N ov e m b e r 2 0 1 1
The Newsletter for Consumers & Supporters
Social Security to Hand out 1st raises since ’09
Social security retirement benefits are set to receive a 3.6 percent
O k l a h o m a m e n ta l h e a lt h c o n s u m e r c o u n c i l
c o n s u m e r a l e rt
cost-of-living adjustment in 2012, the first increase since 2009. For many social security recipients that increase could be an off-set by increases to Medicare premiums and other expenses. Under the new increase, a senior with a payment of $1,186 per month will receive $43 more or approximately $516 per year. Under 2011, rules Congress lowered the 6.2 percent social security tax to just 4.2 percent. Employers continued to pay 6.2 percent. The increase in a persons Medicare Part B in 2012, is dependent on what they were paying in 2011, and whether the basic premium goes up or down. Which means a person pays more or less for Medicare Part B in 2012 depends on what they were paying this year and whether the basic premium goes up or down.
OMHCC’s snOwflake CelebratiOn “Snowflakes are just like people, each one is individual” December 9th Please help us help the homeless have an easier holiday this season. Donations will be accepted at the OMHCC office until December 8th for personal hygiene items.
Oklahoma Mental Health Consumer Council 3200 NW 48th St , Ste 102 Oklahoma City, OK 73112 Tel: 405.604.6975 Toll Free: 1.888.424.1305 Fax: 405.605.8175 E-mail: www.omhcc.org
“We care, because we’ve been there”
Mailing a Letter to Cost a Penny More Next Year WASHINGTON — It'll cost a penny more to mail a letter next year. The cash-strapped U.S. Postal Service announced Tuesday that it will increase postage rates on Jan. 22, including a 1-cent increase in the cost of first-class mail, to 45 cents. Under the law the post office cannot raise prices more than the rate of inflation, which is 2.1 percent, unless it gets special permission from the independent Postal Regulatory Commission. The PRC last year turned down such a request. The post office lost $8 billion in fiscal 2010 and the bottom line is likely to be even worse when final figures for fiscal 2011 are released next month. The rate increase will make only a small dent in those losses, caused by the recession, movement of mail to the Internet, and a requirement that the agency fund future retiree medical benefits years in advance. Other proposals to cut the losses have included reduction of mail delivery from six to five days a week and closing thousands of offices across the country. The current 44-cent rate has been in effect since May 2009. Because most stamps being issued are "Forever" stamps, they will remain good for first-class postage. But buying new Forever stamps will cost more when the prices go up. While the price for the first ounce of a first-class letter will rise to 45 cents, the cost for each additional ounce will remain at the current 20 cents. Other prices will also change including: _Postcards will go up 3 cents to 32 cents. _Letters to Canada and Mexico will increase a nickel to 85 cents. _Letters to other foreign countries will go up 7 cents to $1.05. _Prices for advertising mail, periodicals and parcels also will rise about 2.1 percent. _There will be a new three-month option for renting post office boxes, for people who need them only for a short time. _Delivery confirmation will be free on some parcel services, rather than being an extra charge.
VA Anti Stigma Campaign The Department of Veterans Affairs launched Make the connection—a national public awareness campaign based on powerful personal video testimonials– true stories of veterans who faced mental health issues; reached out for support; and found ways to overcome their challenges. Watch hundreds of Veteran videos and learn more at www.MakeTheConnection.net. This is an example of a “contact” approach to reducing stigma that was developed after extensive audience research. The campaign seeks to make it easy for Veterans to make it easy for Veterans to “make the connection’” between what they are experiencing and the kinds of resources and services that can help get them on a better track. It does this by providing information, but much more importantly, it allows Veterans to “contact” others who have made “the Connection,” sought services/treatment, and found an improved quality of life. It avoids language about diagnoses, illness, and treatment in so that a Veteran does not have to label him/herself as being sick in order to get on a path toward improved function and wellness. Discussion of symptoms and illness are on the website, but are not the first (or even second) things site visitors will find.
