Better Mental Health Magazine Issue 4 by BMH Magazine

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MAGAZINE

9 772204 196001

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ISSN 2204-1966

ISSUE 4

US$8.99 £5.99 €7.99 AU$10.99

â&#x20AC;&#x153;Look at everything as though you were seeing it either for the first or last time. Then your time on earth will be filled with glory.â&#x20AC;? Betty Smith

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a look inside ISS U E 4 30 16

topics featured in this issue 6 10 14 24 34 38 46 56 60 116

Welcome, from the Editor Keir discusses using the right words Family Systems - Therapy in perspective The bipolar caregiver Religion, culture, and the stigma Party drugs without the party Developing complex medications Dissociation disorders Life as a young adult with ADHD Workplace bullying in brief

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contents

74 56 real people and real lives 16 30 46 52 74 80 92 98

Why Me? A bipolar marriage Sally accepts her bipolar disorder Adreyo examines lifeâ&#x20AC;&#x2122;s tapestry Naomi grounds through dissociation Losing your best friend Anxiety in paradise How Lidia beats anxiety Mathewâ&#x20AC;&#x2122;s moment of mental illness

improve wellbeing every day 60 110 102 108

7 Tips of wellbeing An alternative insomnia approach Considering the meditation approach The importance of hydration

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from the editor

Better Mental Health Magazine Issue 4 4 June 2015 ISSN: 2204-1966 (print) ISSN: 2204-1974 (digital) 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: contact@bmhmag.com fb: facebook.com/bmhmag g+: google.com/+bmhmag tw: twitter.com/bmhmag p: pintrest.com/bmhmag li: linkedin.com/company/bmhmag

Printed in the UK by The Magazine Printing Company using only paper from FSC/PEPC suppliers www.magprint.co.uk

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The Diagnostic and Statistical Manual of Mental Disorders version 5 (DSM-5) is over 900 pages. The ICD-10 Classification of Mental and Behavioural Disorders is nearly 300 pages. They both describe essentially the same disorders, sometimes in the same way, sometimes slightly differently. It is designed to help practitioners communicate. These are mental disorders only and there’s a lot (my non-technical term) to cover. Add to this the ideals of mental health (such as stress or resilience) and mental wellbeing (such as general health and happiness). There’s a huge amount (more non-technical terms) to cover. Better Mental Health Magazine can’t cover all of it. But we don’t try to. Mental health, whether a disorder or mental outlook, is wide-ranging and far-reaching. It’s loosely defined to meet a need for understanding and communication for a general audience. This is not a technical manual or textbook on mental health and wellbeing. We know that mental health is different for all people. Even two people with the same diagnosed disorder will experience it differently. And the wellness advice will be different for many different people. I tend to think of mental health like colour. Bipolar, for instance, we could call red. But there are different shades of red. And what one person describes as red (dark red or crimson, for instance), another might describe quite differently (deep red or carmine). And what if someone is colourblind? They may still recognise it as what we call red but not be able to differentiate it from another colour. It doesn’t mean it’s not red, or that it’s red for everyone, just that

about

we experience it differently. To me, that’s important.

aspects to mental health. But that’s not always the complete picture.

It’s important that we understand mental health is different for everyone. It’s important that we can see that each person experiences their life, their mental disorder or mental health or overall mental wellbeing differently. Each experience is as unique as each mind. Like colours, it’s about our own personal perception. That’s what matters.

I thank everyone who does actually struggle with their lives, with their mental health, with the implications of their mental health, for sharing their stories. Of course, I also thank those people who simply have a good life through maintaining positive outlooks to mindfulness and wellbeing. These are two important aspects that do, in fact, often cross over. Thank you, to all our contributors.

This issue has been difficult for us to put together. We are a small team and there has been a lot going on that has affected all of us. We seem to have been surrounded, personally or by association, with many difficult situations. My own mental health has been particularly difficult. We get there in the end – that’s what we do. We’ve had more instances than usual (and we have a lot) of contributors “disappearing”. Sometimes, someone will send the most amazing article. When we try to contact them for additional details, they don’t reply, ever, or one reply and then nothing. Our concern, of course, is for their wellbeing. So we spend time trying to get in touch and make sure people are okay. This doesn’t always work out so well. And that’s one aspect that makes putting this magazine together so difficult.

We’ve started including references for the more academic or practitioner articles. It doesn’t necessarily make for great reading but some of our readers have expressed interest in reading the source and it’s respectful to our contributors for their research effort. I hope you enjoy reading this issue. Please, keep well, keep safe, take care and enjoy better mental health.

Luke Myers Editor

This is about real people, with real lives. In some cases, they have been, or still are, quite difficult lives. Often, the article we publish is only one aspect of their life. Yet, I sometimes have the privilege of a full conversation and am welcomed into the much fuller life of the person. We do like our articles to be positive because we want you to know that there are many positive bmhmag.com

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Ruth Myers Counselling

Based on my fields of experience and interests, I take a HumanCentered / Person-Centered approach, which focuses on what you feel your needs are and the direction you would like to take. It is a gentle approach with respect, genuineness and empathy and one which derives from the belief that you understand yourself the best. Contact me to book your first in‑person or online session. www.ruthmyerscounselling.com.au

“Humans’ ability to grow is infinite... when they feel safe.” Carl Rogers

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about

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 as 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.

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We all say the wrong things by Keir Wells We live in a society of political correctness (PC). So much so that the phrase “political correctness gone mad” is a very common reaction. Gender, race, religion, sexual preference and now, it seems, mental health are subjects where we are constantly second-guessing what we say and write in order to ensure our adherence to the constantly evolving and increasingly confusing PC guidelines.

“So, tell me your story” It was only a few months ago that I attended the wedding of my best friend here in Melbourne. He’d done me proud. Not necessarily by marrying an absolutely wonderful young lady (which was definitely the case), but by ensuring I was seated next to a very attractive and single

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Quite frankly I vote in favour of PC. I do, though, recognise that it is getting somewhat out of hand and I admit to being a contributor. I am a manic-depressive, not bipolar. I am Aboriginal and not “part” Aboriginal. On the other hand I’m happy to refer to myself as a psycho, nutcase and loony. They are terms I use as part of my mental health management techniques, which involve laughing at myself. woman during the reception. As we sat and chatted about various inane topics, such as our respective friendships with the newlyweds, she asked the question: “So, tell me your story.” All credit to her. She sat and listened politely as I talked excitedly about my work in the mental health field.

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She seemed quite attentive and even interested when I explained the concept behind the mental health not-forprofit organisation I head up. Then she came in with an absolute bomb. “Y’know, I really have my doubts about people who only ‘attempt’ suicide.” Her comment reminded me of the tests to which suspected witches were subjected. Either by fire, water or some other deadly means, the suspected witches (and warlocks) were deemed innocent only if they succumbed to the torture and died, obviously not having the powers that would be required to save them. Her rationale, it seemed to me, was that if you only ‘attempted’ suicide then your mental illness was suspect. There was so much I wanted to say and ask. What I managed, though, was:

“You have to understand that in many cases it’s the only measure of control people feel they have over their lives… to attempt to take it or harm themselves in some manner.” “No!” she replied with conviction. “I believe that everyone has full control over themselves and their own lives.” I’ve told many people this story and most of them get quite incensed about it. Why? She didn’t understand and she said the wrong thing. Don’t we all say the wrong thing at times? She definitely wasn’t being nasty. She simply didn’t understand.

She didn’t understand I appreciate all too well that it’s that sort of ignorance and reaction that can have dire impact in society – the family, workplace and community.

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Years ago, when I told my wife – at the time – that I had been diagnosed with manic-depression, she began divorce proceedings almost immediately. Only a couple of years later she tried – unsuccessfully, thank goodness – to use it against me in custody of our children. As far as I’m concerned now, she didn’t understand. Ultimately, whether born of ignorance, arrogance and just lack of common sense, everyone is going to say the wrong thing about mental illness at some stage. People will react negatively and even apply the “mental illness” tag in an often destructive manner. We need to try and be less sensitive. We need to recognise that everyone, regardless of their level of understanding, will make mistakes as we move towards a society that’s more aware and accepting of mental illness.

“How about we just settle on ‘psycho’?” Interestingly, it was only around six months prior to the wedding conversation that my friend – the one who was married on that day – asked me at what stage in the

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“ That’s such an incorrect thing to say ” dating cycle did I disclose that I had a mental illness. It took me a bit by surprise as it wasn’t something I’d actually considered. I realised right then that even though as a writer and speaker I openly shared the story of my illness with the world, I had always kept it to myself when dating. It presented a marvellous challenge, especially with a first date looming just days ahead. On the evening of the date everything was going wonderfully. A fabulous meal, interesting conversation and plenty of laughs. There was definitely something there, until… For the life of me I can’t recall precisely how I slipped it in, but I managed to mention conversationally something along the line of: “Well, I suppose my main challenge in life is my manic-depression.” “Oh, you mean bipolar.” I nearly let it slide. The thing is I don’t like being called bipolar. I was diagnosed as manic-depressive, I associate

featur e with being a manic-depressive and that’s what I like to call myself. “Well, I prefer manicdepressive, but how about we just settle on ‘psycho’?” I said with a bit of a laugh. The look on her face told me told me that this was the first and last date I was going to have with her. “You can’t say that!” she shot back at me. “That’s such an incorrect thing to say.” She went on to give me quite a talking to about how such terms perpetuate the mental illness stigma. Well, I suppose she was right to some extent and I really should have known better. It was only a month or so earlier during a speech that someone in the audience had objected to the same thing. Ironically, during the question and answer session she

laughingly referred to herself as a “loony”. No, I didn’t point it out to her.

Times are changing We need to understand that times are changing and that it is going to take time for people to be more accepting of mental illness in society. From my perspective, what’s needed right now is for everyone to take on board that people will say the wrong things at times. You can get upset and angry about it all you like but I believe that is what will help perpetuate the stigma. Let’s all just be a bit more understanding and patient. Let’s all work to help society gain the awareness that mental illness in others isn’t something of which to be scared.

Keir Wells is the founder and CEO of Fully ARMED Australia, a not-for-profit mental health action organisation. He has carried manic-depression since childhood and speaks openly of his lived experiences in trying to raise awareness and help others. He can be contacted through keir@fullyarmed.org or www.fullyarmed.org

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Family Systems Therapy When you access therapy, you could be asked questions about your family of origin. Gathering information helps a therapist understand the broader context of your life experience and what brings you to therapy. Depending on the style of therapy you are receiving, however, the â&#x20AC;&#x153;bigger pictureâ&#x20AC;? of your life may or may not be examined. Therapists who use a Family Systems approach will explore the broadness and depth of your life experience from mental health, family hierarchy, culture, gender roles to parenting styles. In doing so, they begin to assist the client in addressing where patterns or better

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constructs lie and continue to play a role in your life. Unlike other therapies, where the theory has been developed by one or two people, Family Systems therapy has been a collaborative approach by theorists who were interested in

featur e examining the social constructs of family. However, there is little doubt that the development of feminist theory in the 1970s and 1980s also played a huge part in examining the role and function of family and how it has developed attitudes and behaviours within individuals and impacted on the family as a whole. The idea of family systems theory was to focus on a structure that exists within the family, often through generations, which enabled stereotypical patterns to exist. In turn, this created models of the self which were based on rigid patterns, thus causing conflict and personal dilemmas. By examining these patterns in therapy, the therapist is able to creatively and gently question the impact of these beliefs so that the participants are actively able to create change while still maintaining a sense of belonging to their family. The goal of therapy is to first create change from a problem but not just from an individual. Instead, the family creates new ways of working together, strengthening what already works for the family. It encourages members to develop new coping skills and strategies that bring about positive communication and interaction between family members. While it is often helpful to include family members in the therapy sessions, it is not always necessary or realistic that family members are able to gather. When working with children or young people, however, it

is vital that the whole family is included so that family roles and beliefs are examined. When a family is included in the therapy, it enables individual family members to gather a different perspective on how family beliefs impact on each other and whether or not those family traits have been helpful or not. It allows members to see from another personâ&#x20AC;&#x2122;s point of view and therefore create new possibilities for enhancing positive relationships. Family Systems therapy seeks to deconstruct the built-up narrative of the family and re-construct the family unit into positive, helpful and empathetic ways of communicating with each other. Families, therefore, are seen as the creators of new pathways and writing a new future without maintaining old, stale and unhelpful models of behaviour. Ruth Myers is a professional counsellor working in Sydney, Australia. She has worked in a range of roles involving family support, mental health, trauma, early childhood and disaster recovery. She also continues to study in the field of Psychotherapy with a particular interest in loss and grief. She enjoys bushwalking, yoga, long drives and good coffee. bmhmag.com

Kya gives her personal account of being married to a partner with a mental illness

Why Me?!

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people Kya has been married to her highschool sweetheart for seven years and is the mother of a gorgeous and sassy one year old girl. Kya graduated from Weber State University with a Bachelor’s degree in Public Relations and Advertising in 2014. She currently works at a paediatric clinic helping mothers understand how to better care for their children. She also works as a director and coach for a group of competitive cheerleaders where she teaches athletics and self-confidence.

Orange bottles cluttered the medicine cabinet yet my name wasn’t printed on a single label. Stacks of unpaid medical bills littered the coffee table, however, I hadn’t seen a doctor for years. Fist-sized holes covered the walls but my knuckles weren’t bruised or bleeding. I didn’t cause this chaos, but it consumed me. I was conditioned for this life since I was a little kid. Growing up with a manic-depressive, alcoholic father opened my eyes to a world I was too young to see. Midnight joyrides consisting of blurred headlights, erratic swerving, jarring stops and the occasional DUI. Sleepless nights spent listening to the violent arguing in the next room. That dreaded WHACK sound followed by my mother’s whimper. Don’t get me wrong, everyday wasn’t horrible. Some days were filled with extravagant gifts and genuine laughter. But they were always followed by days of fighting and tension. When the bruises could no longer be hidden and the arguments became exhausting, my mom attempted to leave my dad. It took years. My mom did not use the “rip the BandAid off” approach. The separation wasn’t fast or painless. Those years included moving from houseto-house and from school-to-school. My mom would get fed up and move out. My dad would offer a bmhmag.com

transparent apology and move in. My dad would get overly suspicious and move out. My mom would feel guilty and move back in. Never in the same house and never in the same town. They called it quits after six long years of this. And ever since, I found myself searching for the stability my parents never gave me. It was instilled in my mind that a man could provide it for me; someone the exact opposite of my dad. But I kept finding myself in toxic relationships as if I was destined to follow in my mother’s footsteps.

perfect… for a “ Things were moment

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After countless failed relationships, I realized that I needed to provide stability for myself. I would go to college, get a good job and be very selective of who I let into my life. And then I met my husband. I saw so much good in him: kindness, sense of humor, drive, good looks and most of all, stability. I trusted him to provide for me mentally, emotionally, physically and financially. Never in a million years would I expect him, the former quarterback of my high school, to look at me twice, but he did and I jumped at the opportunity. At first, things were great. He was the exact opposite of all the other guys I had dated and, more importantly, he was the exact opposite of my dad. He made me feel worthy of all the things I never had growing up. And, with that, I let my guard down. Relying on a man, once again, to take care of me. We dated for a year and became engaged soon after. We had a beautiful wedding, a perfect honeymoon and we moved into a condo we remodeled together. Things were perfect… for a moment. better

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people My new husband’s personality changed shortly after we said “I do”. It started with the little things; his drive, sleeping patterns and temperament. But it wasn’t long before the oh-so-familiar traits came out. He would snap without warning, he wouldn’t sleep night-after-night and worst of all, he became physical. I promised myself that if a man ever laid his hands on me, I would leave. But the occasional push and shove wasn’t enough to make me give up on our relationship. I tried so hard to avoid a man like my dad. Yet, here he was right in front of me. How could this happen? My subconscious must have made this decision for me. Actively seeking the traits I tried so hard to steer clear of. I had a lot of questions. How did I not notice this before? How did he hide these symptoms from me for over a year? Do I even know who he really was? I needed answers. After some persuading, my husband finally agreed to reveal his past. He said that he recognized these symptoms at a young age. It took a while to talk his parents into getting assessed by a doctor and once he did they diagnosed him with depression and anxiety. The doctor prescribed medication but his father preferred the “man up” approach, telling him that these feelings were in his head and he could push past it. His mother, on the other hand, told him to take the pills. She said she was tired of his attitude and thought the pills would help. After he had been on medication for a while, he complained that they weren’t helping. He saw numerous doctors, but they all came to the same conclusion. Severely depressed and anxious. He tried many different kinds of medication and plenty of different combinations, but none of them seemed to make a difference. These afflictions were difficult for my husband to deal with so young. He assumed that no one would bmhmag.com

be able to relate. He felt alone. So he put on a mask. He pretended to be someone he wasn’t; happy, healthy, normal. But that only made him feel more empty inside. He continued to hide throughout junior high and high school. And then he met me. He said he was so used to convincing people that he was someone else that he did the same with me. He didn’t want me to think he was broken so he wore the mask whenever we were together. He assured me that all of our relationship wasn’t a lie. He was the same person I fell in love with. The only thing he wasn’t honest about was his mental stability. He told me how much he loved me over and over and begged me to stay. I was torn. Part of me wanted to get out as fast as I could. But the other part of me wanted to make it work. Not only because I was stubborn, but because I saw something promising in my husband. I know it took a lot for him to open up to me and I wasn’t about to throw all of it away. I had to try. The next few years were rocky to say the least. As our lives got more stressful with our new marriage, bills and school, his mood became worse. He would snap at any given moment. I was scared to stand up for myself, but I was also scared to let him walk all over me. I fought back in the beginning, but after it got me nowhere, I stopped fighting. I became someone I was ashamed of. I saw more and more of my mother in me every day. We both got really good at hiding our problems. Friends and family would ask how we were and we would lie, telling them that married life was wonderful and we couldn’t be happier. Saying those words when we both knew they weren’t true tore us up inside. But we kept hanging on. At one point, we both decided we couldn’t live like this anymore. We needed to take action and we began our quest for help. But where were two poor college students without insurance going to find help? better

