Visit from Dr. Vickery, mindfulness, and GLAD

We had the great pleasure of hosting Dr. David Vickery this past Monday.  What an honor and privilege it was to hear about the latest scientific research regarding neuroplasticity and neuron regeneration.  One of the biggest discussion topics was about how Mindfulness Meditation practices can help lessen the severity of depression symptoms.  Dr. Vickery talked about how the Benson's Relaxation Techniques have been scientifically shown to greatly benefit those who suffer from Depression.  He left us with a homework assignment to begin implementing GLAD into our daily lives.  http://www.healthyplace.com/blogs/buildingselfesteem/2014/10/do-negative-thoughts-consume-your-mind-try-this-technique/.  Mindfulness can also work for those who have Bipolar disorder too. Dr. William R. Marchand, MD, has published the book "Mindfulness for Bipolar Disorder" which discusses in depth the techniques and benefits of mindfulness.

If you have been diagnosed with a mood disorder and are looking for a support group, we would love to have you.  You can contact us at (731) 215-7200.  We meet every Monday starting at 6:30pm hosted inside The Life Church located off of Hwy. 18 headed towards Boliver.  

Borderline Personality Disorder relations with BP

Differentiating Borderline Personality Disorder from Bipolar Disorder

By BERNADETTE GROSJEAN, MD

Borderline personality disorder (BPD) and bipolar disorder frequently co-occur (numbers range from 8% to 18%), although they are distinct clinical entities (Paris J et al, Compr Psychiatry2007;48(2):145–154). A proper diagnosis guides the most effective treatment, but you’ve probably faced the difficult challenge of diagnosing these conditions, which share several clinical features.
BPD can be described by four types of psychopathology: affective disturbance, impulsivity, cognitive problems, and intense, unstable relationships. What’s most important—in addition to seeing that your patient meets DSM-IV criteria for BPD—is to establish that patterns of affective instability, impulsivity, and unstable relationships have been consistent over time. Thus, obtaining a detailed history is crucial. Also, the key features we see in BPD, such as dissociation, paranoia, and cognitive problems, are often affected by the patient’s environment and, particularly, his or her relationships. A patient might have a history of rapid and sudden deterioration when relationships change—such as threatening suicide after a breakup or severe mood swings when separated from her family. Generally, the more intense or significant the relationship is, the greater the risk of chronic stress and mood dysregulation.
Many of the same features are seen in patients with bipolar disorder, such as dysphoria, hyperactivity, impulsivity, suicidality, and psychotic symptoms. As a result, borderline patients with this cluster of symptoms are often misdiagnosed with bipolar disorder, possibly because of the effectiveness of psychopharmacological treatments for such symptoms. In fact, a more thorough assessment might show that these patients actually suffer from a personality disorder. In one study, more than one third of those misdiagnosed with bipolar disorder met DSM-IV criteria for BPD (Zimmerman M et al, Compr Psychiatry2010;51(2):99–105).
In BPD, mood changes are generally short-lived, lasting only for a few hours at a time. In contrast, mood changes in bipolar disorder tend to last for days or even weeks or months. Mood shifts in BPD are usually in reaction to an environmental stressor (such as an argument with a loved one or a frustration in the waiting room), whereas mood shifts in bipolar disorder may occur out of the blue. Some clinicians consider BPD an “ultrarapid-cycling” form of bipolar disorder, but there’s little evidence to support this link (Gunderson JG et al, Am J Psychiatry 2006;163(7):1173–1178). Patients with BPD might rapidly cycle through depression, anxiety, and anger, but these mood shifts rarely involve elation; more often, the mood shifts are from feeling upset to feeling just “OK.” Likewise, the anxiety or irritability of BPD should not be mistaken for the mania or hypomania of bipolar disorder, which usually involve expansive or elevated mood.
At a more existential level, patients with BPD—particularly younger patients— often struggle with feelings of emptiness and worthlessness, difficulties with self-image, and fears of abandonment. These are less common in bipolar disorder, where grandiosity and inflated self-esteem are common, especially during mood episodes. And while both conditions may include a history of chaotic relationships, a patient with BPD may describe relationship difficulties as the primary—or sole—source of her/his suffering, while the bipolar patient may see them as an unfortunate consequence of his behavior.
A pattern of self-harm and suicidality often serves as a cue for diagnosing BPD (but are not necessarily required). But both can be seen in bipolar disorder, too. In BPD, suicide threats and attempts may occur along with anger at perceived abandonment and disappointment. Patients often explain these impulses as a way to be relieved of pain, or to “stop their thinking,” more so than to end their lives, per se. Patients with BPD may experience “micropsychotic” phenomena of short duration (lasting hours or at most a few days), including auditory hallucinations, paranoia, and episodes of depersonalization. However, patients generally retain insight, and can acknowledge that “something strange is happening” without strong delusional thought. When psychotic symptoms occur in bipolar disorder, they happen in the context of a mood episode, they tend to last longer, and patients may be unable to reflect on their behavior.

