for a developmentally disabled child is extremely challenging. It takes a tremendous amount of time and patience. I know this because I have a family member with Down Syndrome. Life in the US is different from life in South Asian countries though. The drive towards upward mobility, professional advancement and
monetary wealth, coupled with the challenges of parenting for a developmentally disabled child can be overwhelming. The absence of immediate family can lead to social isolation and depression. Parents of developmentally disabled children can begin to believe that they are victims, or that they are deserving of their “fate,” and they may repeatedly ask themselves the question, “Why us?” The cases of Pallavi Dhawan and Saiqa Akhter are tragic, but they create a teaching moment. A moment for the South Asian community to do some introspection and think about the way in which developmentally disabled children are treated in our communities, and also how we view the parents. It’s the big elephant in the room that no one wants to talk about, but the South Asian community can be a leader if they recognize the reality that although there are many beautiful things about our culture, there are ways for us to improve as well. If you know a parent who has a developmentally disabled child, don’t treat them as social pariahs. Give them a call. Talk to them. Offer your help. Encourage your children to play with their children. Teach tolerance. It may save a life. better
Parents of disabled children are also discriminated against, vilified and demonized
Furqan Sunny Azhar is a US immigration attorney of South Asian descent. His practice includes the representation of employers in all aspects of US immigration and compliance, as well as those in immigration court proceedings, including the representation of asylum seekers fleeing persecution in their home countries. His parents are retired professors, his mother a professor of Early Childhood Education and his father a professor of Sociology and Statistics. He lives with his wife and two daughters in Plano, Texas.
2:365 ART BOOK The Art of Living with Bipolar Disorder by Missy Douglas Ph.D Someone with Bipolar Disorder Type I experiences periods of depressive lows and hypermanic episodes. Deciding to create a single piece of art every day for a year, no more and no less, seemed like an interesting challenge. But that was the challenge Missy Douglas set herself. We talked to her about her mental health and the 2:365 Art Book project.
BMH: You were diagnosed with bipolar disorder at 19. Why did it take 17 years to start disclosing? Missy: Like many others, I was petrified of being judged by, and losing the respect of, my family, friends and colleagues. This changed when I started working with my artistic partner, American contemporary sculptor, Kim Rask, in 2011. The supportive nature of the collaboration, my desire to freely exchange ideas with him – and the fact that many years had passed since diagnosis – gave me the space and confidence to become more open about my private struggle with the disorder. BMH: Prior to this, you obtained a degree, masters and Ph.D and were a university lecturer in art history. Did the bipolar impact this? Missy: I dealt with the highs and lows in secrecy and basically concealed my true self. I told very few people (not even my parents, family or close friends) and developed my ‘sky blue performance’. I would put on my entertaining, confident, public face and perform to within an inch of my life (it is for this reason that sky blue is a very prominent and important colour in the palette of 2:365). This way of living was unsustainable, exhausting and terrible in terms of my long-term prognosis. BMH: Surely, this would have had an impact on your private life as well. Missy: Not only were the swings up into mania and down into depression all the more debilitating behind closed doors, this double life had damaging effects on my personal relationships and marriage. Because I fashioned a fake normality when relating to other people, it prevented me from forging a genuine connection with them. Despite what people perceived to be my professional success, I was unable to achieve an understanding of who I really was and what I really wanted out of life. better
about the 2:356 Art Book project 2:365 examines bipolar disorder and its effects on the creative voice. Each day for the entirety of 2013, British artist Missy Douglas, with unmedicated bipolar disorder, painted a 6 x 8 inch canvas in oil. The project name reflects two phases of bipolar disorder, and the year long project.
Day 177, New York City Please God, no.
Completed wherever she was in the world, each painting attempted to reflect her emotional and psychological state – mania, depression and stability – over that particular 24-hour period. The collection of 365 paintings and accompanying book is a pictorial and written catalogue of Missy’s yearlong journey. They have received attention throughout the international mental health community and have been nominated for a 2015 National Council for Behavioral Health Inspiring Hope Award in the USA.