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people We were referred to a church-run counseling center. We made an appointment with the psychiatrist who gave us no new information. Although I tried to argue that my husband’s condition was more serious than he thought, he prescribed us with the same cocktail of anti-depressants and anti-anxiety medication.

wanted was for his “ All hepain to go away

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A few weeks later, my husband became desperate. All he wanted was for his pain to go away, that’s all he had ever wanted. But no one would listen to us. His thoughts became more grave and I grew worried for his safety. He would describe different plans he made to hurt himself. It even got to the point where I hid all of the medications and knives in the house. In the midst of all of this chaos, I made myself a deal. As long as my husband made an effort to get better, I wouldn’t give up on him. I couldn’t count how many nights we spent on our knees praying, begging for help. We didn’t know where to turn. Every professional we saw told us the same old story, yet he wasn’t getting better. One day I came home to an empty house. The clothes in my husband’s closet were gone and he was nowhere to be found. As I searched the house for answers, I found a note on the fridge. It read:

I’m so sorry but I can’t do this anymore I don’t think I love you, I don’t think I ever loved you I can’t even say that I know what love is Maybe I’m incapable of love My heart broke right then and there in the kitchen. How could he give up on us, on me? I was supposed to be the one to walk away from a relationship like this, not him. bmhmag.com

Consumed by so many different emotions; anger, guilt, blame, sorrow and pain, I picked myself up off the kitchen floor and got in my car. I needed to find my husband. I started calling his cell phone. No answer. I texted him multiple times. No answer. I called his parents. No answer. When I didn’t find him right away, horrible scenarios ran through my mind. Could he really follow through with one of his suicidal thoughts. I pushed that idea out of my head and kept driving.

husband is the strongest, “ mymost caring and loving

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I can’t explain the relief I felt when I saw my husband’s car in his parent’s driveway. When I walked through the front door, my father-in-law was yelling at my husband and my mother-in-law was crying in the corner. Through the screaming and crying, I gathered that my husband came into the house with a gun to his head screaming, “WHY ME?!.” After some persuading, my husband put down the gun and agreed to check himself into the psychiatric ward. He spent nine days in the hospital. The counsellors explained to me that when people have a mental break-down, as my husband had, they usually make irrational decisions. This information assured me that I needed to keep fighting for my husband regardless of what his note said. When he returned, I expected a cure. But we had no such luck. The main goal of the hospital was to keep my husband from hurting himself, not making sure he was correctly diagnosed. They did, however, conclude that my husband’s problems went deeper than just depression and anxiety and refereed him to an after-care doctor, which we could not afford. We were back at square one. better

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people The only thing we knew for certain was that my husband had been misdiagnosed. We found a facility that tested for mental illnesses and we scraped up enough money to pay for the appointment. There, it was determined that my husband was suffering from bipolar disorder and borderline personality disorder. Finally, something that made sense. They even referred us to a doctor on campus. Little did we know that, as students, we had been paying for a psychologist with our student fees this whole time. We set up appointments with the doctor who could prescribe medications, a personal counsellor for my husband and a coupleâ&#x20AC;&#x2122;s counsellor. We worked through our hardships and were able to start afresh. I wonâ&#x20AC;&#x2122;t say that being married to someone with mental health issues is easy but my husband is worth it. To this day, I can honestly say that my husband is the strongest, most caring and loving husband and father I know. He is not like my father. He never was and he never will be. Some people have no clue what itâ&#x20AC;&#x2122;s like to have bad mental health. The idea that your mind can be aired out in twenty-four hours is like saying heart disease can be cured if you eat the right breakfast cereal.

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The Caregiver caring for someone with bipolar disorder a personal perspective by Muffy Walker

Our mission is to eliminate bipolar disorder through the advancement of research, to promote care and support services, and to erase associated stigma through public education. www.ibpf.org Muffy Walker graduated with a Master's of Science in Psychiatric Nursing from the University of Pennsylvania. She worked in the mental health field for over 18 years until she moved to California when she obtained her MBA with a focus in marketing from the University of California-Irvine. Walker is the co-founder and Chairman of International Bipolar Foundation (IBPF). After learning that her youngest son had Bipolar Disorder, Walker joined other mental health boards and ultimately started IBPF. She has dedicated the past 18 years of her life championing the education of the public about mental illness and has won numerous awards for her advocacy work and serves on a plethora of mental health boards.

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featur e Putting baby locks on the kitchen cabinets to protect my toddler was one thing, but locking away the steak knives from my seven-year-old was not something I ever imagined would be necessary. I also never imagined that I would need to use my skills as a psychiatric nurse on my own child. When my youngest son, Courtland, turned four, my husband and I began noticing behaviors that were foreign to us. Court had become unusually aggressive; having uncontrollable temper tantrums in the grocery store aisle, throwing toys across the room at his brothers, and kicking me at the slightest parental control. Once a gregarious, outgoing child, he had become fearful, frightened to go to school, afraid to be in his room alone, or afraid to go outside to play. Court now shunned the beach; the sand bothered his toes, and in summer he wore winter clothes, complaining he was cold. The inside labels on his shirt and seams on his socks sent him into fits of rage. Finally, after being incorrectly treated with an antidepressant, Court experienced a full blown manic episode and was ultimately diagnosed with early-onset bipolar disorder. Even with medical training, my husband and I were ill prepared for the frustration we experienced trying to steer our way through the mental health system, the fear we encountered not knowing what the future held for our youngest son, and the lack of understanding and support we met on a daily basis. Our lives changed dramatically. We read every book printed, searched the internet for any clue offering help or hope, sought multiple opinions from varying disciplines (psychiatrists, psychologists, neurologists, etc.), and clicked on every available website. I quit my job and dedicated my waking hours to learning more, helping my son, and emotionally supporting my family. We looked into alternative schools and ultimately sent him to 4 different schools. We used mood charts, star charts for good behavior, practiced Ross Greeneâ&#x20AC;&#x2122;s bmhmag.com

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Bipolar disorder does not just affect the diagnosed person “3 basket approach”, and hired a mentor as we learned that author Danielle Steele did for her son, Nick Traina. We went to family therapy, individual therapy, and social skills groups. The first 10 years were particularly difficult. We walked around as if on eggshells. We chose our words carefully so as not to upset Court; learned to disguise his many pills in pudding; in order to monitor his sleep we allowed him to stay in our room; repaired multiple broken windows, and sheltered our two other boys from Court’s untempered profanity. Bipolar disorder does not just affect the diagnosed person. Marriages are stressed to breaking points, siblings feel left out or slighted, friends may be ignored, and parents may harbor feelings of guilt or helplessness. All relationships are challenged in one way or another. Within the first year following Courtland’s diagnosis of bipolar disorder, I found very little support, both for myself and my family. I began talking with other moms at the playground, explaining why my son was different and what his aberrant behaviors meant. I wanted my son to grow up not feeling ashamed that he had this disease. We talked openly and honestly about it and encouraged him to do so, as well. In the early years, our openness came back to haunt us. Parents whispered about him at t-ball games, no one invited him to

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featur e birthday parties, sleepovers or play dates. The children on the playground called him names like psycho, looney head and mental case. The boys taunted him and told him to go back to the mental hospital (even though heâ&#x20AC;&#x2122;d actually never been at one). Each day when I picked him up from school, he would shuffle over to the car with his head hanging down, telling me of yet another example of the bullying he had endured. I wanted so badly for him to fit in, for the other kids to understand him and to accept him for who he was. After all, the children with diabetes or other physical illnesses were not excluded. Only those with mental illnesses were. As I continued to talk openly about his disorder, people I had known for years, began secretly sharing with me that someone in their family was also diagnosed with bipolar disorder. Strangers called or emailed me, confiding that their son or daughter, mother or uncle also had bipolar disorder. They all shared their stories of sadness, grief over a future now robbed of its potential, loneliness for their excluded child, fear for their childâ&#x20AC;&#x2122;s safety and unanswered questions about medications, hospitalizations, conservatorship, doctors - the lists were endless. If you are reading this, then you are probably all too familiar with my examples of living with someone who is not stable, or of the bullying and negative stigma and the futility of attempts to correct them. As caregivers of someone with the disorder, we need to be aware that just as with so many other illnesses, the symptoms of bipolar disorder range broadly within a spectrum. Although one person may be psychotic (loss of touch with reality) or a danger to himself (one in five children with bipolar disorder will kill themselves before the age of 18), another may be relatively high functioning, attend regular school, and hold a meaningful job. Think Rachmaninoff, Hemingway, Vincent Van Gogh, and Carrie Fisher. All are highly successful, extremely creative people, all who have/ had bipolar disorder. Caring for someone with bipolar bmhmag.com

disorder can be especially difficult given the nature of the disorder. For caregivers, coping with someone with bipolar disorder takes a heavy emotional toll and strains the relationship, often to the breaking point. An added burden is the stigma of mental illness, which leaves families feeling frightened and isolated, unaware that many other families share their experience. So, what can we do to help ourselves in our role as caregivers?

ü Exercise daily, even if for only 20-30 minutes a day. ü Get adequate rest and sleep. Adhering to a healthy sleep schedule may be difficult with all you are now dealing with. Research shows that the scent of lavender eases anxiety and  insomnia.

ü Listen to soothing music and turn off the TV and video games an hour before going to bed.

ü Make love, not war. Research shows that sex

actually helps induce a sleepy state by releasing endorphins.

ü Try some slow, deep breathing. This type of

breathing relaxes your body, oxygenates your blood and reduces the stress you feel.

ü Eat nourishing foods. Try to avoid caffeine,

sugar, and processed foods. Avoid alcohol. Many believe alcohol helps them relax and sleep, however, alcohol disrupts the sleep cycle causing a nonrestful sleep.

ü Enjoy some “me” time. Plan ahead for some “me” time, whether it’s a walk with your dog, lunch with a good friend, or curling up with a good book. “Me” time can be very restorative.

ü Acknowledge and understand your negative

emotions. Guilt, anger, isolation and resentment are normal feelings often associated with the caregiving process. If you notice yourself feeling this way, take a step back and remind yourself that these are part of the normal process.

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ü Laugh. Enjoying a good belly laugh helps the

body relax, raises your blood oxygen levels, produces endorphins, stimulates your internal organs, and boosts your immune system. Know a good joke?

ü Give yourself a pat on the back. You aren’t doing

this to win a caregiver award but at the same time, you may not have realized how taxing it would be. If your loved one with bipolar disorder does not show his or her appreciation, don’t take it personally. Appreciate your own efforts and how they’re helping.

ü Find support. Whether you seek support from your church, a professional therapist, or simply check in with a cheery friend, support is essential.

ü Redefine your priorities. Taking care of someone

with bipolar disorder may leave you with little time and energy for yourself. Adjust your expectations of yourself and explain to others why your time and focus on them may need to change.

ü Arrange respite care. ü Have hope. Remember, bipolar disorder is

treatable and in most cases can be stabilized. Be prepared for the condition to worsen and/or improve at times. We won’t give up hope.

My dreams for Courtland have not disappeared, they have just changed.

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when life gives you lemons... by Sally Buchanan-Hagen

Sally works as a nurse in an emergency department and is currently completing her honours degree in nursing. She was diagnosed with bipolar type I disorder when she was 23. Sally had her first depressive episode when she was 14 and her first full-blown psychotic manic episode when she was 23. Sally blogs for The International Bipolar Foundation and bphope. She has also written for Youth Today and upstart, and volunteers for the Black Dog Institute.

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Someone once asked: if I could choose to get rid of my bipolar disorder, would I? I didn’t even hesitate before replying: ‘No.’ Fortunately I have a love-hate relationship with my bipolar disorder. I say ‘fortunately’ because I think it would be awful to have a hate-hate relationship with such an intimate chronic illness and I think it could be dangerous to have a love-love relationship with my mood swings because I probably would never comply with treatment. Unsurprisingly, when I am depressed I hate it and for the most part I love it while I am manic. It’s only when I’m euthymic I can look back and see the good and bad parts of both mood states. My illness has made me who I am. I’m a strong believer in not becoming your illness but I wouldn’t be myself without my bipolar. The good and bad parts of my life have predominantly been shaped by the disorder and I wouldn’t be where I am today if I didn’t have this mental illness. And I am grateful for this. My depressions have strengthened my resilience and perseverance. While in the grips of the darkest depressions I would want to die. But I haven’t. I am proud that I have kept myself alive to this point and when something bad happens now, it pales in comparison to those suicidal depressions and I know I can handle it. I’ve gained perspective. Depressive episodes have made me contemplative, measured and wise. They have aged me in a few ways but I feel I have wisdom beyond my years. I’m comfortable speaking to people who are depressed and going through tough times. I am confident in the support I offer, whereas before I would have felt uncomfortable and not have known what to say or how to help. Although my mania becomes destructive at it’s peak, I still have a lot to thank my manic episodes for.

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I got through university and further studies thanks to hypomania and mania. While studying I could write an essay or assignment in a day and study for exams in less than a week. Because of this I could work extra hours in my part-time job. Usually when I’m manic I want to learn. I want to learn EVERYTHING (and I believe I have the power to do so). In one month over summer I read all of my university nursing textbooks as well as medical, chemistry, biology and physics texts cover-to-cover. I now have a reasonable medical knowledge – more than is needed for my job as a nurse which makes my work easier. Another summer I taught myself three languages. In times of hypomania and mania I am more creative than usual and I will draw, write poetry and record music. I could write and record an instrumental piece in 24 hours and that usually involves piano parts, and many cello and violin tracks. While elevated I have bought instruments – all of which I have taught myself. I now play 7 instruments. When I have been hypomanic I have had the confidence to travel overseas alone, something I wouldn’t have done while euthymic. (This was before I was diagnosed. No one would let me travel now while hypomanic, which is probably a good thing). Nevertheless I got to explore many countries and these experiences will stay with me forever. I love to run and was able to run half marathon distances when I was recovering from one manic episode. The things I have done while manic have made me who I am. Overall my mental illness has made me a better and more well-rounded person. I am far less quick to judge and I take the time to listen to people no matter what the problem is. This has been an

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attribute that I have taken into my workplace as a nurse and I think I am a kinder, more compassionate and more understanding person because of it. It hasn’t just been me who has adopted this attitude, but so too has my family since my diagnosis. Being open and non-judgmental has led me to meet interesting, sincere and understanding people – many of whom have become my friends. I’ve come to appreciate what I have and not to take things for granted, such as times of wellness, family support, my job, friends and where I live. Before I started having severe mood episodes I knew I was lucky but never really deeply appreciated what I had. I’m also more inclined to live in the moment now and to take every day as it comes instead of worrying about the future or dwelling on the past. My illness has taught me that if I deviate from my life plans, things have a way of working out even if the outcome isn’t the exact original end goal. I feel that all of these things that bipolar has taught me has made a better person. I know that there are others with bipolar who aren’t as lucky as me and can’t say the same thing. I understand this, bipolar brings with it terrible costs and I don’t want to make this destructive and deadly illness seem appealing or trivialise how damaging and awful extreme mood episodes are. Trust me, bipolar disorder is a huge burden to bear. There are times when I would give anything not to have this mental illness. But I deal with it by viewing myself as lucky – lucky to have been given the productive hypomanic times, sometimes fun manic times and the sobering depressed times. Even though life has been complicated and hard since the onset of this illness, I have grown and learnt so much about myself. I would not be the person I am today without my bipolar disorder, and for that I am thankful.

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Religion culture and stigma submitted by a reader from Trinidad and Tobago

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Sociologist, Erving Goffman, has described social stigma as a socially discrediting attribute, behaviour, or reputation. He believes that persons with stigmatised conditions shift on the social construct from “normal” to “discreditable”. According to the Oxford dictionary, a stigma is a mark of disgrace associated with a particular circumstance, quality, or person. Regardless of the definition one chooses, the common conclusion that can be drawn is that stigmas can essentially attach an undesirable yet misguided label to individuals who are stigmatised.

What causes a stigma to be developed in the first place? Why is it that only certain groups receive them? What criteria exist for a person to be marginalised in this way? Initially, my belief was that stigmas form as a result of a mixture of misinformation and deviation from socially accepted norms.

Generally, stigmas can be seen to exist in situations that deviate from societal norms. Groups that are often stigmatised are those who have physical disabilities, certain illnesses, are of a different ethnic or religious background than the dominant culture, or individuals whose sexual orientation sway from what is considered to be socially acceptable.