This article originally appeared in The Carlat Psychiatry Report -- an unbiased monthly covering all things psychiatry.
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Accurate diagnosis of BPD and bipolar disorder can be difficult, but it’s essential for proper treatment and optimal outcome. Remission rates in BPD can be as high as 85% in 10 years (Gunderson et al, Arch Gen Psychiatry 2011;68(8):827–837), particularly with effective psychotherapeutic treatments (Zanarini MC, Acta Psychiatr Scand 2009;120(5):373– 377). Unfortunately, such treatment is not always available. Some medications can be used in BPD, such as an SSRI for impulsivity, severe and persistent depression and/or suicidality, or an atypical antipsychotic for recurrent dissociative symptoms or disinhibition. However the only consensus seems to be that medications should be used as adjuncts to psychotherapy (Silk KR, J Psychiatric Practice 2011;17(5):311–319). The long-term use of a mood stabilizer or atypical should be reserved for known cases of bipolar disorder.
TCPR’s VERDICT: Clinicians sometimes think of a BPD diagnosis as pejorative (chronic and untreatable) and may be reluctant to disclose it, but patients and their families often find it helpful to be informed of the diagnosis. Similarly with bipolar disorder, accurate diagnosis often determines prognosis and effective treatment. For the clinician, however, it’s imperative that you make the proper diagnosis in these two often overlapping, but fundamentally quite distinct, conditions in order to optimize your patients’ outcomes.

Send a Christmas Card to the Governor

hopeworkscommunity posted: "The plan as it currently stands is to totally and completely eliminate funding for peer support centers in Tennessee. 45 centers will close and the over 3000 people served a month will be left out in the cold. The post below talks more about the situati"
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Send a Christmas card to Governor Haslam

by hopeworkscommunity

The plan as it currently stands is to totally and completely eliminate funding for peer support centers in Tennessee. 45 centers will close and the over 3000 people served a month will be left out in the cold. The post below talks more about the situation.

What I am asking is two things.

1. Send a christmas card to Gov Haslam. Share your knowledge and experience with peer support with him. Let him know Tennessee deserves and needs what peer support centers add to the mental health system in Tennessee. His address is:

The office of Governor Bill Haslam
1st Floor, State Capitol
Nashville,  TN   37243

His email address is bill.haslam@tn.gov.

2. Share this with at least 3 other people. Ask them to share it with at least 3 other people and so on.

This is the time to act. Let Governor Haslam know what you think. Make your card a Christmas gift to Tennessee.

The death of peer support in Tennessee.

There are 45 peer support centers in Tennessee. Next year if things go as planned there may be none.

The initial recommendation of the commissioner of mental health to the governors request for a 5% decrease in budget was to recommend that 4.5 million dollars be taken from the budget for peer support centers. That would leave 0 for next year.

It makes you just want to shake your head. When I heard I emailed a bunch of people. I thought I had misheard. I knew no one could seriously make such a suggestion. I was wrong.

Peer support centers do two primary things. They save money and they save lives. A lot.

For a few dollars a day per person served peer support centers give a chance at success for people who have never had success. People who have never made it in the community make it. The last figures I saw indicated a 90% decrease in psychiatric hospitalization. The savings from that alone should almost pay for the program. In a time when the jails are filling with the mentally ill how in the world can we shut down one of the most successful community based services we have?? This program defines the notion of “bang for your buck.” How is this in any way a savings?? We lecture our children about thinking before they act and considering the long term consequences of their actions. Shouldnt we expect the same out of ourselves and particularly our political leaders?