BMH: Do you think completing the project has changed this? Missy: It’s really helped me improve my sense of personal and professional wellbeing. It feels as though a huge burden has been lifted from my shoulders and things are starting to become clearer as to my true aims and goals. BMH: Why did you choose this way of expressing yourself and your mental health? Missy: Kim and I have attempted to readdress some of the ideas and forms of my earlier work. Psychological introspection has become a central theme in our painting and sculpture and we’ve really tried to focus on the ways in which the physical body can both harbor and reflect psychological pain. So by the time we hit upon the idea for 2:365 at the end of 2012, the concept resonated pretty deeply.
Day 36, Brussels
I am consumed with rage and it forces me to lash out. I throw today’s canvas across the room in frustration. I hate everything and everyone around me. Normal activities are infuriating. Looking back at the weekend, I feel like a fool. How could I have let myself be seduced by such a false sense of happiness that I knew would abandon me?
BMH: How did you manage not to be explosive during manic periods and not work at all during depressive periods? Missy: Given the slow working time of oil paint, canvasses could take up to several hours to complete but even on days when the painting process was very quick, if I was submerged in a depressive phase or frantically bouncing off the walls in mania, it would extremely difficult to focus on the project. When this happened, I had to consistently remind myself that the key to 2:365 was to be mindful of the pain or energy I was experiencing at that very moment and to channel it into that one single painting before me. This was of particular importance at the beginning of the year as I was aware that the artistic – and thus the emotional – process would become easier. BMH: How do you feel about telling people now the project is complete and you need to promote the project? Missy: I am still a little reticent but the project has really taught me that the best policy is to be open and honest about the personal challenges you are facing, especially mental health problems which are far more ubiquitous than we realize. better
people BMH: How has the response been? Missy: Well, to gauge interest in the project, Kim and I decided to show the first 120 canvasses at a small private exhibition in Brussels, Belgium in the summer of 2013. It was a big moment: I was finally going to have to come clean to everyone about my bipolar disorder. Despite my fears, the support we received was remarkable. Visitors from across Europe and the UK were not only captivated by the paintings but were keen to engage with the meaning behind them. Friends, family â&#x20AC;&#x201C; and strangers â&#x20AC;&#x201C; started opening up to me about their own experiences with depression, bipolar disorder and schizophrenia. I realized that what had started out as a personal project with little real altruistic intention had the potential for huge social impact. BMH: Do you feel that discipline impacted your bipolar during the project? Missy: Iâ&#x20AC;&#x2122;ve always benefitted from routine to manage my symptoms and keep on top of things. That I had to produce a painting every day actually kept me from sliding into extremely bad depression or escalating into full-blown mania. On one level it gave me a daily purpose and a reason to get up in the morning. BMH: What sort of support did you have throughout the project? Missy: Kim, of course. We approached several organisations when we commenced, but there was little interested. Encouraged by the Brussels showing, we reached out to the International Bipolar Foundation to ask for their support in the creation of what was to become the 2:365 Art Book. They have been unstinting in their encouragement and it has been a real pleasure to collaborate with such a dynamic organization dedicated to the understanding and treatment of the disorder. 10% of each book sold goes to the Foundation. BMH: And now, what has the response been like, since the launch? Missy: I have been contacted by hundreds of fellow people with bipolar disorder and their loved ones across the world. People have felt empowered to share their stories and have expressed a newfound
Day 314, New York City I am flying. I feel the yellow heat on my skin and dive into the cool turquoises below. I feel full of passion and confidence. Nothing will go wrong and I will become great. I am untouchable.
resolve to speak openly challenge some of the misconceptions surrounding the disorder on a personal level and within their local communities. This has convinced me that the 2:365 journey was truly invaluable. I finally see that support is a truly mutual process and that publicly acknowledging personal struggle can have a hugely beneficial impact on those around you. BMH: Thanks, Missy.