Commonly, when people hear the term mentally ill, they assume the person is ‘crazy’ or just a ‘lunatic’ as a result of misinformation and the general stigma that has been placed on mental illness. However, I have realised over time that factors other than ignorance come into play. Religion has been a major issue in my society that I noted from both personal experience, as well as from interviews conducted with individuals who suffer from, or have a loved one suffering from a mental illness.

Although many of the negative connotations that stigmas attach to individuals can be proven to be untrue and actually cause more harm to a person, many people globally are still victims of some sort of stigma. People who suffer from mental illness constitute a great portion of the people who are still stigmatised today.

Living in Trinidad and Tobago, one is introduced to a multitude of races/ ethnicities, cultures, and religions, which all coexist in one melting pot of culture. There are a number of bmhmag.com

religions and religious sects present, and generally, religious ideologies have set the tone in the shaping of the values and morals of the society. Thus, religion has played a role in moulding the mindset of a large portion of the population; including beliefs about mental illness. Where the issue of mental health and mental health stigmas are concerned, the patients who come from a religious background are often the ones who fail to receive proper medical care and treatment. The major reason why individuals from a religious background fail to be treated for their mental illness is because the parents or other family members enforce the idea that the mental illness does not actually exist. The religious radicals tend to dismiss the scientific evidence and claim the cause of the problems are due to demonic possession or dark spiritual rites such as ‘Obeah’ (religious practices based on folk magic/sorcery) as a result of the individual straying from their religion, thus letting the devil inside of them. Therapy, along with prescribed medication, are seen as totally unnecessary. If the individual who suffers not only fails to receive the necessary help, but is also placed in an uncomfortable situation where their family pressures them with religion, and also faults them for making themselves feel that way. The idea that if we pray more our depression will disappear, and all that needs to be done is to simply pray and better

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be happy, is a common thought that sufferers hear regularly from family. In some cases, they are taken to a place of worship to be prayed for by their religious leader so they can be cured. Families may become stricter when enforcing religion. In extreme cases, the parent or guardian may resort to more drastic measures by trying to “beat the devil out” of their child. It is an unfortunate reality that a number of mental illness sufferers are faced with in Trinidad and Tobago, and perhaps other parts of the world where similar ideologies may exist. Although there are institutions in place for treating mental health patients, there are issues within these very institutions which further complicate the elimination of the stigma. The Guardian TT newspaper published an article on March 25th 2015, Putting some context to mental health in T&T, listed weaknesses in our mental health system. They stated a lack of awareness campaigns, need for collaboration between the health sector and mental-health team, lack of resources, and the absence of a research culture. Directly related to treatment, there is only one mental health hospital in Trinidad and Tobago – the St. Anne’s Psychiatric Hospital. Additionally, faults exist in the outpatient facilities, with a major one being the dismissal of patients seeking emergency treatment because they don’t have an appointment for that day, as though suicidal thoughts or

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parents or other family members enforce the idea that the mental illness does not actually exist

used in this society to describe such individuals), and to allow those descriptions to fade away.

This shows a disregard of the severity of mental illness in this nation from the institutions in charge. If problems exist within the organisations responsible for tending to mental health in the country, then little hope can be seen in curbing the mental health stigma in Trinidad and Tobago.

To end the belief that spirituality is directly related to the development of mental health issues. Yes, spirituality can become a coping mechanism for some, but it is neither a cause nor cure for the very real illnesses which exist. They need to let people know it’s okay if they or a loved one have been diagnosed with a mental illness, because with proper care and treatment, they could learn to cope and lead a stable lifestyle. Also, they should offer family counselling. This will help family units cope as a whole, better understand the illness and the necessary and available treatment for the patient.

Indeed, more awareness should be brought to the general public, to both inform and break the stigmas that exist. To tell the public that being mentally ill does not equate to being a raging lunatic (or the words “crazy” and “mad” which are frequently

Hopefully, positive changes can be made over time to improve the status of mental health treatment in Trinidad and Tobago. Ideally, this will be in all other nations that may face similar issues, and to one day end the stigma for all.

other worrisome issues can be put on hold for an appointment at least one month later. It only makes matters worse that the national suicide hotline is on the verge of shutting down within a year due to lack of funding.

References:

Ravello, Caroline C. “Putting some context to mental health in T&T.” The Trinidad Guardian Newspaper 25 March 2015. Newspaper Article. http://www.guardian.co.tt/ lifestyle/2015-03-24/putting-some-context-mental-health-tt.

Editor: In Issue 3, we published a personal account of mental health by a Trinidad and Tobago resident. This article was submitted in response to that. The author asked to remain anonymous due to the feeling of stigma in a small community. We fully support the request for anonymity and express our thanks for the submission. bmhmag.com

Illicit Drugs

as Treatment for Mental Illness

by Margo H. Huber

According to the National Alliance on Mental Illness, mental illnesses are medical conditions that disrupt a personâ&#x20AC;&#x2122;s thinking, feeling, mood, ability to relate to others, and daily functioning (Mental Health Conditions, 2015). better

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For example, anxiety disorders cause people to feel excessively frightened, distressed, or uneasy during situations â&#x20AC;&#x153;in which most other people would not experience these same feelings,â&#x20AC;? and those feelings affect their ability to behave normally. Similarly, depression is a mood state that can lead to serious cognitive impairment, behavioral issues interfering with daily

functioning, and even suicide if left untreated. Many behavioral scientists believe feelings, thoughts, and behaviors result from the activation of neural pathways. Chemical mediations determine how we perceive our environment and also affect how we react to the stimuli. The higher frequency of the activation of the neural pathways, the more

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established they become and the more entrenched the behavior becomes. Introducing radical new experiences are postulated to break up these old neural pathways, in the same way that the solution to a broken nose is to break it again. These mental disorders can be fixed by changing brain patterns away from mental illness and toward mental health using drugs, and many of which are currently illicit. Psychedelics, drugs that produce hallucinations or an expansion of consciousness, have an extensive history of being tested and researched. This is one of the reasons they are being considered medically. The Central Intelligence Agency experimented with LSD in the early 1950s for the use of mind control, the US Army hoped hallucinogens could have a part in chemical warfare, and they have been used as animal tranquilizers. Now, they are being tested as treatments for mental illnesses such as depression, anxiety, and addiction. However, these drugs may have limited potential in altering the neural pathways in mental illness involving chronic low or anxious feelings because of the immense threat of â&#x20AC;&#x153;bad tripsâ&#x20AC;?, where the user experiences psychoactive effects that cause intense dread, anxiety, and dangerous hallucinations, which psychedelics can often cause. Terrifying thoughts and feelings and loss of control can result in users that suffer from mental illness, resulting in complete neural breakdown, damaging the neural pathways that are better

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an 80% success rate for people in smoking cessation helpful as well as the maladaptive ones. Also, increased heart rate and blood pressure, increased temperature, and even death can occur. Bad trips for people with depression and anxiety are extremely common and psychedelics may not be a good treatment. Unless the patient is in a comfortable and safe environment and the amount of the drug has been monitored. This takes time and must be done in a properly controlled environment. Psilocybin is a hallucinogen that is being considered for treatment of depression and anxiety and naturally occurs in many species of mushroom. Psilocybin works by reducing blood flow to areas of the brain that allow introspection or higher-level thinking, which instigate depression and anxiety. However, this use is contradicted by the observation that psilocybin should not be taken when depressed or anxious because, much like LSD, this increases the chance of having a traumatic experience. However, there is one area of research that has shown success: there is an 80% success rate for people in smoking cessation up to six months after treatment, showing greater potential of success in regards to addiction rather than depression or anxiety (Senthilingam). Often, addiction can occur when

featur e the neurotransmitters over-stimulate the brainâ&#x20AC;&#x2122;s reward system, which encourages repeating the behavior that leads to addiction (Understanding Drug Abuse). Psilocybin manipulates the brain to over-stimulate certain areas too. As higher-level thinking and introspection decrease, new points of view emerge. This leads to a person feeling capable of independence from their addiction when they experience how that could possibly occur by means of a changed mindset. Under controlled circumstances, doctors and medical professionals could certainly use psilocybin to help end addictions. LSD is another hallucinogen that is being considered for treatment of mental illness. But again, it is imperative that the use of this drug is restricted to patients experiencing feelings of anxiety. Treatment of depression and anxiety then is not the safest idea, seeing as how bad trips can be extremely detrimental. However, LSD is a potential treatment for cluster headaches, as it is thought to affect the parts of the brain that extend from the brainstems Locus Coeruleus (LC) and Raphe Nuclei (RN), including the hypothalamus (Understanding Drugs, 1999). Although the exact cause of cluster headaches is unknown, many specialists believe it to be related to the hypothalamus.

Clinic Staff, 2015). Because cluster headaches happen in cycles relating to a 24-hour day and following the seasons of the year, looking to the part of the brain that controls our internal clocks is practical. Finding ways to alter the neural pathways in the abnormal hypothalamus may be one way to find a treatment, and LSD holds promise. However, according to the data mentioned in the writings of May, cluster headache patients are â&#x20AC;&#x153;prone to overindulge in addictive behaviors (May).â&#x20AC;? LSD may take care of the problem of cluster headaches, but although this drug is not addictive, the fact that it causes addiction-related behaviors is another painful burden that the patient may have to undergo if being treated with LSD. Another downside to LSD is that LSD intoxication can cause hyperthermia, exceedingly elevated body temperature, and rhabdomyolysis, the destruction of muscle cells. The patient needs to consider all of the negative effects LSD can bring and weigh these outcomes against the cluster headaches he is currently experiencing.

The hypothalamus is linked to metabolic processes, neurohormones, body temperature, hunger, certain behavior patterns, fatigue, and most relevantly, circadian rhythms (Mayo bmhmag.com

been found to cure or treat various diseases and illnesses, they have not been put into use yet. One reason for this is in the hands of the patients. Children and teens are often educated inside the classroom with lectures or speakers on the importance of sobriety and the dangers of drug use, or outside the classroom through public service announcements or parental guidance. As a result, children acquire a proclivity at a young age to avoid using drugs and are often hesitant to use them for medical purposes as well.

Ketamine is another recreational drug responsible for disconnecting memory, motor function, sensory experience, and emotion in its users (Rogers, 2015). It is abused mostly because of its almost immediate effects, but in the same way, it has cured patients with depression in one day (Bowden, 2015), instead of in weeks, months, or years of treatment. This is revolutionary because major mental illnesses could potentially be solved in a fraction of the time and with a fraction of the expense. However, this rapid treatment may decrease counseling, behavioral therapy, or psychotherapy. This would potentially lead to a decrease in jobs for these types of fields; however, it could also introduce many new jobs dealing with the distribution of Ketamine or the research and advancement of it. However, although these drugs have better

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To better understand the apprehension amongst ages 14 years through 18 years, I sent out an anonymous survey to the high school students at Lausanne Collegiate School in Memphis, Tennessee and gathered 100 responses. Given the prompt, “If you were to have or do have a mental illness, would you use illicit drugs like LSD, psilocybin, or Ketamine as treatment, knowing all of the potential negative side effects?” Of the respondents, 16% said yes, 55% said no, and 29% said maybe. Those who responded in the affirmative generally reasoned that “anything to help” would be beneficial, and one person responded saying, “If [illicit] drugs aren’t being used in medicine, all the effects of drugs will never be known.” In contrast, those who would not make the personal decision to be treated for mental illness with illicit drugs argued on account of the “risk of worsening the mental illness,” and the social stigma attached saying, “people may judge you for taking these drugs,

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would only consider it if a medical professional recommended it despite your mental illness.” The people who said maybe either were not aware of all the side effects, would only consider it if a medical professional recommended it, or said it depends on the severity of the illness. From the reasons provided for not wanting to undergo this form of treatment, health consequences were the most common, followed by the risk of addiction, and moral reasons last. In light of that, a higher percentage of students would reject this treatment based on their concern of health problems more so than on moral grounds. Because of this, one can infer that they would make this choice later on in life too, because choices made regarding health are typically less wavering than those regarding morals. However, as seen with the use of electroconvulsive therapy (ECT), which is “the procedure in which electric currents are passed through the brain, intentionally triggering a brief seizure” (Mayo Clinic Staff), moral reasons or social obligations are still a deciding factor; people often disregard this safe and effective treatment for major depressive disorder, manic depressive disorder, and schizophrenia because of the shame placed on its patients because of its reputation of

being misused. For these reasons, researching, testing, and especially conducting treatments with drugs currently classified as illegal is looked down upon by a vast group of people. The second most popular reason to not undergo this treatment is the risk of addiction. Although the hallucinogens discussed are typically not addictive, addiction is always a risk. This is apparent in that 23.5 million Americans are addicted to alcohol or drugs (New Data Show Millions), not including sugar or caffeine. Ironically, a few of these drugs, including psilocybin, are being tested to cure addiction. As of now, there is not enough information known about the exact quantity needed of the drugs at hand, or how to best administer them. Until then, medical professionals and researchers do not know the most efficient ways to ensure the absence of significant negative side effects, like making the illnesses worse or even creating new ones. One issue understandably overlooked by the respondents is the tendency of people, especially those struggling with a mental illness, to not admit that they have a problem, and thus will not agree to medicate themselves to remedy it. However, if this is the case, the patient at hand would not be in favor of taking more traditional medication either, which does not make this an issue with illicit drug use. In fact, as seen with the recent addition of prescribed marijuana in medicine, a common pattern emerges that includes a person’s fabricating an illness to receive this medication, or bmhmag.com

the standard treatments have serious side effects doctors willingly prescribing possibly it in order to augment revenue in his clinic, thus skewing data results and tainting the general outlook on this type of treatment. However, the reasons for apprehension by the subject seem too nominal to impede the potential curing or treatment of mental illness. According to National Alliance on Mental Illness, “1 in 4 adults – approximately 61.5 million Americans – experiences mental illness in a given year;” “serious mental illness costs America $193.2 billion in lost earnings per year;” “and suicide is the tenth leading cause of death in the U.S., with more than 90 percent of those who die by suicide having a mental disorder” (Mental Illness Facts). This means that the lives of these people and their friends and families are hindered, as well as so much more. For example, if anxieties are left untreated, they mask a deeper problem. If this deeper issue is not uncovered, and the anxieties are still an issue and not treated, the root issues cannot then be corrected. However, if they are remedied, the lack of these underlying issues will prevent anxieties or depression in the future. The conventional treatment with antidepressants may also have serious side effects. Fatal skin rashes, seizures, and better

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cardio-toxicity are just a few examples of the negative side effects. The fact that these treatments are legal does not necessarily make them any safer than these potential treatments consisting of currently illicit drugs. Also, many people who suffer from anxiety and depression consistently self medicate with alcohol, cigarettes, or self-harm, none of which truly helps the patient but instead masks the problem or creates many new ones. These are more examples of supposed remedies that have the same or worse negative side effects of LSD and psilocybin. However, if LSD, psilocybin, or another potential medication is presented in a monitored and controlled setting, these issues could have solutions not found yet. Despite the current negative consequences elicited from the use of these drugs, it is important that scientists, doctors, and patients are open to the advancement of this type of treatment. The potential effectiveness of these drugs is still not known, nor how to lessen the consequences if no the same research or experimentation is taking place. The treatments available now, whether self-prescribed or prescribed by a doctor, are often not sufficient, and the patients suffering from mental illness are tired of reaping the consequences. Drugs have been used as warfare, tranquilizers, and for mind-control purposes; it is now up to the people of today to put these drugs towards benevolent purposes, such as the treating or curing of mental illness.

featur e Margo Huber is a sophomore at Lausanne Collegiate School in Memphis, Tennessee. She has a passion for mental health justice and wants to work in the education system as an adult in order to impact the lives of children in a positive manner. She was inspired to write this research paper for her 10th grade English class on the use of medication for mental health due to her fascination with both of these subjects.

Lausanne Collegiate School in Memphis, Tennessee.

Editor: When I received this piece from Miss Huber, I asked her about her title, qualification and experience. Her reply seemed quite despondent, ‘I don’t have any of those things, I’m just a school student. So I guess you can’t use it’. It took a minute for that to sink it. Of course I wanted to include it. To have such a thoughtful piece by a school student, who is passionate about the improvement of mental health management is a great inspiration to us and, we hope, also to anyone reading this. Thank you, Margo.