But it is more than an economic issue. It is more than a political issue. It is profoundly a moral issue and it is wrong!!!

If it actually sees the light of day it will be the planned abandonment of one of the most vulnerable populations in this state who basically have no where else to turn for this kind of help for a short term financial gain that in the end will cost far more than it saves. In plain terms it will be an act of large cruelty.

I urge you to stand loud and express your opinions. This is an old battle we thought done last year when support for peer support become recurring dollars. Once again we are a political football. Now is the time to end the game.

hopeworkscommunity | November 27, 2013

Suicide Prevention

When you see someone in need of help . . . Just do it. 

http://www.sprc.org/

The world is my country,

All mankind are my brethren,

To do good is my religion. 

Sent from my iPhone

about family . . .

Larry Drain, Legislative Liaison for DBSA Tennessee, wrote the following blog on recovery. His words meant so much to me that I felt they might mean a great deal to our understanding family in Jackson.

After the onset of my health challenge, my family became more real and dear to me, yet, not "perfect" in their support. They did not understand the problem. And I did not understand it myself. 

Please know, I think my family is special because of our strong emotional ties. However, realistically, we were facing a great unknown with my unique health problem with its drawn out recovery. We were struggling in the dark. 

After years of recovery and wellness, my family is with me, as strong and willing to help as ever. Yes, I am blessed and grateful. 

A shout out . . . Mom, I really love all of you guys!

Family by hopeworkscommunity

Healing is about community and family is, for many people, the most powerful community. Too often though in the name of treatment compliance the mental health system fractures the family into groups with competing interests.

Recovery is real. People do get better. They do find new and better life. It is really tragic though that so many people I know talk about recovering despite their families and not because of them or with them.

I remember the first time it was explained to me what a positive effect the medical model ultimately had on the functioning of families with a member who struggled with some form of "mental illness." It, the argument went, decreased blaming and conflict among family drastically if it was understood properly. The loved ones behavior was the result of a biologically based brain disorder. It was not a matter of fault, not a matter of willful decision or deliberation. Their behavior was the result of factors beyond their control. It was the genetic cards they were dealt. And, so the reasoning went, who could blame someone who was largely the victim of forces beyond their control?

The model gave families hope. Treatment was available that made a difference. The core of that treatment was medication and if their loved ones would be compliant with the treatment and take their medication then there was every hope that their symptoms could be managed and life could go on. For families the task became to help their loved ones accept the reality of their disease and to be medication compliant. The disease was chronic but if their loved ones would accept their need to take the medication forever the effects of the disease could be managed and the effects on them and the overall life of the family minimized.

For too many people it hasnt been that simple.

The medical model has lead to a family increasingly torn by blaming and strife. It has lead to a life increasingly devoid of hope. For many the "cure" has been worse than the "disease." Medication has not worked as advertised. It has not been the magic bullet promised. It has side effects that are disruptive and destroying of the quality of everyday life. For some people effects can be permanently life altering or even endanger life altogether. Some people have been helped, but for many the search for the "right medication" comes to define a life marked by less and less quality.

Families are told that their loved ones resistance to medication is a symptom of their illness. They dont realize how much they "need help." . The net effect is that while people may or not be blamed for their "illness" they do become blamed (held accountable) for their failure to be compliant with treatment (take medication).

Love becomes trying to exercise power over someone because they "dont really know what they really need." The result is further and further family conflict and battle. The family sees the conflict as evidence of the working of the disease and decides to push things harder and harder. The end result is a family broken.

The medical model sells the family short. To live with someone you care about having problems with mental health issues is a trauma for everyone. There are issues of loss and grief for everyone. Everyone is damaged. The medical model tells the family that treatment is what happens to their loved one when what is needed is the opportunity for healing for all. In the end it is unfair on all ends.

Families are a we. Anything that defines proper interaction as "us vs. them" in the end pose a very real risk of doing as much harm in the long run as the problem they attempt to solve.

Treatment compliance is defined as the same thing as recovery…. sadly so for many people. Some families do get past this. They realize that they are all in life together. They support the choices each other makes and support them learning the tools and knowledge to make good choices. The treat hope as a real thing. They know that everyone is more than the difficulties they struggle with and that families are defined not by the presence of pain and suffering, but how they deal with that pain and suffering.