Day 242, New York City Today is a day of contrasts. The morning sees my mind tick, tick, ticking, my body buzzing. I feel fantastic. Within minutes, I crash and the waves pour over me. I am a complete failure. No one respects or likes me. You are alone. A former lecturer in fine art and art history, Missy Douglas is a British artist and writer currently based in Seattle, USA. Awarded a Ph.D from the University of Cambridge UK in 2005, she has worked as a professional artist in the fields of oil painting and sculpture since 1999. She is the co-founder of fine art studio ucki ood with American contemporary sculptor, Kim Rask. Her work has been exhibited in solo and group shows across the US and Europe, as well as being featured on BBC Online World News and BBC Radio. As a writer, she has contributed to a variety of publications including Psychology Today, Bipolar Burble, Brussels Weekly and The Benezit Dictionary of Artists. The 2:365 Art Book containing reproductions of all 365 images and Missy’s written diary of the year is available to buy through Missy’s studio web-shop at www.uckiood.com. 10% of proceeds directly benefit the International Bipolar Foundation (www.ibpf.org). Paintings from the 2:365 collection are also available for purchase. For more information, visit http://www.missydouglas.com or http://www.uckiood.com.
Bipolar Disorder is as complex, interesting and difficult as it is common, so weâ&#x20AC;&#x2122;ll only give some of the basics here to help put Missyâ&#x20AC;&#x2122;s project into perspective.
repeating cycles of mania, wellness, depression, wellness more subtle periods of depression then hypomania
experience periods of mania and depression together
mood decision making behavior ability to function
sadness, withdrawal, fatigue, depression, guilt, despair
heightened mood, racing thoughts, high energy and activity
of people are initially misdiagnosed
the lifetime suicide rate for people with bipolar disorder
Sir Isaac Newton Winston Churchill Beethoven Frank Sinatra Marilyn Monroe Vincent van Gogh Florence Nightingale Robert Downey Jr. Catherine Zeta-Jones are just a few people with bipolar disorder
characterised by mood swings
men are just as likely to be affected as women
of people are affected by bipolar disorder
10 years time it can take for some people to be correctly diagnosed
Medications Cognitive Behavioural Therapy Psychotherapy Electroconvulsive Therapy are common
treatments want to know more? for more information visit the international bipolar foundation website at http://ibpf.org/
please understand that some of the numbers vary across countries, these are representative averages
The pursuit of
nothing Daniel Marcus discusses how our increasing pursuit of happiness can impact our stress and directly affect our physical wellbeing
The pursuit of happiness may be an illusion. It is like running towards a mirage of an oasis in the desert; chasing after it will leave you tired and thirsty. We are all, however, thirsty for happiness and this desire or unalienable right seems to be at the height of its popularity. The UN‘s “World Happiness Report” and the New Economic Foundation‘s “Happy Planet Index” are two examples of many happiness-measuring initiatives and signify the increasing importance society places on this elusive emotion. A deep understanding of happiness is limited due to its subjective nature. Even now, research on the subject remains in a state of immaturity. Although both adults and children pursue happiness, it seems that this mystifying pursuit can lead instead to stress and disappointment. Money is often coupled with happiness. Many of the relevant surveys, indices and reports consider macro and/or microeconomics as happiness indicators. It should be a surprise then to discover that as long as basic needs can be met, happiness levels across socioeconomic groups remain comparable. This counterintuitive finding – also known as “The Easterlin Paradox“ – has been explained by theories such as adaptation and relative income. People adapt to more money. There is a short period of satisfaction and then, once expectations and habits adjust to the new material acquisitions the level of happiness reverts back to its original state. The influence of
relative income has been demonstrated in studies presenting subjects with a choice between a high salary that is less than their peersâ&#x20AC;&#x2122; or a low salary that is more than their peersâ&#x20AC;&#x2122;; people preferred the low salary. A striking area where socioeconomic status (SES) seems to be influential is the expectations placed on children. There is more pressure (both internal and external) to achieve economic and educational success in higher SES groups. Social environments and expectations vary between SES groups and cultures, as do coping mechanisms for dealing with stress. Adults self-navigate lifeâ&#x20AC;&#x2122;s problems whereas kids receive more guidance and it may be beneficial for educators to identify the pressures inherent in particular groups of children in order to steer them on to a positive path. Separating hedonic happiness (pursuing pleasure) from eudaimonic happiness (pursuing meaningful activities) may serve as a useful compass for this journey. These revelations are worrying and further compounded by the drive to accumulate money and material wealth which can cause people to neglect invaluable aspects of life. Family, friends, meaningful activities, sleep and exercise are often casualties of the pursuit of a socially defined happiness. Ironically, these wonderful eudaimonic elements have been shown to be the strongest sources of happiness and highly resistant to adaptation. The pursuit of meaningful, goal-oriented activities is a real endeavor with ups to celebrate and downs to learn from whereas happiness is not a meaningful goal, it is nothing more than a by-product. There are many societally defined forms of happiness, money is one and beauty is another. The failure to achieve these predefined happiness endowers can be stressful and stress related health problems may ensue. Aesthetic happiness can often be realized with the help of surgery, orthodontics and dentistry. The positive psychological effects of orthodontic treatment is well documented, this is both a testament to the profession and an insight into a journey through teasing, chronic stress or depression better