References

Bowden, T. (2015, January 21). Ketamine research reports 75pc success rate in treatment of long-term depression. (ABC) Retrieved February 18, 2015, from abc.net.au. LSD. (n.d.). Retrieved February 18, 2015, from Brown University Health Education. May, A. (2015). Illicit drugs and cluster headache: An inevitable discussion. (International Headache Society) Retrieved February 16, 2015, from Cephalalgia. Mayo Clinic Staff. (2015). Cluster Headache Causes. (Mayo Foundation for Medical Education and Research) Retrieved February 18, 2015, from Mayo Clinic. Mayo Clinic Staff. (2012, October 25). Electroconvulsive therapy (ECT) Definition. Retrieved February 23, 2015, from Mayo Clinic. Mental Health Conditions. (2015). (National Alliance on Mental Ilness) Retrieved February 22, 2015, from National Alliance on Mental Illness. Mental Illness Facts and

Numbers. (2013). Retrieved February 17, 2015, from National Alliance on Mental Illness. New Data Show Millions of Americans with Alcohol and Drug Addiction Could Benefit from Health Care R. (2010, September 28). Retrieved February 17, 2015, from Partnership for Drug-Free Kids. Rogers, K. (2015). Ketamine. (Encyclopædia Britannica, Inc) Retrieved February 18, 2015, from Encyclopædia Britannica. Senthilingam, M. (2014, September 17). How ‘magic mushroom’ chemical could free the mind of depression, addictions. (Turner Broadcasting System, Inc. ) Retrieved February 16, 2015, from CNN.com. Understanding Drugs. (1999, June). Retrieved February 18, 2015, from LSD: A Psychedelic Hyperdimension. Understanding Drug Abuse and Addiction. (2012, November). Retrieved February 18, 2015, from National Institute on Drug Abuse. bmhmag.com

drug

development by Dr. Abimbola Farinde

The development of a new drug or agent brings with it properties that are specific to that agent. In many cases these properties can either be an advantage or disadvantage when it comes to its selection for use in a particular patient. Both pharmacodynamics and pharmacokinetics are considered to be branches of pharmacology that are typically studied in conjunction with one another. The concept of pharmacokinetics focuses on the study of the time course of drug concentration in the body fluids, and this is generally divided into the analysis of its absorption (how the drug enters the blood circulation), distribution (the dispersion of the drug throughout the body, metabolism (changing from the parent component to metabolites), and excretion (elimination of the drug from the body) whether a reversible or irreversible accumulation better

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featur e of the metabolites (Greenblatt, 2000). Ultimately, how the body can influence the pharmacokinetic properties of a drug is described as well as based on the site or dose of the drug how the absorption rate, distribution, metabolism, and excretion will also be affected is studied (Brunton et al., 2006). In the past, classical pharmacokinetic studies generally focused on the use of predetermined parameters such as volume of distribution or elimination half-life under controlled conditions during the new drug development process. But unexpected factors that could affect the pharmacokinetics of a drug were not identified. So, cases of altered drug pharmacokinetic were only identified in the post-marketing phase when in clinical use (Greenblatt, 2002). Also, pharmacokinetic drug interactions tend to occur when Drug A can alter the absorption, distribution, metabolism, or excretion of Drug B resulting in an altered concentration of Drug B. Examples of this can include cytochrome P450 interaction, protein binding, an effect on the excretion of the drug Lithium, or the pharmacokinetic properties of

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benzodiazepines that are oxidized in the liver being affected by other medications that inhibit oxidative liver enzymes (Schatzberg, Cole, & DeBattista, 2010). Clinicians must be able to find a connection between drug concentrations and their responses. This enables them to apply pharmacokinetic principles to real patient situations for the effective therapeutic management of the drugs, such as the case with lorazepam, and determining dose where it is therapeutic compared to where it can have an adverse effect (Abrams et al., 1988). The concept of pharmacokinetic focuses on the timecourse of drug absorption, distribution, metabolism, and excretion and its subsequent application to the management of drug therapies in an individual patient. Pharmacodynamics, however, primarily deals with the relationship between the drug concentration at the site of action and the resultant effect to include the time course and the intensity of therapeutic and adverse effects on the organism (Greenblatt, 2000). For instance, with a single dose of a psychotropic agent the concentration and clinical effect will increase and reach a maximum effect and ultimately decline with use and this is observed with sedatives which generally work within one dose or a few days to directly optimize ion channels enabling them to work quickly (Schwartz, 2010). When it comes to the effect that a particular drug will have at a site of action, this can be highly dependent on the drugâ&#x20AC;&#x2122;s binding with a receptor (drug-receptor interaction), and the concentration at the site of the receptor can also determine the intensity of the drugâ&#x20AC;&#x2122;s effect. The physiological effect that drugs can have on the body and the mechanism of the drug action, drug concentration, and subsequent effect is the purpose of studying the pharmacodynamics. Once a drug enters the body, the interaction to a drug receptor is a key component because the receptor is responsible for drug selectivity and the quantitative relationship between the drug and better

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featur e the effect if it is on the central nervous system (van Stevenick et al., 1999). The reasons for various routes of medication administration can either be associated with demonstrating efficacy or therapeutic blood levels through a certain route, providing options for individuals who are unable to take medications through a particular route, preventing side effects that might be associated with administering a medication through a certain route, option for a rapid or slow absorption of the medication. For instance, medications that are given orally generally go through first pass metabolism (liver metabolism) so the effect of the drug may not be as quick as a medications that is given intravenous, nasally, intramuscularly, rectally, or sublingually which do not undergo first-pass metabolism so the desired effect of the medication is achieved much quicker (Dipiro, JT et al., 2005). The advantage of not undergoing first-pass metabolism is especially important in emergency situations where a medicationâ&#x20AC;&#x2122;s effect has to be immediate such as an agitated, aggressive, or combative individual, so a parenteral psychotropic medication can be administered. Or, if the individual is able to take oral medications, a rapidly disintegrating medication that undergo rapid absorption to the oral mucosa would be helpful (Schwartz, 2010). It is also important to have various route of medication administration because the absorption of a medication through a particular route may be erratic. This is the case with phenytoin therapy because, while it is approved for intramuscular use, this is not recommended due to its unpredictable absorption and pain on injection, which is why intravenous or oral administrations are preferred for this drug (Lexi-Comp Online, 2004). Metabolism is viewed as a dynamic process because bmhmag.com

there is always constant degradation and rebuilding which takes place through a sequence of pathways (Brunton et al., 2006). A large majority of medication undergo hepatic metabolism, especially through the cytochrome P450 system but this proves to be impossible for individuals who have moderate to severe hepatic impairments. In order for these individuals to be able to have the same options as those individuals whose liver is not compromised, a drug that has various routes of administration can prove to be extremely useful. These individuals are then not deprived of effective drug therapies as a result of damage or impairment to their organ. In the same respect, medications that undergo excretion renally can be difficult for individuals who have renal impairments. By bypassing this organ through the use of another route of administration, an individual is able to have access to a variety of medications despite their impairment. For cellular metabolism to occur the reaction must involve degradation of molecules and generation of molecules through a reaction involving oxidation or reduction) and when an organ system is involved, proper functioning is required or this can lead to accumulation of the drug and potential toxicity as an end result. Consequently, if metabolism can be bypassed by another route of administration in a particular patient this approach should be taken. The complexity of the human body and the absorption and effectiveness creates complexity for medication development. The uniqueness of each person increases the complexity of that development. Application of particular drugs, the dosages and methods must still be considered and monitored to achieve the most beneficial result for that individual. Understanding this complexity helps our understanding that there may not be a single right solution for all individuals and changing medications may be a necessary path in finding the most effective medication for a particular condition. better

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featur e References Abrams, S. L., Harry, T. A., Hedges, A. A., Murray, G. A., & Turner, P. P. (1988). Pharmacodynamic and Pharmacokinetic Comparison of Two Formulations of Lorazepam and Placebo. Human Psychopharmacology: Clinical & Experimental, 3(2), 133-138. Brunton, L., Blumenthal,D., Buxton, I., & Parker, I. (2006). Goodman and Gilmanâ&#x20AC;&#x2122;s Manual of Pharmacology and Therapeutics. (11th ed.). The Mc-Graw-Hill Companies, Inc. Hoboken, NJ: John Wiley & Sons. Dipiro, JT et al (2005). Pharmacotherapy: A Pathophysiologic Approach. 5TH edition. New York: The McGraw-Hill Companies, pp.1243-1261 Greenblatt, D.J., Von Molte, L.L., Harmatz, J.S., & Shader, R.I. (2000). Pharmacokinetics and pharmacodynamics. Neuropsychopharacology: The Fifth Generation Process. Greenblatt, D.J., Von Molte, L.L., Harmatz, J.S., & Shader, R.I. (2002). Pharmacokinetics, pharmacodynamics, and drug disposition. Neuropsychopharmacology: The Fifth Generation Process,38, 507-524. Lexi-Comp Online (2004). Phenytoin. Hudson, Ohio:LexiComp, Inc. Retrieved from http://online.lexi.com/crlsql/ servlet/crlonline Schatzberg, A.F., Cole, J.O., DeBattista, C. (2010). Manual of clinical psychopharmacology (7th ed.). Washington, DC: American Psychiatric Publishing, Inc. Schwartz, T. L. (2010). Psychopharmacology Today: Where are We and Where Do We Go From Here?. Mens Sana Monographs. pp. 6-16. van Stevenick, A. L., van Berckel, B. M., Schoemaker, R. C., Breimer, D. D., van Gerven, J. A., & Cohen, A. F. (1999). The sensitivity of pharmacodynamic tests for the central nervous system effects of drugs on the effects of sleep deprivation. Journal of Psychopharmacology, 13(1), 10.

Dr. Abimbola Farinde, PharmD is a clinical pharmacy specialist who has gained experience in the field and practice of psychopharmacology/mental health, and geriatric pharmacy. She has worked with active duty soldiers with dual diagnoses of a traumatic brain injury and a psychiatric disorder providing medication therapy management and disease state management. Dr. Farinde has also worked with mentally impaired and developmentally disabled individuals at a state supported living center. bmhmag.com

Care Cards a helpful grounding technique by Naomi Hill

Naomi creates â&#x20AC;&#x153;Care Cardsâ&#x20AC;? to help her remember even the basic details of her life, including her name.

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I walk through my front door. The same door that has been mine for over a year. Something’s different, something has changed and I don’t recognise anything. The couch, the table and the artwork on the wall. It’s not how I remember it. It’s different. I start to panic. My face heats up and I start to sweat. I must be in the wrong house. I run back outside to look at the place. It’s OK. It’s my house. I run back inside but I still don’t recognise anything. Why can’t I remember anything? My breathing is rapid. I need to slow it down. It’s too hard. I’m scared. Who am I? I go through my handbag. I find these cards. They are blue – my favourite colour. I go through them. They are photos. First one says, My name is Naomi. Then my age and where I live. They tell me that I am an artist. The art piece on the card matches up with a piece on the wall. A cat walks up to me. I pat it. I go back to the cards. There are photos of cats. One of them matches up with the cat nearby. I start to recognise things around the room. I get to the last card. It says I am safe. I start to calm down. I gain control of my breathing. I remember who I am now. Everything’s going to be OK. I am safe. This is just one scenario where I effectively use my cards as a coping strategy. They are a series of 16 cards, mostly of photos and drawings of mine that primarily serve as a positive grounding technique. I have three cards on personal identity: name, age and city. I have four cards on major hobbies: art, poetry and singing. Four cards on pets: three cats and a card on how they benefit me. Then there are four miscellaneous cards: important quotes with which I identify – my personality strengths, interests and one about my desire to be well. The last card in the deck is the most important. It is an image of a character holding a pillow with the words ‘I am safe’ along the bottom. bmhmag.com

I came up with the cards after a less mobile suggestion was made in a group therapy I was doing. The idea was to fill a shoebox full of items that had sentimental value and could be used when under extreme distress. The box might include relaxing music CDs, photos or a stuffed animal. I thought the idea all well and good but it had a couple of flaws. Being not very mobile, it wouldnâ&#x20AC;&#x2122;t be convenient to use when you are out, unless you want to carry around a shoebox with you everywhere you go. They also arenâ&#x20AC;&#x2122;t very conventional if you needed to use them while you had visitors. So I adapted the idea to fit my own needs, making them mobile and a lot more convenient for a wide range of circumstances. I come up with a list of circumstances where I would use them and what would be beneficial to help me during those times. I then opened the program that I use for my art, got an A4 base and divided it into eight segments which would make the cards a little bigger than a business card. I designed most of the cards with a picture and a written phrase or two and some with just writing. After making the baseline cards I decorated them with things that appeal to me, such as paw prints and detailed borders. After finishing the designing process better

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Naomi Hill is a public speaker on the issue of mental illness awareness and acceptance, working as a volunteer program manager at Fully ARMED Australia. Naomi can be contacted at naomi@fullyarmed. org

people

}

realising that I’m going to be OK

I printed them, cut them into cards and laminated them.

I use them for a series of symptoms that I live with. Mainly dissociation, anxiety, panic attacks, extreme distress or just needing some comfort. Their primary attribute is grounding, bringing me back into the present and realising that I’m going to be OK. I also use them to deal with flashbacks and when I awake after a nightmare. I carry them around with me everywhere and never go out without them. When I need them I just get them out and look through them one at a time, focusing on the ones that help me most for that scenario. Self-identity cards for dissociation/depersonalisation. Hobbies and ambition cards for feelings of low self worth and distress. Cards of pets for comfort. All of them for grounding. The safe card can be used in any scenario. If you plan on making the cards for yourself or helping someone else, then here are a couple of tips. I advise against making cards where the subject has variables. For example, I wouldn’t make a card with a picture of my boyfriend on it. Yes, I adore him and he is a huge support for me. But if we had a fight recently and I needed my cards, I would see the card of him and possibly run the risk of experiencing negative emotions. Keep the cards positive. They are a coping mechanism designed to bring you out of a distressed state, not make you more distressed.

A4 Separated into 8 parts makes for easy creating and printing

The cards are just one of the techniques I use to manage my conditions. Over the years I’ve discovered that managing my own mental health means doing a lot. I’m always looking for new ways and exploring them. And so it is with these cards. Try them. See if they work for you. After all, most things are worth at least one chance. bmhmag.com

Who am I and how did I get here? D I S S O C I A T I O N D I S O R D E R S Dissociation disorders are a psychological illness in which a person disengages from their feelings, memories or even sense of identity. Individuals who experience a traumatic event will frequently have a certain level of dissociation during the course of the traumatic event itself, or in the following hours, days or weeks. For example, the traumatic event seems â&#x20AC;&#x2DC;unrealâ&#x20AC;&#x2122; or the person feels separated from whatâ&#x20AC;&#x2122;s proceeding around them as if watching the events on television. In most cases, the dissociation resolves without the need for treatment. better

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featur e Some men and women, nonetheless, develop a dissociative disorder that requires therapy and/or medication. Currently, dissociative disorders are controversial, and contain complicated problems that require specified diagnosis, treatment and support.

A RANGE OF DISORDERS Mental health professionals recognise 4 primary kinds of dissociative disorder, including: Ø

Depersonalisation disorder.

Dissociative amnesia.

Dissociative identity disorder.

Dissociative fugue.

SYMPTOMS The symptoms and signs of dissociative disorders depend on the type and severity, but may include: Ø Feeling disconnected from yourself. Ø Problems with managing intense thoughts and

feelings.

Ø Sudden and unexpected changes in mood – for

instance, becoming very depressed for no reason.

Ø Depression or anxiety problems, or both. Ø Experiencing as though the world around you is

distorted or unreal (called ‘derealisation’).

Ø Memory problems that aren’t linked to physical injury

or health-related ailments.

Ø Other cognitive (thought-related) issues such as

concentration and focussing problems.

Ø Major memory lapses such as forgetting important

personal information.

Ø Feeling forced to conduct yourself in a certain way. Ø Personality confusion – for example, behaving in a

way that the person would usually find abhorrent or offensive.

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CAUSES Many mental health experts believe that the underlying cause of dissociative disorders is chronic trauma in years as a child. Examples of trauma include repeated physical or sexual abuse, emotional abuse and/or neglect. Unpredictable, or perhaps frightening, family environments might additionally trigger the child to ‘disconnect’ from the world around them during times of stress. It appears that the intensity of the dissociative disorder in adulthood is immediately disconnect from the related to the severity of the childhood world around them trauma.

}

Traumatic events that occur during adulthood may also cause dissociative disorders. Such events may include domestic violence, war, torture or going through a natural disaster, being involved in or witnessing a accident or violent crime.

C O M P L I C AT I O N S Without therapy and/or medication, possible complications for an individual with a dissociative disorder may include: Ø Broken down relationships and job loss. Ø Sleep problems such as sleeping disorders. Ø Sexual problems. Ø Severe depression. Ø Anxiety disorders. Ø Eating disorders. Ø Problematic drug use including alcohol. Ø Self-harm, including committing suicide.

DIAGNOSIS If you are concerned that you or a loved one may have a dissociative disorder, it is important to seek professional help. Diagnosis can be tricky due to the fact that dissociative disorders are complicated and their symptoms are typical to better

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featur e a number of other conditions. For example: Ø Physical causes (such as head injury or brain tumours)

can cause in amnesia as well as other cognitive problems.

Ø Mental illnesses such as obsessive-compulsive

disorder, panic disorder and post-traumatic stress disorder might trigger comparable symptoms to a dissociative disorder.

Ø The effects of certain substances, including some

recreational drugs and prescription medications, can imitate symptoms.

Ø Diagnosis may be further hindered when a dissociative

disorder coexists with another mental health problem such as depression.

T R E AT M E N T The effectiveness of treatment options for dissociative disorders has not yet been studied. Treatment choices are based on case studies, not medical research. Generally speaking, treatment may take many years. Options may include: Ø Carrying out treatment in safe surroundings – health

practitioners will attempt to make the person feel safe and relaxed, which is sometimes sufficient to stimulate memory recall in some people with dissociative disorders.

Ø Psychiatric drugs. Ø Hypnosis. Ø Psychotherapy. Examples include cognitive therapy

and psychoanalysis.