OMHCC HAS GONE INTERNATIONAL Author Helena Smole from Skofja Loka, Slovenia, EU sent OMHCC a copy of her new book “Balancing the Beast”. She says “It is most delightful to see more and more people coming out of the closet with their schizophrenia, with manic depression – nowadays called bipolar disorder, or with a similar disorder such as schizoaffective disorder. In my book I write about my experiences with schizoaffective disorder, which I perceive as a mixture of schizophrenia and manic depression. There are many books about mental illness written by authors first hand. My
contribution to the subject is the bright approach I chose in order to make mental illness more casual and less frightening. Next to my optimistic style of writing, there are also humorous illustrations by Leon Zuodar, making the whole trouble with mental illness more bearable.” Smole also stated that she “wished to inspire people in despair and help make mental illness casual by coming out of the closet with her story.” Her weekly blog can be followed through ww.helenasmole.com and her book is available at Amazon.com.
Building New Traditions
Holidays - Discover Sacred December Celebrations Today
You know that feeling you get when you start noticing the same thing everywhere around you, and it keeps popping up? That’s what I get this year about building own holiday traditions. Then as I recently bought a Christmas fir ring (Adventkranz) for the home, and thought this was one of the first traditions D. and I started as a new family, I thought… yes, Christmas is mostly about how you feel about it. And you feel it based on rituals and traditions built around. Some get stuffed down your throat by consumerism and society, some you discover if you look into Yuletide and ancient rituals, and some you get to create for yourself. So here are my own rituals for this time of year, which, ironically enough, don’t involve Christmas trees or Santa Claus. 1. Walking at night through the snow. Preferably around woods. 2. Reading a good book by candlelight. 3. Cooking especially good stuff. Can’t wait to start the baking, cooking, tasting. So, in the end, traditions are the string that gets woven around this time of the year. Whether we like or hate them, we’re free to reinvent new ones, and anchor them to a state of mind that gets recreated each year. By Maria Dinu
While Christmas is the most universally recognized holiday in the world. It has become a celebrated affair of magic, myth and religion. Most of the Christmas festivities that we know today actually sprang from pre-Christian festivals that had been celebrated for centuries. The birth of the sun celebrated on the 25th December was replaced with the celebration of the birth of Jesus Christ on this day. For Christians “Christ” was the new “Sun” the “Son of God” the new “light of the world”. While there are approximately 2.1 billion Christians in a total world population of 6.6 billion, making it the largest religion worldwide, there are many other cultures and religions holding sacred celebrations during December today. Here are some of the most celebrated festivals: · Jewish people commemorate Hanukkah (the Hebrew word for “dedication”). This feast is also referred to as “Feast of Dedication” or “Feast of Lights”. It is an eight day festival which commemorates the rededication of the Holy Temple in Jerusalem. The Jews reclaimed and rededicated their temple in 165 B.C. after a victory which drove the Syrian army out of Jerusalem. A primary ritual during this time is to light a single light each night for eight nights and the number of lights lit is increased by one each night. The extra light lit each night is called a “shamash” meaning “guard” or “servant” and is given a distinct location, usually higher or lower than the others. Special blessings are recited over the lights each night. There are approximately 14 million Jews worldwide. · Muslims are observing Ramadan when it falls during the Christmas season. It is noted that Ramadan moves all over in relation to our calendar. Considered the most venerated, blessed and spiritually beneficial month of the Islamic year. Believed to be the month in which the first verses of the Koran (the divine scripture) were revealed by Allah (God) to the prophet Muhammad. It is a month where fasting, inner reflection, devotion to God and self control is observed. In Saudi Arabia it is 100% Muslim and Islam is the only accepted religion and non-Muslim religious activities are banned in public thus no Christmas celebrations. Saudi Arabia, as the birthplace of Islam is responsible for protecting the faith’s holiest shrines at Mecca and Medina. There are approximately 1.3 billion Muslims worldwide. · African Americans are celebrating Kwanzaa which means “first fruits” and is based on African festivals. It started in 1966 by Dr Maulana Karenga, an American academic. Celebrations over seven days from 26 December to January 1st that reflect on and reaffirm traditional African values, ancestors and culture. There are seven guiding principles reflected upon. One for each day of the festival: unity, self determination, collective work and responsibility, collective economics, purpose, creativity and faith. Kwanzaa is observed by more than 18 million people. Kwanzaa is not celebrated in Africa, as it's an African-American holiday. · In Hong Kong the festival of a Ta Chiu is held (a Taoist festival of peace and renewal) held on 27 December each year. Participants