The pursuit of meaningful, goal-oriented activities is a real endeavor
Chronic stress has a wide range of negative health effects
prior to the procedure. It is not just parents who request orthodontic treatment for their children, kids are acutely aware of their appearance and can suffer social exclusion simply for having crooked front teeth. The emphasis society places on aesthetics can force young, unhardened souls into a battle against chronic stress. Chronic stress has a wide range of negative health effects and current research is uncovering how both the pursuit of hedonic happiness and emotional stress can directly threaten physical health, starting with the upregulation of stress hormones. Interestingly, the concept of eustress – interpreting something stressful with a positive and/or productive perspective - has received recent scientific support and has been attributed to more favourable psychological and physiological health outcomes.; This signifies the importance of one‘s perspectives and cognitive appraisal abilities when tackling life‘s stressors. A potential objective window into the subjective stress experience may be revealed by the common jaw joint disorders known as temporomandibular disorders or TMD. The causes of TMD related persistent facial pain are multifactorial. However, studies have shown stress, depression, sleep disorders and childhood events to be strongly correlated. In one study, children who reported being neutral about or dissatisfied with life at age 11 were more likely to develop TMD related facial pain by age 14. In addition to this, a surprising
A Pain in the Jaw Could Signal Stress Temporomandibular disorders (TMD) refers to problems with the jaw and facial muscles that control it. Some
possible symptoms include facial, jaw and neck pain, toothache, headaches, shoulder pain, or tinnitus. While the cause is not certain, grinding or clenching teeth or tightening facial muscles – common signs of stress are often suspected. If you have regular or constant pain, make sure you have it checked.
number of studies displayed the counterintuitive correlation of more TMD as wealth increases. Why would wealthier people that are supposedly happier and less stressed have more stress related facial muscle pain? What environmental and/or internal pressures cause children to suffer from chronic stress? A misinterpretation of what it means to be happy may be behind these kinds of counterintuitive findings. Demoting happiness from a goal worth pursuing to a mere by-product of meaningful activities could help resolve or reduce these issues. A refocusing of our happiness lens would clarify the meaningful from the meaningless and reveal the pressure to be happy as the fabrication that it is. In the desert that we call life we should help other wanderers, appreciate our relationships and strive for ingenuity rather than remaining stubbornly trudging towards the nonexistent oasis of happiness. Concepts in this article are drawn from the author’s research paper, “The Pursuit of Happiness, Stress and Temporomandibular Disorders”. Marcus, D., Baehrisch, E. The Pursuit of Happiness, Stress and Temporomandibular Disorders. Health, Culture and Society, North America, 5 Nov. 2013. The original research paper, with full references is available at: http://hcs.pitt.edu/ojs/index.php/hcs/article/ view/129/175
Daniel Marcus is an Australian dentist from Melbourne who has practiced dentistry in Australia, New Zealand, Germany, and volunteered in remote northern Australia and Cambodia. His exposure to different people from all walks of life inspired him to wonder about the inner workings of the human mind and particularly what impels it. Happiness is a powerful motivator and Daniel tasked himself with unravelling its mysteries by linking the subjective emotions of happiness and stress with the objective components of TMD in his research article, “The Pursuit of Happiness, Stress and Temporomandibular Disorders”. better
Common Signs of Stress Cognitive Signs
Irritability or short temper
Anxious or racing thoughts
Sense of loneliness Depression
Aches and pains
Earing more or less
Headaches or dizziness
Sleeping too much or too little
Diarrhoea or constipation
Avoiding other people
Chest pain, rapid heartbeat
Loss of sex drive
Using alcohol, cigarettes, or drugs to relax
The Gift of Mental Illness And Why You Should Never Give Up on Life Melanie Berman shares her thoughts about living with mental health and her resounding faith, purpose and determination in life, despite living with bipolar and obsessive compulsive disorders. One in four American adults struggle with mental health issues. That means someone you know. A friend, a family member, an acquaintance or you.
lack of independence that the mental health challenges have given me. Why, you may ask? Why not trade it in for an easy, dare I say, “normal” life?