Ø Stress management – because stress can trigger

symptoms.

Ø Treatment for other disorders – typically, a person with

a dissociative disorder may have some other mental health issues such as depression or anxiety.

Ø Treatment may include antidepressants or anti-anxiety

medications to attempt to improve the symptoms of the dissociative disorder.

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A D H D i n Yo u n g A d u l t h o o d by Anna Schultz better

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“It’s frustrating, hectic, but normal, because I’ve never been anything different so I don’t know what it’s like to not have ADHD,” says Amy Schultz, now a junior at Indiana Wesleyan University. Amy achieved nearly straight As in high school, earning her significant academic scholarships from several different colleges. But in her first two years of college she spent hours in class and studying outside of class and her grades did not reflect the amount of work she invested.

Amy described her main symptoms as procrastination, difficulty focusing, and awful concept of time. She explained, “that’s one of the effects of the chemical imbalance in our brain. We easily lose track of time and we often underestimate how long a task will take.”

The three symptom groups for ADHD, according to the National Institute for Mental Health, are inattention, hyperactivity, and impulsivity. Individuals who deal with inattention “have difficulty focusing on one thing; they become bored with a task after only a few minutes, unless they are doing something enjoyable.”

Josh Fortney, aged 28, has believed for years that he has some form of ADHD, but has never been tested. Josh says, “Many times when I’m working on something, whether it’s a project or whatever, my mind will think about other things that I need to be doing. Most things I can really only focus on for 15 to 30 minutes with full attention. I start feeling overwhelmed by other things I need to be doing.”

Hyperactivity affects people’s ability to stay still, so they “fidget and squirm in their seats,” feel the need to “be constantly in motion,” and “have difficulty doing quiet tasks or activities.” People who struggle with impulsivity “have difficulty waiting for things they want and waiting their turn.” The National Institute of Mental Health (NIMH) claims that the average age of ADHD onset is seven, and these symptoms may continue into adulthood.

The NIMH claims that adults with ADHD may suffer from anxiety, procrastination, and chronic boredom. Josh explained that when he says, “overwhelmed,” he means “bored;” he thinks of things that are more fun like “jumping out of an airplane and doing somersaults. I feel like I have a lot of built up energy and there’s nothing I can do about it, so a lot of times I’m tapping my feet or tapping my toes bmhmag.com

inside my shoes.” NIMH says “to be diagnosed with the condition, an adult must have ADHD symptoms that began in childhood and continued throughout adulthood.” For Josh, symptoms started at age seven. Their family moved from Shawnee, Oklahoma to Huntington, Indiana between his second and third grade year in school. In Oklahoma Josh’s grades were superb, but after the move they started dropping. He says of his mother, “She thought it was culture shock or a hard time adjusting, so she blamed my grades dropping on the move instead.”In college, Josh struggled with forgetting about assignments until the night before, or the due date of an assignment. He said, “I would get one assignment done and felt like I had all my homework done.” As a functioning adult, Josh has found methods with which to live with his undiagnosed ADHD. His position as a Total Loss Claims Processor at The Hartford Insurance Company involves tasks set apart in phases that only take a few minutes and have deadlines. This allows him to prioritize, complete them, and move on. This aligns with the NIMH suggestion of strict organization and routine for individuals dealing with ADHD symptoms. Amy’s symptoms were not identified until she reached college, partially because the structure of college differs so greatly from grade school. Projects in high school generally include smaller checkpoints, making it more difficult to better

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get behind. “When you go to college there is none of that,” says Amy. “You are given all the assignments for the entire semester – whether or not you do them or when you get them done is up to you. The teacher doesn’t care if you do it two weeks before or the night before it’s due. If you haven’t learned how to work ahead or haven’t been taught to study, you are not going to be able to function. I didn’t know how to plan ahead.” Amy’s impressive GPA plummeted in her first semester away – she nearly failed a class. She explained, “It was because I just didn’t do the homework. It wasn’t because I didn’t want to; I just never left myself enough time to do the assignments.” Her father felt sceptical of her efforts. According to Amy, “he didn’t believe that someone who got grades like I did in high school could do so badly in college and be putting forth the same amount of effort.” Professors, not knowing her capabilities, also doubted her. “Professors will only believe you for so long when you say you forgot or when you say you’re overwhelmed, because to them, it’s not their problem. If you can’t handle college, that’s your deal.” Professors must maintain objectivity in grading. Universities have to uphold standards. Unfortunately, Amy lost her academic scholarship after her freshman year because her GPA fell below those standards. This setback left her even more disappointed: “I was called lazy, I was told that I didn’t care and that if I just

featur e tried harder my grades would get better. And when you spend hours studying for an exam and you still fail, you start to wonder if you really are just stupid. That’s a really sad point to hit.”

Amy’s symptoms were not identified until she reached college She searched for other possibilities, attempting to explain her struggles to her parents. Her mother spoke to an aunt, a licensed psychologist, who suggested that Amy be tested for ADHD. Her aunt had said that in many high functioning ADHD cases, the student’s symptoms do not cause them to be impaired until college because of the rigid structure of high school. Left to his or her own devices, the lack of structure causes a student’s impairment to come to light. In March 2013, the IWU Health Center diagnosed Amy with ADHD and her family began exploring options for medication. When she received her diagnosis, Amy felt relief: “For the longest time I thought there was just something wrong with me.” After months of experimenting with different drugs and dosages, Amy found an effective treatment. She said, “What made things better was a combination of medication and a change in habit. Medication isn’t a

cure-all; you have to be willing to force yourself into a routine and plan ahead, which is very unnatural for people with ADHD. But then with medication, my efforts go farther. All those symptoms aren’t magically fixed, but the combination of my being aware of those problems and the boost of brain function I get from the medication cause studying to actually stick. I’m able to focus on an assignment long enough to finish it. And by putting in a normal amount of effort I can get a normal amount of success, instead of putting in an extraordinary amount of effort and getting very little success.” In the fall semester of 2013, Amy made great progress in winning her scholarship back. “I’m no longer ashamed to admit that I need medication to be able to do well in school because it’s a heck of a lot better than to just give up. I’d rather do well on medication than give up and become the lazy person I was accused of being. It’s ok to admit that you need help.” The NIMH claims that ADHD is the most common childhood disorder, that it affects about 4.1% of American adults and 9% of children. The NIMH mentioned, “studies show that the number of children being diagnosed with ADHD is increasing, but it is unclear why.” Perhaps parents are beginning to test their children for ADHD rather than waiting until symptoms create consequences. bmhmag.com

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Attention Deficit Hyperactivity Disorder ADHD, or Attention Deficit Hyperactivity Disorder, is the most common of the behavioural disorders in young children and adolescents. To varying degrees, ADHD can interfere with personal functioning, school, family and social life. If it is not identified and treated early, it can affect adult life. ADHD is a neurological disease with the main features of inattention, impulsivity and hyperactivity. Although these types of behaviour are found in all children, they are chronic and highly pronounced in the cases of those with ADHD. And they occur in all circumstances of life and in both sexes equally. Despite academic difficulties caused by ADHD, there is no link between this disorder and intelligence. It is estimated that 5% to 8% of the population has ADHD. In half the cases, ADHD persists into adulthood, but sometimes the symptoms diminish during adolescence. About half of children with ADHD also have other problems such as learning disabilities, anxiety, anger or emotional problems. These problems often lead to socialization difficulties and poor self-esteem. It is still unclear whether these area symptom or impact of ADHD bmhmag.com

SYMPTOMS OF ADHD ADHD symptoms tend to increase in situations requiring discipline or some effort.

Symptoms of Inattention The person often: Ü makes careless mistakes and struggles to pay attention to small details Ü struggles to maintain attention in tasks or activities Ü seems not to listen when being spoken to Ü violates instructions Ü has difficulty in organizing activities or work Ü tries to avoid engaging in tasks that need mental effort Ü loses items needed for activities Ü can be distracted easily by outside stimulation sources Ü is forgetful in daily life.

Symptoms of hyperactivity or impulsivity The person often: Ü fidgets with hands or feet Ü will be unable to stay sitting down in the classroom or in other situations Ü runs about or climbs over things where it is inappropriate without fear of danger Ü struggles to keep quiet during rest and recreation periods Ü is very active Ü talks more than would be considered appropriate

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featur e Ü Ü Ü Ü Ü

attempts to answer questions before they’ve heard them in full struggles waiting for things, especially in queues interrupts others has difficulty controlling actions and words in stressful times has mood swings.

CAUSES OF ADHD This disease has no single cause. Probably related to certain brain chemicals, it is not caused by unmet emotional needs or by psychosocial problems. Even if it is a hereditary disease, certain factors may, however, increase the risk, such as: Ü Foetal exposure to certain toxic substances such as alcohol, tobacco or drugs Ü meningitis Ü head trauma Ü premature birth Ü problems occurred at delivery that could have caused a lack of oxygen to the infant.

DIAGNOSING ADHD The diagnosis of ADHD is not easy and there is no medical test or examination to enable a clear diagnosis. The specialist who makes the diagnosis carries out a thorough assessment of the patient and environment. To help determine whether a person has ADHD, the health professional uses several tools, such as best practice statistical diagnostics, psychological testing, neuropsychological tests, and feedback from certain behavioural scales.

TREATING ADHD There is no treatment that can cure ADHD. The objective of the intervention is to reduce the effects of the disease on the sufferer, that is to say his academic difficulties, sufferings related to the rejection that often suffers, low self-esteem, etc.

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When ADHD is treated well, the prognosis is generally good. The stigma associated with ADHD is tenacious. For this reason, medical treatment is always combined with a psychosocial intervention (eg. social skills program, behavioural psychotherapy, family therapy, educational support or participation in sports or community activities). In schools, interventions that promote the organization of work for appropriate supervision is advised. In addition to the psychological and social interventions, medication is often necessary to reduce the symptoms of ADHD. The doctor will usually not prescribe these drugs just because a patient is turbulent, unless this behaviour is pronounced enough to disrupt the patient’s social skills and self-esteem.

Attention Deficit Disorder in Adults The term “attention deficit” is confusing. What we must remember is that ADHD is not an attention deficit, but a deficit in the capability to control the persons degree of attention, impulsiveness, and their hyperactivity. Also, while these people are struggling to pay attention to a conversation or to stay on a task that does not interest them, when they are involved in an activity that stimulates their interest they are capable of hyper-concentration. That is to say, they have the ability to keep their focus on one activity to the exclusion of any other.

SYMPTOMS OF ADHD IN ADULTS Among the most commonly mentioned complaints of people with attention deficit include: Ü

be and feel disorganized Ü have difficulty paying attention Ü have itchy feet or general unrest Ü finding it difficult to start a project or to stay focused on a task better

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featur e Ü Ü Ü Ü Ü Ü Ü Ü

have difficulty managing time so is often late to appointments unable to maintain concentration for long periods of time loose objects regularly forget details or commitments striving for perfection be impulsive, leading to poor decision-making putting things off constantly take risks, and more.

Be aware that it is possible to suffer from attention deficit disorder without presenting all these signs and symptoms. Additionally, just like any other mental health condition, the degree to which these features are present varies from one person to another. Management of ADHD will depend on the individual and their particular symptoms and impact of those symptoms.

TREATMENT OF ADHD IN ADULTS Medication Once a diagnosis is received, adults with ADHD may wish to speak with their doctor about the medicines available to treat ADHD. However, whether you choose to take medication in your treatment plan or not, you must remember that drugs alone are rarely sufficient to help adults with ADHD to have a life filled with success.

Psychotherapy When someone is living with undiagnosed ADHD-related difficulties, the desire to want to succeed in life, at school, at work and in relationships often generate feelings of inadequacy and a low self-esteem. However, these feelings do not disappear automatically after diagnosis. Adults diagnosed with ADHD may have recourse to psychotherapy in order to be able to overcome their sense of failure, to help them overcome depression or anxiety (if they are also diagnosed) or to help them to manage anger and despair that they may experience.

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about

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 contact@bmhmag.com. 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. bmhmag.com

7 Wellbeing Tips Taking better care of your body fosters and improves your wellbeing very quickly once started. Along with participating in physical activities you like and nourishing your body correctly, there are a number of other ways you can boost your mental health and wellbeing These are some simple ways to improve your overall wellbeing.

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1 Thought Diary Writing about negative emotions helps greatly. Studies have proven that individuals who write about their deepest emotions are much less depressed and much more positive than before they began a â&#x20AC;&#x153;thought diaryâ&#x20AC;?. 2 Meditate People have a tendency to believe meditation is complex. In practice, you do not need much time to learn to meditate, it is quite soothing, and one of the greatest things you can do for your wellbeing.

wellbeing 3 Exercise

6 Challenge yourself

You don’t have to take out a full gym membership to gain the benefits of exercise for your wellbeing. Whatever your ability you can start exercising by taking a short walk, a long hike, jog, cycle, yoga, swim or join a local sports team.

Challenging yourself to do something you wouldn’t normally do gives a massive boost to your well being. Nothing dangerous or anything that puts you at risk of harm, but things such as pushing yourself at a workout, enroll in a dance class, etc. Just something that puts you out of your comfort zone a little.

4 Remember to laugh When we are feeling low it’s very easy to take life way too seriously. In a simple study it was revealed that children laugh around 200 times a day. And adults? Only fifteen times daily! 5 Value yourself Decide how you want to live but be sure to live your own personal worth. Understanding and living within your values will result in a sense of balance, trust and gratification.

7 Think positively Keep tabs on your own ideas. You could be captured in a vicious cycle of negative thoughts, which appear to sprout without being able to understand what’s going on. Not only do our thoughts sink into negativity but we may begin to see them as truths. We need to work through these ideas and see them for what they are: changeable and wrong.

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Setbacks and Crises the fear of spiralling out of control by Robyn Hall

So, my dog died. Thereâ&#x20AC;&#x2122;s no nice way to put that. She was old, deaf, slow and getting slower, but I wasnâ&#x20AC;&#x2122;t ready for her to go. Not now. Not when my mental health has finally reached a point where I can reasonably predict it and manage it. But, as with so many things in life, it happened without warning and without consideration of my needs. Sunny was my pal, my shadow. Strange for a golden lab, she was never overtly affectionate, preferring to show her love by ghosting me everywhere and throwing me a handful of frantic wags better

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whenever I got home. She was the runt of the litter and always remained small, so was mistaken for a young dog most of her life (another thing we had in common). She loved her independence. If I let her on the couch, she would curl up on the opposite end to me, asserting her own space. If I let her on the bed, she’d sleep at my feet, despite the hundreds of efforts on my part to bring her into the little spoon position. She had one of those faces that (except when she was panting) held only a single expression, so you never could really tell if she was happy, sad, nonplussed, confused, angry, contemplative, ambivalent, etc. You had to rely on her body language: helicopter tail wagging, shame cowering when my torn washing was on the lawn, hackles up whenever a stranger knocked on the door. Her deep brown eyes took you in with an air of acceptance; she held no pretences for visitors but she didn’t mind if you were there. Over the last four years or so, she started to seem older. She was slower moving and harder of hearing. She was easier for other dogs to knock over, but she always hopped back up and kept right on playing, no matter how much she got rumbled. I guess I didn’t want to admit it was coming, because I didn’t bmhmag.com

What would that preparation look like? I knew someone who kept trying to tell me that ‘Sunny is looking very old’, and ‘Sunny won’t have too much time left’ until I told her to stop telling me that my dog was going to die. My partner tried, over the last six months, to get me to acknowledge the fact that it was coming, but I always told her we’d talk about it later. Even as it was happening, it was surreal. The last two days were just a steady decline. The hardest and most heartbreaking thing was that she still wagged her tail, even as we arrived at the vet (only dog I’ve known who loved the vet). Here are some of the things that I thought during that time: Is she really going to die? Surely not, she’s not that old. Shit. I think this is really it. * cry cry cry * Well, at least the dog food will be cheaper. ASSHOLE!!! WHAT IS WRONG WITH YOU WHY WOULD YOU THINK THAT?!? Oh man, she’s so cute and soft, did I cuddle her enough? I NEVER CUDDLED HER ENOUGH!! I cuddled her enough, don’t be silly. * cry cry cry * Don’t leave me, old girl, not now. * cry cry * I’m sorry, I shouldn’t be putting that on you. You do what you need to. * cry * What am I going to do when she’s gone? Will I have a breakdown? ASSHOLE!! DON’T MAKE IT ALL ABOUT YOU. better

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I didn’t “actually

“

want to think of what my life would be like without her. Fourteen years of throwing her in the car for drives, fourteen years of swimming with her in the river, fourteen years of her being there with me through heartbreak, loss, anger, frustration… I’ve done most of my self-discovery these last ten years, and she was a permanent fixture of that. I really didn’t prepare myself.

know how to mourn

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EVERYTHING DOES NOT ALWAYS HAVE TO BE ABOUT YOU!! But seriously, like… will my mental illness come back out to play?… I hate having depression… I’m scared… GOOD GOD! WHAT THE ACTUAL HELL? FOCUS ON THE EVENTS AT HAND AND CUDDLE THAT DOG!! I’m just saying… * cry cry cry *