summon all their gods and ghosts of their ancestors so that the collective power will renew their lives and fulfill wishes for the coming year. At the end of the festival, priests read aloud the names of every person living in their area. Then they attach the list of names to a paper horse and set it aflame, letting the smoke carry the names up into the heavens to reach the Gods so they will remember them. · In Japan no official celebrations of Christmas as less than 1% of the population is Christian. The major religion in Japan is Buddhism and Shinto. December in Japan is a time for preparing for their most celebrated day of the year “New Year’s Day”. People prepare by thoroughly cleaning their houses on new year’s eve then adding special decorations. People dress in their finest clothes often being traditional Japanese kimonos. A tradition is for the father of the house to be followed by all the family as he marches throughout the house driving away evil spirits. Custom is for the father to throw dried beans into the corners of each room as he bids evil spirits to withdraw and good luck to enter. The family then attends the Shinto Shrine where they clap hands to get the attention of the “Gods” and request good fortune. People send new year’s day cards like people send Christmas cards in west. There are 376 million Buddhist world-wide and 4 million Shinto world-wide. · The indigenous people of Australia, the Aborigines, being one the oldest cultures and people on earth, do not celebrate Christmas (even though Australia is largely a Christian country widely celebrating Christmas). The Aborigines have their own rich and honored culture in particular the “Dreamtime” storytelling which is an integral part of their life. It plays a vital role in educating children with stories of history, culture, the land and their people. Stories which have been handed down from one generation to the next over thousands of years. December celebrations include in Arnhem Land, Northern Territory, Yolngu Aboriginal people who observe the last season of their six-season cycle. Gudjewg, the wet season which begins in late December. There are less than 500,000 Aborigines in Australia today.
Need Help this Holiday Season? The Salvation Army may be your answer BE A VOLUNTEER BELLRINGER The Salvation Army Central Oklahoma Area Command is signing up volunteers, groups, churches, companies and youth groups for the Annual Red Kettle Christmas campaign. Choose a four-hour shift one day this Christmas season - or more! - and help ring the bells for The Salvation Army! Be a part of the magic, help raise money to feed and shelter those who suffer and have fun doing it! Sign up now for a Bell ringing shift for yourself or your group by contacting: Oklahoma County: Lois Green lois_green@uss.salvationarmy.org or 405-246-1101 Clothing Assistance - An needy person can receive clothing assistance Monday through Friday during normal business hours. The Salvation Army Oklahoma City also has the "Warmth 4 Winter" program, in which The Salvation Army teams up with KFOR television on a coat drive to give to those in need. Utility Assistance - Qualified individuals in need receive financial assistance to help pay for heating fuel, electricity and water bills. With the help of OG&E, Oklahoma Natural Gas and PSO of Oklahoma, citizens can choose to add a dollar or two to their utility bill to help those less fortunate with their heating and cooling costs. * Food Assistance - The Salvation Army's Food Pantry provides bags of nonperishable food to families and seniors in need. * Meals - Dinner is available to everyone and is served each evening at 5 p.m. at the Red Shield Kitchen, located at 330 SW 4th St. Holiday Assistance List Hope Center of Edmond 405.348.1340 1251 N. Broadway, suites A &B, Edmond, OK 73034 Applications taken Mon, Nov 7 thru Weds, Nov 30 Alameda Church of Christ 405.321.0788 801 E. Alameda Norman, OK 73071 Distributes baskets & gifts to families in Cleveland Co. Citizens Caring for Children 405.753.0499 730 W. Wilshire Creek Blvd, Ste 111 OKC, OK 73111 Provides gifts for foster children thru their Santa Stop YWCA 405.948.1770 2640 W. I-44 Service Rd OKC, OK 73112 Provides Adopt A Family program 11/11-12/9 M-F 8-5
How Christmas festivities and pressures can damage health and well-being The Christmas holiday period is traditionally a time for celebration. However, the festive season often brings many detrimental health effects, which nurses may encounter when coming into contact with patients over the coming weeks. While many people will be looking forward to having time off work, the impact of Christmas can be profound and not always positive. The effects range from increased stress, family conflicts and alcohol misuse to heightened loneliness, increasing mental health difficulties and domestic violence. The global economic downturn and associated money worries are likely to make this Christmas more stressful than most. Stress -A range of factors contribute to making Christmas a busy and potentially very stressful time of year. These include pressures of shopping, time, financial concerns and social demands, as well as fatigue, general overindulgence and lack of physical exercise. A Medical News Today (2008) article warns that Christmas pressures can lead to anxiety, sleep disturbances, headaches, loss of appetite and poor concentration - all of which are symptoms of stress. It adds that, over time, stress can contribute to