These struggles are are not easy. Conditions can range from depression or anxiety, to OCD and Bipolar Disorder, to Borderline Personality Disorder and Schizophrenia. There are all types and levels of severity.
Because there is a gift in mental illness. It may be hidden under a whole lot of crap. But man — is it there?!
As a 22 year old living in Northern California with a Bipolar Spectrum Mood Disorder and OCD, my life has been far from easy. But I would not trade‑in the mood disorder for a perfectly chemically balanced brain. Yeah, you read that right. I wouldn’t trade the sleepless nights filled with panic or the depressive episodes or even the unexplainable periods of severe irritability. I wouldn’t trade‑in the broken relationships, the devastation experienced by both myself and my family with every episodic mood swing, the medical leaves of absence from college, having to quit most jobs I start, or even the better
Two and a half years ago, May of 2012, I was living a “normal” life as a student at UCSC. I was taking classes and I lived in a house with four of my best friends. I was even planning on studying abroad in Rio de Janeiro in July! I was very excited about it and enthusiastic about life in general. But, somehow, there was always something missing. I prayed at night, searching for some kind of spiritual comfort in the emptiness. I wasn’t exactly depressed, but I felt like I was living on the surface of life. One night in May, I specifically remember praying for “something deeper”. Shortly after, on May 3, 2012, my life changed and it has never been the same since. I had to call my parents because I didn’t know what was
I would not trade-in the mood disorder for a perfectly chemically balanced brain
Melanie Berman lives and studies in Northern California. She loves dogs, dancing and nature. She has also undergone mental health challenges but has used her faith to shed a positive light on her situation.
happening. I couldn’t sleep at night because I was so afraid of hurting myself or someone else. I couldn’t get violent images out of my head. I felt like, overnight, I had turned from “normal” to some psychopathic potential murderer. Later on in treatment, I learned that these thoughts are common of OCD, and that they are named as “egodystonic thoughts”. At the time, however, I genuinely thought I was extremely dangerous and it was incredibly disturbing. I am learning to love myself and even embrace the gifts of the mood disorder My parents received my anxious phone call that next morning, after a sleepless night of telling myself over and over again to stay still and I would be fine. They quickly came to pick me up. I left UCSC, went home to Santa Rosa to live with my parents, and I entered psychotherapy and psychiatric treatment. The next two and a half years, well they haven’t been pretty. Med trial after med trial, and so many different modalities of therapy — yet nothing seemed to work. Thankfully, I have recently found a med and a therapist finally to keep my OCD under control. So, definite progress has been made. In terms of the mood swings though — recurrent depressive episodes and periods of severe irritability — there is better
still a lot of progress that needs to be made. But, I have not lost hope. “Why?!” you may ask, “why not just give up?” Because I love life too much. Yes, I may get really, really depressed sometimes. I may get so angry I can’t even control myself. I may get so anxious and worried during panic attacks and thought spirals that I might die or that I will spend the rest of my life “healing” — sometimes seen by myself as wasting away. On a bad day, it can be a major struggle to get out of bed. On a good day, I see even that struggle from a different perspective. This Mood Disorder was a gift. It has taught me more about myself than any other experience I’ve ever had. That depth I was praying for — well it came in the form of a mood disorder. I asked, and the mood disorder was delivered. Though I may be 22 and living with my parents, unemployed and taking one class — those are all external, shallow analyses and to me they are meaningless. The strength I have gathered from the Mood Disorder could never, ever be replaced. Maybe I’ll move out one day and get a degree. Maybe I will even get a job. Maybe I will spend my life between mental hospitals. Who knows? And you know what? With all the fear, with all the uncertainty and all the very possible despair, I’m still excited to find out where my life will take me. Because life, to
people to give up on life is a slap in the face to your loved ones, and mostly to yourself me at least, has nothing to do with outward success. Each of us has a soul that is on a journey. And our soul is sometimes fed through getting knocked down repeatedly, and standing up slowly but unfailingly every time. I believe we are here on this earth to learn lessons and grow. If not — if life was happy and easy all the time — it would just be boring. We need the pain so that we can also know what joy is. I was created with a mood disorder. And I am learning to love myself and even embrace the gifts of the mood disorder. At age 20, my journey went into high speed and pummelled me into something I never thought I could handle. Well, look at me now, two and a half years later and handling it. It may not be perfect but I get tons of support. As I should. On any given day I could feel anxious, happy, desperately depressed, angry, or calm. Like most people, just more intensified emotionally. Sometimes I feel so inspired by my emotions to create — and that is another gift. Writing has been a huge therapeutic tool for me.