And so it went, back and forth, up and down, until all of a sudden I was sitting on the floor of a vet surgery with her head in my lap making one of the most horrible decisions a person will ever have to make. Would ‘preparing’ have made it easier on me? I don’t know. I felt like it wouldn’t, because when she was still here I didn’t want to think about her not being here. I’d get sad, cry and I couldn’t see the point in focusing on that. Maybe for some people, that preparation would be helpful though, and that’s the thing about mental illness, loss and grief. It’s individual and unique. My biggest fear after she was gone was the fact that I didn’t think I was coping very well. Then that morphed into the realisation that I didn’t actually know how to mourn and I thought I was doing it wrong. I racked my brain. I rummaged around, moved things, moved them back, peeked under things and shifted cobwebs. A crappy side effect (for me) of depression is that when I’m stressed or feeling overwhelmed, it’s hard to find a coherent, solid thought. It’s sometimes like I’m reaching into clouds trying to pull out a clump of fairy floss. I put out a call on Facebook for people to give me hints, and boy, did I get them. It seems most people feel that: ü Grieving is exclusive to the individual, and there is not really a ‘wrong’ way to do it, unless your way is to go out and punch strangers in the face. If that’s the case, there is probably a better, more productive and less violent way for you. ü It may not ever get easier to miss someone, you just get bmhmag.com

better at dealing with it. The passage of time is the only thing that will ease the pain. ü Talking to someone can help. ü Let yourself cry. So (in addition to bawling my eyes out at the beautiful responses of my friends and loved ones), I had an answer, of sorts. I wasn’t doing it wrong. I hurt because there is a hole where my ghostie little pal was, and pretty much all I had to do was get through each day. Here is where the fear set in. ü

So, I knew that I would mourn in my own way — which for me was to throw myself into my art in the hope that I could create something beautiful out of all that emotion — but what if my mental state had other plans? I can remember only too well how it felt to be a passenger in my own body, a weak bystander too afraid to stop a horrible dogfight. I was scared that if I had enough days of numb sadness in a bunch, that I would slip down again, through the cracks in the floorboards, through the cool soil under the house, through the marbled red and ivory clay and into my own private depression hell. My fear was increased, because I wasn’t just afraid of slipping into depression again, I was afraid of the implications of that: jeopardising my relationship, my employment and my friendships. Here, in chronological order are the steps I took when I realised I was afraid. ü I talked to someone about it. I talked to my partner and was honest. I told her that I was afraid this event would send me into a tailspin and I would end up back where I had come from: a depressed, anxious shell of myself. ü I called my psychologist and made an appointment to talk to him (suggested by my partner). better

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“ Itorefuse feel

shame for something that is not shameful

ü ü

18 months ago, this would have been its own source of panic. The fact that it could be seen as a ‘step back’ to see him when he had told me I was doing so well that we could finish our sessions. Instead I see it as a ‘I’ve never been through this and could use some help making sure I stay ok’ kinda thing, a maintenance visit. I took a day off work, and was honest about why. My boss was very lovely about it. I made a point that every time I thought about her and got sad, I would make myself remember a beautiful time I had with her, and make myself be grateful of the time we had together. I figured out a way to take my sadness and fear, and channel it into something positive; I threw myself into art. I let myself cry when I need to cry. I’m not ashamed. I should be sad; I lost someone dear to me.

Now, these things may not work for you — and that’s ok — but they also may. What it boils down to, for me, is the fact that I am honest about my mental health. I’m as honest about it as my asthma. I don’t care who knows. I don’t. My family knows, my mates know, my work knows, and just before Christmas I met my in-laws and they know. I refuse to feel shame for something that is not shameful. If I had tried to hide all of this, then I would have exploded. Instead, I’m doing ok. I’m taking each day as it comes, and making some cool things along the way. Sure, every couple of days I have a cry, but I feel good after, and end it on a thought about that old white dog leaping into the river from the jetty, over and over, on a sticky summer afternoon. Then I have a little smile, make myself a coffee and get on with my day. Robyn is a Peer Support Worker, has two degrees in creative writing and believes that writing is invaluable for self-reflection and healing. She lives with her fiancé, two dogs and two cats. She loves to work on their house, write, draw, play ice hockey and be tattooed. She has been diagnosed with Depression and Anxiety with elements of social anxiety and has a weakness for Reebok Pumps.

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Life, Limitations and the Things that are Worth It by L.S. Hope I live in a remote area of an Indo Pacific island. I live onboard a commercial charter vessel, and manage the hospitality side of the boat. There are few foreigners here, and the appearance of a Caucasian always elicits a friendly, but rather intense reaction. In the local port, everywhere I go people stare at me as though I were a ghost. They chuckled bemusedly and point and laugh, good-naturedly. They call me a word which, in the local language, is in no way derogatory or unfriendly but would translate roughly to Moon Person, Whitey, Alien. I cannot go to the supermarket to pick up some milk, without better

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people running at a thousand staring eyes and gaping mouths, sometimes a curious pinch or two, and a loud volley of Mister! Mister! MISTEEER! from all directions. Sometimes they happily snap pictures of me on their phones, which over here is considered perfectly acceptable social behaviour, a flattering expression of friendship. The owner of the boat I work on is addicted to techno music, and there is almost always a solid wall of noise on the boat while maintenance is going on. His idea of a good time is a big, loud, all-night party, and this is how he expresses his appreciation for good work. When the boat is on charter, I am surrounded from dusk to dawn by guests seeking not only an escape that is more than merely satisfactory â&#x20AC;&#x201C; perfection in food and beverage service, scuba diving activities, and all other aspects of life on-board is expected. In addition to this, companionship is also expected and part of the job is listening to the tales of their childrenâ&#x20AC;&#x2122;s daily activities, watching the interminable photo slideshows from their last holiday and, above all, chatting about the idyllic, charming, stress-free life I must live out here amongst the islands. I am a quiet, bookish, introverted person. I am obsessed with privacy. I am, and have been for some years, successfully medicated for depressive disorders, and I suffer from mild anxiety. I am extremely sensitive to loud noises, and I do not enjoy having my picture taken. I need time out each day, alone and in private, otherwise I turn into a dragon. Even the meanest intelligence can see that I may have made a few pretty glaringly inappropriate life choices. What, one may ask, am I doing here in this life I have chosen? Sometimes I think that some impish element of my many selves has deliberately cast me against my type, like a mischievous stage hand who switched the players names on the script. I often wonder why I live the life I do, why I chose it. Most often, I wonder this in the local supermarket. The supermarket, I have come to understand, is a pretty predictable stress trigger for me. Invasively loud techno-beat Christmas carols sung in a faintly Chinese accent will be blaring from the speakers. The shelves will be bare and I will be mentally calculating bmhmag.com

the amount of trouble I will be in if I fail to procure a certain requested item for an upcoming guest charter. As in all retail establishments in the country, there will be approximately three times the amount of floor staff than seems necessary given the size of the building. Most of them will be standing vacantly in the middle of the aisles, or squatting in groups that obstruct the passing of a trolley, playing on cell phones, giggling, and staring at me as though I had two heads when I try to pass. The blaring speakers begin to crackle and, as though to counter this, the invisible sound-man turns up the volume a fraction. One of the store assistants, a mischievous but friendly teenage boy, musters up his courage, and decides to make a game of following me through the aisles, as closely as possible, ducking down if I turn my head sideways or hiding behind fruit displays. He, in turn, is followed by a small band of other loitering shop assistants, who now happily take photographs of me with their cell phones. I feel my chest begin to tighten. Something inside me starts roaring, like a small child having a tantrum. I want out I want out I want out out out. I feel like steam is gathering in my head without any way to escape and a metallic rasping voice, that I imagine must be similar to that of Lucifer’s on his worst days, screams inside my brain:

out I want out “I want I want out out out ”

LEAVE. ME. ALONE!!! TURN. OFF. THE. NOISE!!! I whip around and pin the giggling teenage boy with my most wide-eyed, deranged and poisonous stare, like a ferocious and defensive animal. He sees the smoke coming from my ears, smiles and shrugs sheepishly, and wanders off. His band of camera-phone-wielding groupies follow to a safe corner to examine and giggle over the images of this giant, pasty white, raving, hyperventilating woman. I blink and sway and grip the trolley, and scan the aisles for the exit. I am a lousy shopper. I hate myself for it later. I remember that boy, he is the one who boxes up my big orders here usually. I check out and then that better

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people nice young boy carefully packs all my things into cartons, and seals them up with masking tape, chatting happily with me as he does so. The poor kid wasn’t hurting anyone, and was just playing a game. I don’t mean to go into Ogre Mode, as my partner rightly calls it. But sometimes, when I am stressed or anxious or feel too crowded, I just lose it. Why then, one may well ask, do I put myself in these situations, and lead the life I lead? I suppose the answer is because even though it stretches my mental and social limitations sometimes – it’s worth it. It affords me the opportunity to do the only things in life that are really worthwhile to me. I get to swim through enormous schools of manta rays; amble through dense virgin jungle, surrounded on all sides by lush damp green and towering trees, hosting some of the rarest birds on earth; I get to glide over the dorsal fins and under the bellies of the colossal whale sharks – sometimes they look at me with their bizarre tiny eyes, and the encounter is more meaningful than any I have had with most humans I know; in the evenings as the sun sets and the boat passes close by the local villages, I get to hear their hand-drum symphonies, an orchestra of complexity I would not have thought possible from such a simple instrument; the bats fly overhead and the sky is an explosion of colour; these islands and this part of the world still looks the same as it would have looked to Wallace on his journey through the archipelago. The urge to pursue these things and these experiences that are of the utmost importance to me probably springs from the mother of all my anxieties. Just like any sane and aware person, I am constantly terrified of death. I am terrified that the end will come, and I will have missed it, the thing that validates life or gives it any meaning. Some people feel this panic and create great works of immortal art. I have often wished I were one of those. But lesser mortals like myself feel the acute death panic and can only respond by living out an orgy of blind, life-hungry immersion in everything good and beautiful and wonderful. It is not a philosophy of life, and probably not very admirable, but it is an irresistible compulsion. I feel like the only way I can ever fool myself into coming to terms with death is by getting as much out bmhmag.com

of life as possible – then, somehow in my twisted, absurd logic, everything will be justified. Unfortunately, as I am not a millionaire with a private yacht, this involves a line of work which allows me access to the experiences that are most important to me. This job involves things that bother me, and things that I am no good at – crowds… a lot of air travel… intense social exertion… loud noises. But what is the alternative? I might complain some days of the difficulties of living remotely overseas, or the demands of the hospitality industry, but I’ve made my choice. It’s worth it. In reality it is the fear of death itself that drives some of us to overcome (well… rationally deal with – usually) a myriad other, lesser fears. Years ago, the first time I ever snorkelled, I remember taking the captain of the vessel aside. I warned him, seriously, that I expected his guarantee that I would not see any sharks to be ironclad. Not even a small one, not even a baby one. I chose to believe, I informed him aggressively, that there was in fact a very special invisible fence that he must have set up around the reef snorkelling-site in which his guests entered, which kept in clownfish and turtles and kept out anything even remotely scary. He chuckled, got in the water with me, held my hand and laughed kindly as I flailed and sputtered. It was only a matter of a few years before I had become so addicted that I had not only learned to scuba dive, but obtained the proper training to teach others. You may never believe it until you try it and take the baby steps, but some things really are worth it. Most days, living overseas in a small island community retains its charm. better

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what is and “ decide what isn’t worth it

Some days though, it is trying. My partner looks at me, and shakes his head indulgently but disapproving, when I turn away from good-natured kids who snap my photo with their phones. He turns around and smiles, gives them a thumbs up, hugs them, poses with them all, high-fives them. I watch, like a wide-eyed, anxious squirrel, from behind a nearby tree. He walks over to me amid shrieks of delight, the hero of the hour to the exuberant troupe of kids. I wish I had what he has, but I don’t. Some aspects of living in a foreign culture are difficult for me.

”

But the freedom it affords, to live somewhere that is still so different, somewhere without shopping malls or neatly fenced suburbs, somewhere so unique, somewhere you can still find the birds of paradise, or see a thousand glowing fireflies over the mangroves at night, or swim with enormous sea creatures without a man with an orange vest and a whistle standing over you… to give this up, with only one short life to live, would be unthinkable. Sometimes, on board the boat, I slink into my tiny, womb‑like cabin. I curl into the corner or the bed and pat my books pathetically. I close my eyes and listen to classical music in the headphones, at a volume just loud enough to defeat the hyper-work music outside. I take deep breaths. And usually, after a few moments of this, somehow everything seems different. I peek out the window and see one of the deckhands performing a traditional female dance with a cleaning bucket on his head. He twirls his arms to the rhythm of the techno music, and the surrounding crew shriek with laughter. Someone throws a wet sponge at the dancer’s head and general chaos ensues. I wander outside. The beat of the music now feels invigorating instead of invasive. The crowd of boat crew appear as what they are – wonderful people. The sun is shining, I remember why I love it here and I remember why I live here. Limited as I am by some aspects of mental heath, I have long since come to the conclusion that the only possible way to make life make sense, is to decide what is and what isn’t worth it. bmhmag.com

ing n i m exa the ry t s e p ta

by Adreyo Sen Adreyo is currently pursuing his MFA at Stony Brook, Southampton. Previously, he has completed his graduate and postgraduate work in English and Sociology. He was diagnosed with bipolar disorder at the age of twenty-four. better

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people Twenty-four, a student in New York, I was diagnosed with bipolar disorder. Struggling with anxiety and depression, I returned to India. Fascination with the nature of my illness underwrote my attempt at memoir, an effort doomed by selfobsession. OCD concomitant with my depression caused fervid self-analysis. I became convinced I was also autistic and schizophrenic; and presenting symptoms of borderline personality disorder. Six years have passed. Three interim manic episodes have better acquainted me with my illness. My identity as a bipolar person no longer mystifies me. Now, I am in a better position to examine how being bipolar shaped my life. I’ll look at all aspects of my personality and childhood development that deviated from the norm. At eight, I was a happy, normal child, excitable and confident about my creativity. My seeing myself as a writer was a mark of extraordinary security. Later, depression would make me see this as arrogance. Even so, there were warning signs. I first experienced a desire to crossdress at seven. I was aware of possessing urgent sexual desires. I was excessively emotional. The slightest insult sent me into a tearful fury and a cycle of obsessive, vengeful

thoughts. There was poor synchronicity between my emotional state and my circumstances – I could be happy when I should be sad and vice versa. We shifted to Delhi when I was eight. My depression started. This was a near-constant state, one I rationalized as the consequence of exile from happiness and popularity and the harshness of my mother due to heightened stress. There was enough trauma here for my illness to set itself into inexorable motion. I felt alienated. This alienation itself was caused by numbing depression. Isolation made me less compliant with social norms. Tenuous family finances and my fear of my mother drove me deeper into depression and into coping mechanisms, such as maladaptive daydreaming, that only won me greater alienation. In my confrontations with my mother, I was terrified by my violent thoughts, by my desire to act out in a manner self-damaging. This fear repeated itself in the years following my diagnosed manic episode, an event rendering me deeply dissatisfied with my “weak” self. My stay in Delhi culminated in mental illness. I became convinced that the ordinary cold I’d caught was a life-threatening one. I coughed compulsively – and was admitted to a psychiatric ward with symptoms of psychogenic cough, a psychosomatic disease. My illness was caused by a desire to bmhmag.com

escape – to escape Delhi, to escape my mother, to escape all that was me. I gladly accepted the idea of going to boarding school. My depression went into instant remission. I was finally happy again. Or rather, I was hypomanic. At boarding school, I was subject to scrutiny and bullying, for possibly hypomanic behavior. This had little effect on me. My emotional state was independent of the way the world treated me. I believed excessively in my agency, becoming disrespectful and quietly rebellious.

I was sexually fervid. I longed to hug and kiss my seniors. My awareness of the consequences made me restrain myself. I daydreamed vividly of a transformative process allowing me to be a woman. My daydreams hinted at my transgendered nature. My uncaring rebellion was accompanied by viscid creativity. I daydreamed almost involuntarily and I was functional enough to transform my daydreams into vivid poetry. These pieces demonstrated an empathy with no basis in reality: my fervid daydreams imbued my protagonists with a sincerity I couldn’t have developed from experience. At seventeen, my dissatisfaction with my sloth and academic mediocrity, and my dream of becoming the editor of the school paper drove me into an undiagnosed manic episode, one with the hallmarks of my typical episode: conflated elation and depression, cyclical and obsessive thoughts, a lack of sleep, and pervasive anxiety. In its wake, I thought my illness was a moral fall. I’d attempted to fly too close to the sun. My last school year was spent in selfobsessed depression. I glorified the idea of committing suicide. My depression, as in Delhi, was deep and constant.