heart disease, stroke and cancer. According to psychologists from Coventry University, most people suffer from stress during the Christmas period, but do not recognize it (Curtis, 2002). They explain that Christmas is a time of additional responsibility and a radical shift in daily patterns, and a range of factors can contribute to raising people's stress levels. Spending weeks worrying about Christmas can also lead to immune system breakdowns, leaving people susceptible to colds. Coming into contact with more people at this time also exposes them to more infections (Curtis, 2002). Family stress- Family issues can add to the stress of Christmas. Not only are there many domestic tasks but also spending concentrated periods of time with family members can increase the risk of conflict. According to NHS Choices, statistics show that January is the busiest month for divorce lawyers. Mental health- Christmas can be a difficult time of year for people experiencing mental distress. Mind (2008) has launched its Christmas appeal to raise funds for MindinfoLine, a confidential mental health information service to people contacting it by phone, email or letter. The charity says Christmas can often leave people feeling even more alone and isolated from their family and friends. Nurses working in mental health settings should be extra vigilant for exacerbations of mental health conditions brought on by isolation or increased stress from the festive season. While the Samaritans do not have figures on the number of calls at Christmas compared with other times of the year, the charity says call rates are higher on Christmas Eve than on Christmas Day, while they dip on New Year's Eve but are higher the day before and on New Year's Day. Loneliness- Loneliness and isolation are particular issues at Christmas. NHS Choices says that, as Christmas is associated with friends and family, it can be difficult for those on their own to avoid feeling lonely at this time. The WRVS (2004) pointed out that Christmas can be a particularly lonely time for older people living alone who may have no one to spend the festive season with. The charity, which aims to help older people get more out of life, says there are nearly 11 million people aged 65 and over in the UK and they are twice as likely to spend Christmas alone than younger people (WRVS, 2004). Difficulties such as bad weather, crowds and increased noise make it harder for older people to leave the house and deal with daily chores. WRVS say the loneliness felt on Christmas Day is often the worst. Psychologists from Coventry University also argue that Christmas can be a sad and nostalgic time, when the loss of a family member may become especially painful (Curtis, 2002). It is often a difficult time for bereaved people, and nurses dealing with relatives who have suffered bereavement can offer help and support during this difficult time. Diet- Christmas is traditionally a time for overindulgence. With ever-increasing levels of obesity, patients may need extra help and support to lose weight in January, or to prevent weight gain over the holidays. Recent research published online by the Journal of Epidemiology and Community Health suggests one in three UK adults - or 13 million people - will be obese by 2012 (Zaninotto et al, 2008). According to NHS Choices, a typical Christmas Day's food can add up to a massive 6,000 calories - three times the recommended daily amount for most women, and over 2.5 times for most men. Its article, Christmas Food Swaps, compiled with help from the British Nutrition Foundation, suggests some changes that patients can make to reduce calorie intake. Nurses may wish to direct patients experiencing weight problems to this advice. Accidents, injuries and violence- Nurses working in A&E and minor injury units can expect busy shifts over the festive season. According to NHS Choices, more than 80,000 people a year need hospital treatment for Christmas-related injuries such as falls, cuts and burns. The combination of excitement, stress, tiredness and alcohol can create unexpected health hazards in the home at this time of year. The British Medical Association also warned that healthcare professionals will have to deal with the consequences of excessive alcohol consumption. A BMA spokesperson says: 'The sad fact is that many doctors and nurses will be dreading working in A&E over the holiday period because they have to deal with the effects of people drinking far too much alcohol.' Conclusion- Clearly Christmas can be a difficult time for some patient groups, such as those with family difficulties or mental health problems. However, nurses can help patients to deal with problems by offering advice on reducing stress, the risk of conflict and loneliness, so helping to make the festive season more enjoyable.
Advice for People Spending Christmas Alone ****Keep busy - try to stop Christmas taking over your life and make time for enjoyable activities, such as reading, country walks and going to the cinema. ****Be a volunteer - many charities and organizations need help at Christmas and you could spend a few hours working as a volunteer. ****Take some physical exercise - this reduces stress and enhances mood. Just getting off the sofa and getting outside should improve mood. ****Eat and drink healthily - traditional Christmas food and drink can be excessive and lead to lethargy. Healthy eating with plenty of fruit and vegetables can lift mood significantly.