They know that all have been traumatized in some way and that finding better life is about healing. They know that healing is not about what they make each other do, but in what they help enable each other to become able to do.

More and more there are voices saying that healing can be a together and not an apart. The Mother Bear Community Action Network in North Carolina (http://www.motherbearcan.org/ ) is one resource I know the most about. They are a pioneer in developing resources that emphasize the development of family strengths and core competencies to enable the family to be part of the healing for all its members. There are places to turn for help.

Recovery is real. Even for families. We dont have to be a burden life has inflicted on each other. Even in the greatest of traumas and amidst the most painful injuries of life the family can be a source of healing and safety

All Inclusive?

What about consumers being totally accepted at church? Other "outside" groups of Christians found help from church leaders to become recognized, supported, and embraced inside their church.  I believe it is time that God's love, and a Christian welcome, be extended to the innocent suffers of mood disorders. Scores of them are Christians sitting next to you in the church pews . . . but still in the closet.

Technorati Tags: mood disorders,Christians in the closet,all inclusive,mental illness,stigma,internalized stigma

Be an Advocate for Privacy for the Mentally Ill

LiveJournal Tags: advocacy,adovcate,legislation,privacy,mentally ill,Tennessee,elected officals,force,victim,DBSA,TMHCA,NAMI

One of the initiatives of DBSA Jackson is to advocate for “a better tomorrow” for the consumers. The case I present to you today causes concern that the stigma toward mental illness is real to our state legislators. I feel it necessary to call attention to the troubling legislation created by our elected officials.

I received the following from Lori Rash, TMHCA:

CONTACT YOUR LEGISLATORS NOW ABOUT LEGISLATION PROPOSED THAT WILL AFFECT CONSUMERS OF MENTAL HEALTH

PLEASE READ: 

NAMI Opposes SB2789/HB2979Compromises Medical Privacy Laws Sponsored by Rep. Vance Dennis of Savannah and Senator Brian Kelsey of Collierville, HB2979/SB2789 forces anyone filing a medical malpractice lawsuit to allow the hospital’s or physician’s attorney to have access to their entire medical history. Under current law, a physician’s attorney already has access to all medical records pertaining to medical negligence issues. However, this proposed legislation would force victims of medical negligence to sign a waiver in order to file a complaint allowing the negligent doctor’s attorney to look at their lifetime medical history ‐ even if the medical records have nothing to do with the issue at hand. “Basically, if a person was treated at any point in their life for mental health and substance abuse issues as well as domestic abuse, these medical records would be available to the doctor’s attorneys and could be brought up in court,” stated Keith Williams, President, Tennessee Association for Justice.  The legislation also allows the other side to have secret, private meetings with the patient’s previous doctors and counselors. If someone files a medical malpractice lawsuit against a hospital or nursing home, this law would allow the lawyers to be able to go back and read all about any illness the patient may have had that does not relate to this specific case. This bill is an invasion of privacy and with the primary purpose to intimidate victims of medical negligence and abuse.         

Lori Rash, LBSW, TCPS, Tennessee Mental Health Consumers Association West Tennessee Manager, 319 Vann Drive Suite L-2, Jackson, TN  38305, home: 731-660-3275   Fax:  731-660-3276

Stigma is something we can do something about!

Below, I share with you a stark definition of stigma.  Consumers and those who love them must make a decisive stand to push back against all forms of social inequality in the form of stigma. We can make a difference!

It’s easy to label someone else and overlook what’s really inside. When mental illnesses are used as labels – depressed, schizophrenic, manic or hyperactive – these labels hurt. Using negative labels leads to branding and shame – what is called stigma. Stigma leads to discrimination. Everyone knows why it is wrong to discriminate against people because of their race, religion, culture or appearance. They are less aware of how people with mental illnesses are discriminated against. Although discrimination may not always be obvious, it exists – and it hurts. Stigma is not just the use of the wrong word or action. Stigma is about disrespect. It is the use of negative labels to identify a person living with mental illness. Stigma is a barrier and discourages individuals and their families from getting the help they need due to the fear of discrimination. An estimated 50 million Americans experience as mental disorder in any given year and only one-fourth of them actually receive mental health and other services.          bp magazine Winter 2012