I demonstrated poor judgment on several occasions – cross-dressing in vulnerable situations, cutting my wrist to skip physical exercise, Munchausening, and antagonizing authority figures. better

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I redeemed myself by scoring brilliantly in the school-leaving examinations. This permitted me to achieve one anxious dream: getting into an Indian college that had given birth to scores of writers.

people My year in St. Stephen’s College was euthymic. I was appreciated for my creativity. I had friends. Secure, I was not unmoored enough to engage in behavior that jeopardized this security. The only troubling behavior, a hallmark of bipolar disorder, was my overspending.

glorified the idea of “ Icommitting suicide

“

At the culmination of this year, I transferred to college in the United States. Here, for the most part, I wasn’t aware of being either happy or sad. I was numb. Not realizing my bisexuality, I invested too much in same sex friends, subordinating myself to them. In my subsequent two academic careers, I would invest myself obsessively in at least one male friend, to the extent of complete loss of self. There were other patterns. Here, I began a pattern of avoidance, developing an obsessive dislike or fear of another person and cutting class in order to avoid encountering this person. This was socially and academically destructive – disliking my junior year roommate resulted in my staying out till 4am. I engendered obsessive and compulsive behaviors in other ways too. Called out on poor hygiene, I engaged in excessive showering and deodorant use. At one point, I stayed in the bathroom until I was convinced

there was nothing left in my bowels. I was also paranoid, convinced people looking at me were inherently hostile. This would result in my misjudging people and expressing hostility in ineffectually passive-aggressive ways. In my junior and senior years, I was very irritable. Acting out on this irritability appealed to me. Stirred to anger, I broke my favorite gadgets. These acts would engender an incredible sense of dirtiness. I was vicious towards the one friend I could take for granted, teasing and taunting him, all the while afraid I’d never be able to sustain stable friendships. This fear was heightened by my continuing inability to sustain friendships I’d had since I was a child. I thought there was something broken in me. My greatest anxiety was with regard to my parents. Emotionally overwrought when I saw them again, I didn’t miss them when I was away from them. I never felt the need to keep in touch. I was never struck by their vulnerability, by their susceptibility to illness. Now, my anxiety was selfish: what would I do when they were gone? This anxiety would deepen, even as my involuntary coldness to my parents continued. I didn’t write, save for a single day when I was possessed with an immense and triumphant excitement. I no longer thought of myself as a writer. On the day that was the single exception, I sat down and wrote three long and rather disturbing poems at odds with my past and future creative output. bmhmag.com

I went to the UK next, pursuing a Master’s degree in Victorian Literature. I was stable during this period, bar a phase in which I desperately avoided my seemingly unsympathetic initial flatmates. My desire to lose myself in my new “best friend” did impact my academic performance. But, after a long time, I had female friend. This went a long way in normalizing the way I viewed myself. That I was sexually attracted to one female friends, while delighting in subservience to my best friend, was something I did not look further into. My bisexuality was an insight I’d come to long after my diagnosed manic episode. I went next to New York. The months between September 2009 and May 2010 witnessed my slide into hypomania and, with this unchecked, psychosis. I was anxious I’d be unable to replicate the sense of wellbeing, and of having friends who loved me, that I’d enjoyed in the UK. Even when I had a new set of friends, I was insecure and desirous, forever, of greater social contact. Becoming delusional, I started to think my everincreasing and extremely exhausting better

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by crippling “ followed bouts of anxiety

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I did write in the long break following graduation. But something had changed. I was denied the effortlessly empathetic poems I’d written as a child. And the poetry I’d write after my diagnosed manic episode would be divergent from my childhood poetry. Now inhabiting an adult valley of sorrow and despair, I no longer had the ability to simulate an unearned empathy.

socializing was helping me devise a “grand theory of social behavior”. A symptom of my bipolar disorder is hypergraphia, continuous and compulsive writing. Mine took on the form of recording every minutiae of my social interactions, convinced they helped me formulate my theory. By my commitment, I’d filled up ten composition notebooks. In March 2010, my mania and consequent sleeplessness impacted my functioning. My worried friends had me committed. Released, I became aware of the illness’ ability to sunder ties with those one has once been loved by. My relationship with my Columbia friends was never the same. My release was soon followed by crippling bouts of anxiety. I desperately wanted to go home. Depression followed me and stayed, an unwelcome guest, for near three years. In a more severe form were emotions I’d first experienced during my undergraduate years. I was somehow wanting, an open sore. Recovering from the manic episode and ensuing depression affected my ability to hold jobs. But I was writing again. My poems were rich with emotions previously demonstrated in my boarding school years. I was most moving when I spoke of my illness. As I climbed out of depression, my ability to write thus diminished.

people In 2012, I once again began to daydream viscidly, a disruptive behavior that fuelled my best teenage poetry. Daydreaming for hours on end, I became enmeshed in a long and linear storyline. In 2013, as my depression reduced, I moved towards mania, undergoing three hypomanic episodes. Approaching mania advertised itself to me through my daydreams – their continuity would be disrupted, they’d leap large swathes of time, they’d repeat over and over again the same sub-storylines, they’d be driven by the anxieties I’d suppressed (my being bipolar, transgender, bisexual, fearing vision loss and never being able to have children), and they’d move towards a magic realism that is the effect of a loosening of associations in the fraught (and creative) brain. That I daydreamed, an escape mechanism I’d discovered as a child, served to mask, predict and ultimately make productive (in a limited sense) my mania. My manic episodes engendered great creative output, albeit output in which it is clear the author is wildly unmoored. To the outside reader, but not to me then, there was a mythic quality to my writing. In the pursuit of an MFA degree, I moved towards stability, though suffering a minor hypomanic episode in 2014. No longer intrigued by being bipolar, I see it as part of my identity, as inherent as my love for writing. What enables

this is a greater acquaintance with my illness. I know, for instance, that my mind doesn’t switch rapidly between elation and depression, except in the nature of minor and slight daily variations, and that I move from a frenetic, irritable and productive high from September into a mild slough of

depression and into a creative, viscidly daydreaming and emotionally fraught high in March. I suppose this is the manner in which being bipolar is as normal as any other mode of existence. We struggle with ourselves growing up – growing up doesn’t involve a specific age marker – and, in the muted and yet more beautiful valley of our adult existence, we come to know ourselves. And to be at peace with ourselves. No matter how the world may perceive us through a lens, we know isn’t as shattered as we once thought it to be. bmhmag.com

Beating Anxiety Creating a BalancedU by Lidia Blanco

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145 beats per minute, hands clenched in a fist, and feeling like the world was closing in on me – some of the feelings that came over me the night I met my “biological mother”. Little did I know this would be the first of twenty-eight visits to the ER upon being diagnosed with Generalized Anxiety Disorder, Depression, OCD and Panic Disorder. I was just 16 when I met my biological mother for the first time, as she had given me through adoption to my grandparents. My grandmother tried giving me the most normal life possible. Unfortunately, due to health complications she passed away 2 years later. Her loss created a series of events that impacted both my personal and professional life. Soon after her death and unable to cope with her loss, my father turned to alcohol for comfort. This detrimental lifestyle caused him to have a stroke. I was left caring for my father and my great grandmother (who was diagnosed with Parkinson’s Disease) while still trying to maintain a normal young adult lifestyle. At this stage, the thought of losing him was the breaking point to my underlying conditions. I was always known as the pillar in my family. However, upon all these events – that pillar began to crumble. Doctors wanted to fix all of this with “magic” pills. That wasn’t the answer I chose for me. bmhmag.com

What is this condition? Anxiety. Anxiety is a normal psychological response that individuals experience in normal day-to-day situations. The way individuals react to anxiety is the difference between those who are diagnosed with anxiety conditions and those who aren’t. There are many types of anxiety disorder, including Panic Disorder, Social Anxiety, Generalized Anxiety Disorder, and phobias.

one point, I was “ at nonfunctional ” I was diagnosed with Generalized Anxiety Disorder, OCD, Panic Disorder and Depression. At one point, I was nonfunctional. Suicidal thoughts and fears of death and loneliness began to control my life. I found myself at the edge, holding pills to take all at once or at times holding a knife close to my wrist. I later developed a fear for driving. I can remember I lost so much weight. I was so depressed I would not eat and all I could do was cry and throw up. I was unable to drive for an entire year. I was terrified to be alone. I could not stay home alone or go anywhere without having my fiancé or someone next to me. The minute I found myself alone, I was again encountering the 145bpm heart rate, sweaty palms and elevated blood pressure. At this point I had to stop working and leaving my on-campus classes for on-line courses. At all times, my fiancé had to accompany me. He quit school and his job to stay by my side 24/7 in fear that I would hurt myself. I found myself calling the rescue 33 times in one year. All this took a toll on his lifestyle. I decided to seek help, as I finally acknowledged the pillar no longer existed. I began to visit psychologists, psychiatrists and life coaches – nineteen “experts” to be exact. Visit after visit, therapy was a component but medication was always suggested. Within three sessions, most of these experts had already prescribed medication to treat my better

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people conditions. Yet, the root of the problem was merely mentioned but not addressed. I chose to stay away from medications because I strongly believed that it would treat the symptoms of my conditions but not the actual cause. Nonetheless, taking the medication would only create a life of dependency and of potentially developing adverse health effects. While medications may be necessary and beneficial for some conditions and some people, I personally wanted to find a way to manage my conditions without medications if possible.

Natural Awakening I came across a psychologist who had the same approach and end-goal as myself. As opposed to the other psychologists, medication was her last course of treatment. Instead, we began implementing behavioral therapy. I found myself facing my fears during every therapy session. I was finally confronting the root of the problem, I was not dodging it, and I was facing it head on. Through therapy, I learned to identify and control my triggers. Her approach emphasized retraining your thoughts by daily journaling as well as weekly sessions. Some of the sessions consisted of my therapist leaving the room and having me face the fear of being alone. I was forced to stay home for intervals of 5-10 minutes. I had to drive around the parking lot to begin to lose the fear of driving. For 6 months my fiancĂŠ drove behind me until, one day I looked in the rear-view mirror and he was no longer following me. With time, her approach allowed me to once again be able to drive and be alone. I gained confirmation that I could, in fact, return to my old self without the need of any pill. After noticing the improvement that one-year of therapy had made, I was determined to embark on a journey where anxiety would no longer control my life. Therapy then became unaffordable and I no longer had health insurance. I was scared that I would not get better. I was bmhmag.com

embarrassed before my family and friends and all I would do was hide this disorder and try to appear normal. I could not live my life this way. I was eager to look for any or all natural alternatives that would diminish my anxiety.

to identify and â&#x20AC;&#x153; I learned control my triggers â&#x20AC;? I incorporated healthy food choices in my diet that would not contribute to my anxiety. My diet consisted of eating every three hours, consuming whole grains, eliminating alcohol and caffeine (no sodas, no juices) as well processed sugars. A multivitamin became part of my regular diet, especially magnesium, B6 and B12. Additionally, at times when I noticed a possible relapse, I consumed decaffeinated tea (Linden or Chamomile). I would also journal every day. I would journal about how my day went and my emotions and fears for the day. I would focus on each day and try not to allow the WHAT IFâ&#x20AC;&#x2122;s control my mind. I also would wake up every morning and say a positive affirmation and smile. It would help my depression and not allow me to start my day already feeling depressed. When I found myself about to have a panic attack, instead of taking my pulse or hyperventilating I would do jumping jacks wherever I was. Doing so would retrain my brain and diminish the thoughts that would lead to my panic attack. Of all these natural alternative methods, implementing a workout regime has had the largest impact by far in reducing my anxiety. After a month of incorporating a workout routine (which includes cardio and free weights 4 times a week), I noticed results that encouraged me to stay on a natural alternative path. Creating a balanced lifestyle through the use of therapy, eating healthy foods, and exercise can lead to natural awakening and create a balanced life. A balanced life through the use of natural alternatives can lead to reduced anxiety. better

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A BalancedU Challenge medical providers when medication is advised. Do so by using improved knowledge on your condition. Ask doctors how this medication works? What are the side effects and withdrawals associated with the medication? How is this medication going to fix all the underlying causes or the root of my problem? What will happen when I can no longer consume this medication? Will I have a relapse in my symptoms? What will this medication do that therapy will not? Environmental stressors, such as school or work for family, could cause anxiety. How does this medication address the anxiety, which is caused by my environment? I encourage everyone that is living with anxiety to become educated on the condition. Accept that you are faced with a debilitating condition that tries to take over your life. But know that it is not unmanageable. Research anxiety; learn about the different types, the medications, the risks, and the alternative methods of treatment. Seek advice and find success stories from others who have overcome anxiety to live a better life. I believe that creating balance in your life starts from within. I am Lidia Blanco and I am a passionate blogger and life coach-in-training. I write for those who are interested in creating a balance in their life through natural alternatives. Specifically, those individuals who suffer with debilitating anxiety disorders and believe that their only way out is through medication. My goal is to teach you the appropriate techniques and methods you need to establish balance in your life. I want to inspire and teach others to control anxiety without medication. I want to share how creating a balanced life through the use of natural alternatives you can and will diminish your anxiety disorder. It is all about creating a BALANCEDU, how I like to call it. Creating a balance lifestyle through the use of therapy, vitamins, exercise and being in touch with our present can lead all of us to natural awakenings and create a BalancedU. For details, visit my website: www.balancedus.com

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Moment My life has been an experience of finding good stable living structures while being in and out of various places, often part-homeless, and dealing with the fact that I live with Schizophrenia. I have lived in rehab and had a few Hospital admissions in the past. I believe I was a sensitive soul that some how was damaged in the Church at one point or another. Yet I think I was seeking a sense of purpose in my whole life back then. My understanding of Mental Illness has been a family history journey of the inner heart, of resilience. My mother has Schizophrenia with part manic condition. Yet her life is more controlled these days, as she lives and breaths new life awareness in her supported living environment now. I myself finally have stable accommodation in Social Department housing. I am a creative person who loves my art and writing. It’s an expression in being creative. Now that I am near 39 year old, I know that I have to really live for the future aspect of life in general. I am a life of ‘Hope, Diversity, Light’. While living as a single gay man in the local community area of Erskineville, Australia. I’m just living a manageable and productive life with some sort of self-worth connection. better

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an experience of mental illness by Mr Mathew R Hrycyk

Life of many moments can come flashing down on your pile of earth. Like one serious motion, of complicated sickness. When faced with so many problems head on, I try to think of a positive outlook on life. I need the safety sense, of new creation hope. And find the solution, to my long-gone dreams, of a once goal chance. Can I reach for a bright shinning new moment in life? I have been placed in a box with the letter X on top. Waiting to step out of one recovery moment. I need the reason for living, a great openness, new improved sensitive life. Near the greatest life is a sense of fabricated hope. In one unbelievable journey, a moment that is headed on the path of pure white, fantastic, holy, old, discovery. So life can be a credit of wealth or the cents of gone money. I find most people are looking for the psychological answer. Which plays some sort of vital part of deeprooted hidden secrets that need to only be carefully healed. So take a chance, like a smooth red ribbon, a directed concave moment of life. Life is a sense of help, in the wind, of flowing white large windmills. Into a winter barn dance, of calamity. To find a pattern, inside the chains of melodies. To bmhmag.com

catch a creation of open broken life. In the moment, of a good, clean, clear, repaired cracked red heart. To then fight for your right. Within one legal action rebel way. So I live for a moment, down to a question of my own life. A sad yet, sometimes, happy way. To live a moment, of crystal living cleansing salt water streams. I am an island. To then reach out, for the sensation dream, a moment goal. A life of a momentary glimpse, down a future spiral, of wondered ideas. I am that one person. Who finds a secret, of living for this moment, in my own personal vast time? My clock has now click clocked, out of time. A moment now has passed on by. So I remember, you are what you are to only be now. So tread lightly, in your moment, of this dark pitch black night. But wait for the new special light. Which will take you on your adventure of a moment in time. Life can be divided into many set-out placed segments, of a moment. In the rhyme, of musical, momentary times. Can I just think of a piano, tuned in key? I try to live, for this moment, in time. I just want to run, for a blessing of moment. Faith. Can a single silver cross, save my moment? I try to think, of raindrop moments. That fall down, passing the skin checks of my face. So I try to imagine oneâ&#x20AC;&#x2122;s self in a carriage of incredible moment light. I ask for my moment of trial. To face up in the wind, of autumn leaves. My moment has come to my whole human life. For living in powerful bright sunlight. Out of the dark sinister teary moment. Into my moment of terrific open flower crop. I have found the answer to my moment, of my loss gone out away of time. To then take centre stage. In one area, action, maze, moment. So take a chance, for a moment. That is placed in grand love light. Take me on the line of true wonderful survival. From one moment that was suddenly crushed in such a tormented alone storm. A single rose has grown out better

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of the blossom of the Garden Of Godly Eden. Adam and Eve are all people, of windows of purity levels. So a moment starts, in a Holy Garden, of Green Pasture Eden. Take your own light, to burn your candle, of Holy wisdom. As I have, in a Holy church, in a spiritual moment. A scent of lime fills the air. Your light has burnt forward, to your moment of Holy meetings. You and I, who now understand where we are to stand, have honestly found living lively springs of spiritual waters. That stream into this Godly Garden of Eden moment. I have reached, with your special help, our Holy wish moment, for unity, love, peace. Long, vast complete, abundant Mission. Of full glass, of light. The moment is near your own revealed Holy secret. Rich, blood red, creation. Light. Inter-faith. Diversity. Moment. Editor: Mathew lives in a dynamic part of Sydney’s innerwest. Just on the city fringes, it’s home to an eclectic mix of people. With expensively renovated terrace houses, public housing, business and commercial areas intermixed, popular with life-long locals, new families and the LGBTIQ community, it makes for an interesting environment. We like the area and chose to locate the magazine here. As one of our neighbours, we were only too happy to include Mathew’s prose and share his perception of mental health. bmhmag.com

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Consider Meditation Meditation is a mental discipline most often defined as a self-controlled, modified state of focus or consciousness that is mainly directed to self awareness. The practitioner seeks a deeper state of relaxation and awareness. This helps achieve various spiritual and mindful advancement functions, greater focus, heightened imagination, higher state of consciousness, peaceful mindset, and unfolding or enlarging inner power, wisdom, internal love and light. Importantly, it is also regarded as a useful instrument for life-pressure relief, increased mental clarity, self-healing, pain reduction, intuition development, psychological cleansing, relaxation, and reconciliation.