Make your Holiday Funds Stretch Farther Nicoma Park UMC Thrift Store Wednesday 9-3 & Saturday 9-1 .25 cent sale (All clothing, shoes, hat & purses, excludes jeans & coats) Everything is always unbelievably low priced for such great quality Located at the corner of NE 19th St. & Westminster in Nicoma Park ***A very warm thank you to the UMC Thrift for contributing hats, gloves & scarves to the
Snowflake Celebration.
What’s Your Holiday Attitude Deck the Hall Or Bah Humbug? Assailant suffers injuries from fall -- Augusta, GA Orville Smith, a store manager for Best Buy in Augusta, Georgia, told police he observed a male customer, later identified as Tyrone Jackson of Augusta, on surveillance cameras putting a laptop computer under his jacket. When confronted the man became irate, knocked down an employee, drew a knife and ran for the door. Outside on the sidewalk were four Marines collecting toys for the "Toys for Tots" program. Smith said the Marines stopped the man, but he stabbed one of the Marines, Cpl. Phillip Duggan, in the back; the injury did not appear to be severe. After Police and an ambulance arrived at the scene Cpl. Duggan was transported for treatment. "The subject was also transported to the local hospital with two broken arms, a broken ankle, a broken leg, several missing teeth, possible broken ribs, multiple contusions, assorted lacerations, a broken nose and a broken jaw...injuries he sustained when he slipped and fell off of the curb after stabbing the Marine," according to a police report. Ooh-rah!
9-Year-Old Girl Arrested After Her School Bus Tantrum Takes aViolent Turn There's a ruffian in Florida who faces felony charges after she allegedly spit at a bus driver and threw a chair at the cops after she threatened to kill them. She supposedly became very upset when she was told she wasn't allowed to eat candy on the bus and then could not be calmed down. After she got off the bus, the police showed up and things went from bad to worse. The rowdy troublemaker started throwing asphalt at everyone, and when the cops asked her to calm down, she said, "Shut the f**k up! I will f**king kill you!" and threw an aluminum patio chair at them. By the way, the culprit is 9 years old. Her name hasn't been released, but the youngster is facing some serious charges including resisting arrest with violence, battery on a law enforcement officer, and throwing a deadly missile into an occupied vehicle (the asphalt). Yikes. Apparently she banged her head against the wall of her jail cell so frequently that the cops had to use pepper spray to calm her down. Her mother says that her daughter is schizophrenic and can get aggressive if she doesn't take her medication. It's yet to be confirmed that that's the case, but I don't know what's worse: A 9-year-old with a debilitating disorder, or a 9-year-old who might have learned this behavior from home. She's been handed over to her parents' custody and has been ordered to home detention for 21 days. On the one hand, that sounds harsh if she was having "an episode," as it were. If she wasn't acting like herself and if her medicine helps, then why keep her from attending fourth grade for three weeks? On the other hand, if she's not schizophrenic, if she's just a sad, angry, and lost little girl who was brought up in an environment of intense acrimony, then home detention isn't the right answer, either. This story doesn't have a happy ending. I only wish the best for the girl and her family and that she gets the help she needs.
Free Dental Clinic in this February The Oklahoma Mission of Mercy will take place at the SE Expo Center in McAlester Feb. 3-4, 2012. This free, two-day dental clinic will help people who are uninsured, underinsured or would otherwise not be able to access dental care. Doors will open each day at 5 a.m. and close once the capacity of patients per day has been reached. Dental professionals will volunteer their time to provide fillings, extractions, cleanings and a limited number of anterior root canals and third year molar (wisdom teeth) extractions. The event is presented by the Delta Dental of Oklahoma Oral Health Foundation, the Oklahoma Dental Association and the Oklahoma Dental Foundation. Volunteers of all backgrounds are needed. For more information, visit www.okmom.org. All Day Fri, Feb 3, 2012 and Sat, Feb 4, 2012 Website: www.okmom.org Contact Info: Mindy Robson Phone: 405-607-4725
“When people walk away from you… Let them go… Your destiny is never tied to anyone who leaves you and it doesn’t mean that they’re bad people. It just means that their part in your story is over.”