I figure, if I can help others through a mental health struggle by shifting their perspective to see it as a blessing rather than a curse, then maybe I could even show people that LIFE HAS PURPOSE. Even when you can’t breathe because you’re mid panic attack or you can’t get out of bed and your pillow is soaked with tears. Even when you are fighting urges to hurt yourself or others. Even when you feel so unstable that you don’t know how you could go from feeling sane one day to actually questioning whether or not you’re a psychopathic murderer the next. You are on this earth for a reason. Not to be forgotten. And not to feel pain. But to come out of tough experiences and GROW. And to show others that if you can do it, they can do it too. We are all in this together. There is always more help and support and you, or your acquaintance, friend, or family member are not the only ones going through something really, really difficult. But to give up on life is a slap in the face to your loved ones, and mostly to yourself. I believe it is the ultimate form of rejecting the blessing of a life that has been given to you. Even if this blessing of a life comes with curses — just remember — they may be blessings in disguise. :-)
Editor: We asked Melanie to “tone down” her original submission. We felt that the aspect of faith could cause unease with some readers. We don’t include articles on spirituality. But we understand that, for many people, such as Melanie, faith plays an important role in managing mental health. It can be as valid as therapy, meditation or medication is for others. We want to express our gratitude to Melanie, who’s strong faith has helped her come to terms with, and manage her mental health.
Keeping it Clean in the Kitchen
changing a habit to reduce stress
Dan Hanna explains how he assessed and changed his habits to lower stress. By keeping things better organized he tends to feel more relaxed. better
I was in the library one day, browsing the self-help section when I came across a book called the Power of Habit by Charles Duhigg. The book describes some of the ways people, organizations and social movements are affected by the routines they use as they go about the day conducting their business. Duhigg makes several important points about habits. But most impressive for me was revelation of the degree to which habits can determine success or failure in personal life. While habits do not equal fate or destiny, they are always worth studying when trying to answer the question â&#x20AC;&#x153;How did I get here?â&#x20AC;? Hoping to take some of the basic principles from the book and apply to them to my own circumstances, I
decided to conduct an experiment using yours truly as a guinea pig. My goal was to break the habit of leaving dirty dishes in the kitchen sink after eating. I wanted to be more diligent about keeping my kitchen sink clean and free of the unwashed dishes left after my meals. Aesthetically, the problem bothered me, and it made me less inclined cook food and eat at home. I thought, if I broke the habit apart and analyzed it, I could figure out how it worked. I needed to know something about myself. Why was I procrastinating when dirty dishes bothered me so much? Was I simply lazy? But I had another reason for dissecting my behavior. I wanted to control it. Simply put, I wanted a clean sink. First, I made a list. I asked myself, “Why change this habit?” List of Reasons to Wash Dishes Now: 1. It’s unappealing when I look at a sink full of messy dishes. 2. It makes me less likely to cook a full meal. 3. It’s embarrassing when company comes and the sink is full of dishes. Next I asked myself, “What might prevent me from rolling up my sleeves and scrubbing?” List of Reasons to Procrastinate: 1. After a meal, I am more relaxed. This makes washing dishes particularly unappealing. 2. Some pots need to soak and when I return to clean them, I don’t like putting my hands in the cold dirty water. 3. Waiting is a viable option because I know that I don’t NEED to wash them immediately. If I chose not to change this habit, the world would not come to an end. Now I was ready to experiment. Motivated by my List of Reasons to Wash Dishes Now, I decided to better