The Effect of Meditation

All the elements included in meditation â&#x20AC;&#x201C; relaxation, focus, self-finding perspective, the modified state of consciousness as well as abeyance of rational thought â&#x20AC;&#x201C; change the physiological, emotional and spiritual facets of the professional. Increasingly, doctors and scientists are prescribing meditation as part of treatment for various health conditions. Meditation helps create peace of mind, discovery of inner power and the consciousness past the ego, discovery of an individual's authentic being, heightened awareness of the internal self, self-actualization and finally spiritual or psychological awakening.

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Breathing and Meditation

There are a few techniques that change between breathing and meditation focussed strategies, yet the two basic approaches are the most frequent. By narrowing the focus to breathing, the mind becomes still, enabling greater clarity and consciousness to come. Meditation practitioners consider their mind-set as well as a direct connection between an individual's breathing. When someone is frightened, agitated, restless, or diverted, the respiration will often be shallow, fast and irregular. When the head is calm, composed and concentrated, the respiration will often be slow, heavy and routine, permitting the head to eventually become more conscious and tranquil.

Transcendental meditation

Transcendental Meditation, or TM, is the most studied and most commonly practiced form of meditation. Introduced in 1955 in India by Maharishi Mahesh Hogi, it's instructed in a seven-step lessons and includes using a mantra practiced for 15-20 minutes two times a day. There are other mantra techniques where the mantra isn't chanted. Instead, the mantra is utilized as a vehicle upon which someone's focus can rest and an important difference between the TM technique. During first sessions of learning TM, the pupil is provided a mantra (or sound) which is employed as a notion in the meditation process. This permits the individual's focus to be directed from an effective style of operation to a more quiet fashion of mental action. The gains of TM increase as time passes

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and are instantaneous. Hundreds of studies have confirmed the positive effects. It's not a faith nor does it entail any lifestyle changes, thereby making it an especially popular type of meditation for the beginner. This specific type of meditation works out the essential prefrontal cortex of the brain, thereby making the brain more healthy, better incorporated and better able to work as a whole.

Preparing for Meditation

Meditation may be practiced in the conventional sense â&#x20AC;&#x201C; a seated position usually cross-legged like the Lotus Position, lying down, it may be practiced while walking or during easy repetitive jobs. Qi Gong is a well-known type of concentrative meditation that includes motion. Other types of meditation include sitting and standing on a stool or a seat. Some include hand-gestures or hand-postures. In meditative practices, the eyes are not open, and the back should to be kept straight to breathing techniques.

Meditation is suitable for everyone

Meditation is a recommended practice for virtually any person seeking a high level of wellness. By practicing meditation often and learning more in each session, someone creates clarity and an internal space which will empower them to command their thoughts regardless of conditions. The aim is to experience a long-lasting inner peace or "nirvana". Ultimately, a more profound awareness of wellbeing and peacefulness comes to the meditator, creating the peaceful and quiet level of consciousness â&#x20AC;&#x201C; the internal self â&#x20AC;&#x201C; better able to focus on the positive.

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Try Body Awareness Meditation Body Awareness Meditation is a meditation designed for the investigation of the nature of the human body, in addition to truly being a basis for concentration building. This meditation is exceptional for those who have an anatomical, health or medical interest in the body. This interest, together with the body awareness, helps in building focus. On the flip side, it is often hardest for those who are the most sensitive towards the human body either with regard to its look, or perhaps they may be uneasy with the biological processes of the body. For many people, however, this style of meditation is beneficial. Since it is incredibly simple, the meditator is likely to feel significant benefits from it without much effort. Just starting and gradually building up expertise, will help facilitate beginners into it.

How to Begin

Pick a quiet, cosy spot to meditate. Choose a position comfy for you â&#x20AC;&#x201C; for this meditation, all positions are acceptable. Having a stiff sitting or lying position will cause distress. Relax any pressure you have in your mind and body. Spend several minutes noticing and engaging with your physical being, like breathing, sitting and relaxing. Spending several minutes doing this method permits the head to develop knowledge of the body and allows for more focus as it analyzes the body for stress. Letting the entire body to relax additionally lets your thoughts become quietened and calm.

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Give yourself a couple minutes for this to happen and let go of distractions, thought and other matters of the mind. Now divide the body into its component parts. Begin usually with legs, arms, torso and head. As you emotionally note the location of every part, begin to divide it up further to become conscious of details that are smaller. Spend a minute being both conscious of each component, but how they feel, like relaxed or stressed, cold or hot and so forth. Begin to emotionally notice individual portions of the body in more detail; muscles, bones, kidneys, lungs, heart, perspiration, skin and any other bodily part that you can note individually. Typically, start from the feet, and the toes, slowly working up the calves, and legs and entire body, one side and the other, feet, legs, arms, stomach, chest, neck, face, until reaching your head. Feel your stress and tension release, relaxing each part as you progress through your entire body.

Live Happily and Healthily

Mastering this does take some time before it becomes a powerfully insightful tool. Donâ&#x20AC;&#x2122;t worry of nothing incredible happens the first time you try. It may only work for some, for others they may choose to concentrate on some other form of mindfulness practice, such as reading, knitting or art. But for many, it may well become a more profound mastery of the entire body to enable you live a more happy and healthy day by improving mindfulness.

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remember to drink water The body is about 60% water, our blood is 92% and bones are about 22% water. Thirst is your body calling for rehydration and by the time you experience thirst, we're already dehydrated. When dehydrated we're impacting the performance of the majority of our body, as virtually all of our systems do not work as well without the appropriate water consumption. Maintaining physical wellbeing is also important for mental wellbeing. Drinking water is as important for the mind as it is for the body. Our brains need sufficient hydration to perform as best as possible. Brain cells require a balance of water along with other elements to function well. Losing that hydration means the balance is lost and your brain cells lose their effectiveness along with it. While this can have long term impact, just being dehydrated will impact our mood. If that's not reason enough to ensure your daily water intake is sufficient, we've put together just a few of the benefits of drinking more water and included some suggestions that will help you do just that.

Drink Water Instead of Soda Swapping sugary beverages for water is among the quickest and easiest ways to stay hydrated and improve your overall health in both the long and short term future - and not to mention, its free of charge.

and Energy Drinks Leave the energy drinks â&#x20AC;&#x201C; drinking water while working out is the ultimate muscle fuel. For a boost of energy, drink water before you drive through the finished set of pull ups, and to lessen cramps and sprains. better

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Lose Weight Though there's no one size fits all solution for weight loss, by making you feel full more quickly, so you'll eat less and discard the pounds, water can help cut your waistline.

Burn More Calories Drinking water can help by modulating your metabolism, you burn off more calories. Your metabolism could speed up by as much as 30 percent by drinking 17 ounces of water per day.

Improve your Complexion Water works to hydrate your skin and reduce blemishes, resulting in a healthy glow even your best moisturizer can not achieve on its own.

Detoxify your Body Water helps to get rid of toxins and wastes from your body by transporting nutrients to where they're needed and supporting healthy digestion.

Lessen Headaches Frequently, dehydration causes headaches. Instead of reaching for drugs next time your head hurts, try reaching for a cold glass of water alleviate or to prevent your headache symptoms.

Improve Mental Health And keeping your entire body as healthy as possible improves your overall wellbeing. And thatâ&#x20AC;&#x2122;s improves your mental health, mental wellbeing, and general mood. bmhmag.com

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I N S O M N I A an alternative path to recovery by Gertrude Phelan

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A good night’s sleep is something many people enjoy every night. Sleep is a big factor in keeping yourself feeling your best as, without adequate sleep, we cannot function effectively. Sleep is as important as other vital processes like eating, drinking or breathing. Not only does good sleep refresh our bodies, but it also repairs our mind. For some people, however, this natural rhythm can be interrupted for many reasons. Maybe an illness, a sudden loss of a loved one or a job, a new baby or even a transition or change such as menopause. It might start by missing a few nights. For some reason, you couldn’t sleep, within a few short days the beginnings of fear sets in. You lie down but sleep seems miles away and you find yourself worrying whether you will sleep tonight, how much you need to sleep, how you can be this tired and not be able to drop off. You try to relax but you only become more and more anxious, and more awake. You have your first night of no, limited or broken sleep and you have to drag yourself through the day like a zombie,

more tired than you ever thought possible. And this pattern continues several night or even every night. Next you go to your doctor who will almost certainly prescribe sleeping pills. While the pills may work in the short-term, they are often highly addictive and can give a nasty “hangover” effect the next day. As some people become tolerant to the medication, after a while, it stops working as effectively. So you return to the doctor. This time, the dosage is increased or perhaps a different pill is prescribed. In some cases, even this does not seem to work. You wonder what kind of insomnia you have that it doesn’t even respond to medication, when they work for other people. I must have a worse form of Insomnia, maybe bmhmag.com

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I have an imbalance in the brain or a hormonal imbalance, maybe my sleep mechanism has become damaged. In desperation, you turn to alternative treatments herbs, CDs, relaxation techniques. These all help you relax but they don’t improve the sleep. All the time, the fear of never having a good sleep ever again is growing and taking hold.

the fear of not sleeping sets in In this increasingly stressful state, your thoughts may continue to deteriorate. You wonder what’s broken, what went wrong, what’s wrong with me? You might think, I’ll never get better, what if I lose my job or my partner? What if I can’t look after the children? What if I get worse? What if I never sleep again? Back to the doctor, antidepressants this time, you’re told that insomnia and depression go hand in hand. The doctor says these are bound to help you. What a relief at last! Then the disappointment to find that they don’t work either, you may not have actually been depressed before. Perhaps the insomnia has been the cause of your depression. It may feel like insomnia is the only thing standing between you and a great life, but stand in the way it does. Speaking with family and friends no one seems to get it. Why don’t you better

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just sleep if your that tired? They say that you probably do sleep but you don’t remember it. No one gets it, not relatives, friends, or doctors. So, here’s some practical and realistic advice: 1. You’re not broken. 2. You aren’t abnormal. 3. You can get better. Getting over insomnia is not going to happen when someone invents a new cure or a wonder drug. It’s not going to happen when you discover the ideal therapist or relaxation technique. It’s going to happen when you grasp the mechanics of insomnia, sleep and your own problem. It will happen when you discover the deep seated reason behind your insomnia. This involves an understanding of what caused it and what’s keeping it there, and what is stopping it from changing. Until you can understand how chronic insomnia works, no cures, no remedies not even sleeping pills will work effectively or long term. Many chronic insomniacs seek therapy from doctors, discuss sleep with friends, read, research and stress, analyse inside and out, go to pieces and panic over something that doesn’t phase a normal sleeper. Sooner or later, the fear of not sleeping sets in and this is what stops sleep, which, in-turn, feeds the fear. In other words, chronic insomniacs overreact to a missed night’s sleep and it is this reaction that is the defining

wellbeing characteristic of the chronic insomniac As the saying goes, it’s not what happens to you in life but how you react that counts. Frantically, trying to do something about insomnia only makes it worse. Some people look for something to make them sleep; recordings, magnets, bracelets, breathing and focusing techniques. They focus intently on sorting out those bad nights. But at that stage, it’s too late. The bad night is just a symptom of a much more involved problem.

Overcoming Insomnia We need to work on things that make it easy for sleep to slip back into our lives, we can’t make sleep happen, sleep occurs naturally when the circumstances are right. To create the optimal conditions for

sleep to occur, attention should be given to the following aspects.

tiredness Going to bed when you’re not tired contributes to the severity of the problem. Good sleep hygiene rules are designed to make sure your tiredness is at the optimal level for sleeping easily. Sleep hygiene, such as only going to bed when you’re tired enough may be all that’s needed in an early problem.

tension When we are tense, we aren’t relaxed. Our hearts beat faster, adrenaline flows, our minds are active. This is not conducive to sleep. Our body goes into fight or flight mode. Try to find a way to reduce the tension and potential anxiety. Activities such as exercise, meditation, yoga or mindfulness, may help.

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expectation When insomnia bites, expectation of not been able to sleep sets in quickly. Low expectation is so powerful that it can override everything else and keep you awake despite having a good tiredness level and tension level. This is because low expectation feeds on fear and, for many, it’s the fear of not sleeping that is the significant issue. Chronic insomnia is an affliction that is kept in place by habitual thoughts and fears and low expectation.

has made any difference to their expectation. Every day, they repeat to themselves negative expectation reinforcing mantras, such as ‘nothing ever works for me’ or ‘I’ll never sleep well again’. This, in turn, weakens expectations. The habit grows stronger and the insomnia becomes more established. Relaxation alone won’t cure insomnia. The positive approach of heightened expectation to sleep may help.

Expectation and fear are fed by our very own thoughts every moment of the day and that makes it the hardest aspect to change. So, no matter how hard you work on your sleep hygiene and relaxation, if your thoughts remain full of fear and negativity, your expectation of sleep will stay low. Insomnia will continue to plague you and you’ll never make any real progress. When expectation is low, even the strongest sleeping pill cannot override it.

Increasing expectation is not a simple or immediate process. But you can start with this: ü Tell yourself a different story. Watch for negative thoughts and beliefs and change them, tell yourself that you will sleep. ü Focus on what’s going right and pay no attention to what’s going wrong. Keep a list of any positives in the day or something that made you smile and focus on those.

Some people say they have tried everything, including meditation, sleeping aids, medication, and relaxation music, without any success. The reason may be that all their work is focussed on tension, so nothing

It seems too simple. But the positive thoughts and improved expectations can be powerful enough to change sleep patterns. It’s at least worth giving a try when what you’re doing isn’t working.

Editor: The importance of changing perspectives to change patterns and see positive outcomes cannot be underestimated. However, mental health conditions can be incredibly complex and have many contributing factors. As discussed in previous issues, please do seek professional advice along with making changes in lifestyle to achieve the most appropriate method of managing your mental health. Gertrude’s approach to changing expectations is incredibly positive, and one we had not previously included, so we think it’s an important addition to the topic of improving sleep. Sleep tight!

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“In today’s rush we all think too much, seek too much, want too much and forget about the joy of just Being.” Eckart Tolle

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a bully in the workplace by Jan Marquart, LCSW, CAS, and author

Bullying does not only apply to acting out children, it unfortunately applies to adults as well. Being a bully is not something one usually outgrows. Bullying is a way of coping and can become a part of an adultâ&#x20AC;&#x2122;s everyday methods for dealing with getting what they want in life. Bullying in the workplace is more prevalent than most people expect. The statistics for bullying in the workplace is astounding. In 2010, a study was conducted by the Workplace Bullying Institute. This study indicated that 35% of American workers had been bullied. In 2006 Schat, Frone & Kelloway conducted a survey which revealed that 41.4% of workers reported psychologically aggressive acts at work which represented 47 million US workers. The effects of bullying in the workplace costs employers a staggering minimum cost of $4bn a year. A victim of bullying who faces psychological aggression at work each

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featur e day is at risk for becoming anxious, fearful, irritable, and seemingly uncooperative to a supervisor or members of a team. A victim of bullying can: û come to work tired from being up all night with worry û perform less than desirable û take additional sick days û begin using substances û become depressed û increase behaviors at home that lead to domestic violence and other symptoms that on the surface seem difficult to explain. There are many reasons why situations of bullying are minimized. Without training for both supervisors and victims a complaint of being bullied can get re-categorized as simply a personality problem between victim and victimizer. A victim can feel afraid that if he complains about an employee he will

Jan Marquart has been a psychotherapist for the last thirty plus years. She has also written 11 books, had articles, stories, essays and poems published continuing to learn from the power of the written voice. Jan’s books, including A Manual on How To Deal With A Bully In The Workplace can be purchased at http://www.JanMarquart.com for more information on workplaces try: www.workplacebullying.org www.meridianwellness.com.au www.safetymedia.co.uk

be defined as a trouble-maker and risk losing his job. As a result a victim of bullying in the workplace usually quits rather than take on the act of disclosing the abuse experienced and be seen as ‘the problem.’ There are effective ways a victim can get prepared before taking the problem to management and ways supervisors can handle the problem to get it resolved. Management is responsible for the safety of each employee. There are currently no specific laws for generic bullying, but this does not mean the management team ought not to take this pervasive problem seriously. Bullying in the workplace is four times more prevalent than harassment, which is legislated against. Whether you are a victim of bullying in the workplace or an employer trying to understand an employee’s out-ofcharacter behavior and symptoms, bullying in the workplace ought to be considered as the possible problem.

A Manual on How to Deal With a Bully in the Workplace

Jan Marquart

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of these people... one has a mental health issue one is a family member one is a partner one is an employer one is a health worker

all of them read

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