Painkiller Addiction in Oklahoma We are facing a tsunami of painkiller addiction that will flood our criminal justice, health care, behavioral health, and social services resources. Illicit online pharmacies have made prescriptions cheap and easy to acquire, fueling a massive wave of addiction that we actually have not seen yet. SAMHSA estimates that over 5% of the nations population, 12 years and older, are using painkillers, nowhere more prevalent than the heartland with Oklahoma leading the nation at 6.7%. Opioid addiction used to be thought of as primarily heroin addiction, but that is changing rapidly. The masses currently addicted to prescription painkillers have conveniently been able to manage their addiction and manage other aspects of their lives like job and family. However, the Senate passed the Ryan Haight Online Pharmacy Act and the DEA is closing down those cheap and easy suppliers of prescription drugs. When that happens this mass of addiction will suddenly become sick and desperate, and a foreseeable progression of consequences will follow. That means increased criminal activity, loss of jobs, which leads to loss of housing, which leads to the break-up of families and increased utilization of social services. 5.5% to 6.7% of the population 12 years and older may be headed toward this foreseeable progression of consequences. Traditional approaches to substance abuse treatment have proven ineffective in treating opioid addiction, with high relapse rates. These approaches start with inpatient detox. In Oklahoma, according to ODMHSAS, there is a waiting list of 1,000-1,300 for residential substance abuse treatment. Detox and residential treatment are huge bottlenecks to an ineffective approach. Is there anything to stop this tidal wave of destruction? SAMHSA has identified the evidence-based best practice, Medication Assisted Treatment, Treatment Improvement Protocol 43, as having the best outcomes for opioid addicts. Even better, in most cases, active opioid abusers can be taken directly into outpatient treatment, skipping inpatient detox and preserving jobs, housing, and families. While new generation drugs have been developed, they are very expensive and are not covered by Medicaid and Medicare, and many private health plans.
Painkiller Addiction: Spotting the Signs and Moving Toward Recovery For many struggling with painkiller abuse, overcoming shame is the first step to realizing they have a problem. But help is out there for those who need it. If you're prescribed opioid medications after you undergo surgery or suffer an injury, the doctor will normally tell you for about how long you'll need the drug. "If your body is still jonesing for the drug after that time period, you know there's a problem," Karim says. However, "very often, the addict doesn't realize they're an addict." But, he notes, most people know when they're craving a medication. "Ask yourself, 'Why do I still need this? Am I still in pain?'" Family and friends are also likely to notice the telltale signs of addiction — for example, if the addict is no longer able to meet work or family responsibilities. There are also physical signs. "For opiates, it's being a little spacey or having dilated pupils," he says. "They could even get psychotic if they take too much." Drug Safety Starts at Home —Not all opioid addicts get their supply from a doctor. According to the National Survey on Drug Use and Health, more than 70 percent of those who abuse prescription pain relievers get the drugs from friends or relatives. If you need to take prescription pain medications, there are lockboxes or drug safes available to keep pills protected from others, whether family members or visitors in your home. And when you’re done taking a prescription medication, toss it — don’t let it linger in your medicine cabinet. "If it's a pill you don't need anymore, I would get rid of it," Karim says. Pills can be crushed or broken with a garbage disposal or with a hammer; they shouldn't be dropped into the trash whole. The U.S. Drug Enforcement Administration sponsors National Prescription Drug Take Back Days every six months where consumers can safely dispose of unwanted medications at specially designated sites in their communities. Many Paths to Recovery—Now celebrating seven years sober, Miller works in recovery peer-to-peer support at the Anchor Recovery Community Center in Pawtucket, R.I. She's also the liaison at Anchor for the Rhode Island Community for Addiction Recovery Efforts, Inc RICARES. "Addicts need both emotional support and medical support," she says, adding that there are many paths to recovery — including 12-step programs, church, state agencies, or organizations like the United Way. "Go get professional help if you can't stop on your own." "There's no shame in understanding that different people have different vulnerabilities with their brains and their bodies," says Karim. "You have to get past the denial and the stigma, but if you do, the treatment is there. All you have to do is find it." "This is a disease of isolation and secrets," Miller says. "People need to know they're not alone. Reach out and get help — don't be ashamed."
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