people tamper with my List of Reasons to Procrastinate. My first reason to procrastinate: After a meal, I don’t feel like washing dishes. I am relaxed and I want to stay relaxed! Here I realized that if I succeeded in changing the habit, I would be able to relax for a greater amount of time than if I continued to procrastinate. I would not be bothered and annoyed by the sight of dishes in the sink later in the evening each time I stepped in the kitchen to get a glass of water or to answer the phone. Instead of a few minutes of ease gained by letting the task wait, I would receive up to five or six hours relief until the next time I needed to cook. The mess would not be waiting for me. My second reason to procrastinate: Some pots need to soak. When I return to clean them, I don’t like putting my hands into the cold and dirty water. This one was tricky because if a dirty pot required soaking, it would simply have to soak; this I could not change. So I thought if I just washed all of the eating utensils – all the cups, all the plates, and all the silverware – most of the problem would have been solved and returning soon to wash solely the pots might then seem like a less tedious chore. This was acceptable to me, so I checked it off my list and continued to the next item. My third reason to procrastinate: Waiting is a viable option because I know that I don’t NEED to wash them immediately. If I chose not to change this habit, the world would not come to an end. This was true. Compared to some of the other problems with this world, a sink full of dirty dishes is only mildly annoying. If I continued this habit, life would not be unbearable. But, and here’s the thing: My kitchen sink on a day-to-day basis would quite often contain unwashed dishes. This won’t do! Dirty dishes bother me. I can’t solve all my problems, but I can certainly do away with this one.
Procratstination Snapshot procrastination impacts around 20% of people
men tend to procrastinate more than women 54% are men 46% are women
40% believe they have experienced financial loss as a result
people who say they are chronic procrastonators 5% in 1978, 26% now
people who are chronic procrastinators
1 in 5 people procrastinate enough to impact thier work, relationships and health
people who procrastinate sometimes
avoid unpleasant tasks fear of failure task or requestor resentement overwhelming priorities goals unclear lack of skills poor time management
increased anxiety severe depression obsessive compulsive disoder attention deficit disorder low self-esteem high stress loss of memory
Beating Procrastion define the task know what youâ&#x20AC;&#x2122;re trying to achieve and make sure itâ&#x20AC;&#x2122;s achievable be realistic start with small, achievable tasks or small parts of large tasks set deadlines how long it will take, when you need to start and when you need to finish ask for help family, friends colleagues may help with the task or just check progress seek support if itâ&#x20AC;&#x2122;s still impacting your life, consider talking to a counsellor celebrate success take the time to be proud of your achievements and keep going! better
people This lead me to a resolution that I decided to adopt formally. It reads as follows: I, Dan Hanna, will (on most days) wash my dishes immediately after eating. My dirty pots may soak, but I will return to the sink to wash them later the same day. To help me along, I made a list of the rewards of keeping my habit and stuck it to the refrigerator door. The list also serves to remind me of the agreement I have made with myself to change this habit until it becomes an automatic one. Here is the list of rewards written as happy exclamations: Nice clean sink! Cook Away! Relax More! Clean Basin Looks Great! The cards will continuously remind me this is what I prefer. This way, I will be training my mind to remember it enjoys these things. I will look forward to a nice clean sink; Cooking will be more fun; I will enjoy the relaxing effects of knowing my kitchen is clean; I will enjoy the visual appeal of having a clean dish basin. So, now the habit is very much set-up and working well and I am hoping to apply the principles used in its creation to form other good habits. I am also building a list of rewards so that I have it available for other habits that I want to change and for new ones Iâ&#x20AC;&#x2122;m hoping to create. If you feel you would like to try something like this, consider swapping rewards in and out to check for effectiveness. What motivates one day, may be uninspiring the next. Good luck! Dan Hanna lives in South Central Pennsylvania, USA. He is 48 years old, and is married to his best friend, Colette. He and his wife like to shop local farmer's markets and to attend craft shows. He copes with Social Anxiety, and Generalized Anxiety Disorder. He plans to blog about some interesting experiences dealing with these two life long problems. Some of which, heâ&#x20AC;&#x2122;s found humorous. Besides writing for the web, he has written a Children's picture book.
Be happy in the moment, thatâ&#x20AC;&#x2122;s enough. Each moment is all we need, not more. Mother Theresa
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