Daily Healthy: mental illness

Stigma: Changing the Conversation and Changing Lives

<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: right; margin-left: 1em; text-align: right;"><tbody> <tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjDWHM3yhSCuIGMzgilriYMiEEPlQsVbXYxX46fwUAx5TgwXpcW5Fg1gJZ9L2pOgZPO6cMXmKyqCwmWmUVhyOG38qkJdFug_Uc_YZz_yRLgjyGg7JNLs0iikWjFgc-76qj4yNELzfQVo3Tv/s1600/Binder+headshot.jpg" imageanchor="1" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjDWHM3yhSCuIGMzgilriYMiEEPlQsVbXYxX46fwUAx5TgwXpcW5Fg1gJZ9L2pOgZPO6cMXmKyqCwmWmUVhyOG38qkJdFug_Uc_YZz_yRLgjyGg7JNLs0iikWjFgc-76qj4yNELzfQVo3Tv/s1600/Binder+headshot.jpg" /></a></td></tr> <tr><td class="tr-caption" style="text-align: center;">Renee Binder, MD APA President</td></tr> </tbody></table> I was reminded recently of the death of an acquaintance who was at the top of her career when she died suddenly after complications from surgery, according to her obituary. I later learned that she had died from suicide, possibly in response to her struggle with chronic pain and resulting depression.  Stigma serves as a barrier to seeking treatment often because of fears of discrimination. A few years ago, a patient requested that I not keep any records and wanted to pay me in cash. He was concerned that if his psychiatric records were ever discovered, his career could be negatively impacted. Were this man’s concerns legitimate? In a more public incident Sen. Tom Eagleton was forced to withdraw as a candidate for vice president in 1972 after it became public that he had suffered from depression and undergone ECT (electroconvulsive therapy).  <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjFuWUcl4ShKpsk347yYenuTebnQgYL0TGvpV-JjbBYX9hLQjJ-KYNC67doTpwplPKDybskMqp8PpPHF9SV-qBrIBxbbAfsKk-J64t2lCrpcvALruOYVFxIUXp7tfKL4FWtixKBHeTYkkIR/s1600/shutterstock_214411201+%25281%2529.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="132" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjFuWUcl4ShKpsk347yYenuTebnQgYL0TGvpV-JjbBYX9hLQjJ-KYNC67doTpwplPKDybskMqp8PpPHF9SV-qBrIBxbbAfsKk-J64t2lCrpcvALruOYVFxIUXp7tfKL4FWtixKBHeTYkkIR/s200/shutterstock_214411201+%25281%2529.jpg" width="200" /></a> According to the Merriam-Webster Dictionary, the definition of stigma is a set of negative and unfair beliefs that a society or group of people has about something; it is a mark of shame or discredit.  How can we begin to address mental health stigma? Here are several ideas: We need courageous spokespersons who are willing to come forward and talk about mental health issues that they or their families are experiencing. Former Rep. Patrick Kennedy is one such champion. He has openly discussed his struggles with mental illness and substance abuse and how treatment has helped him lead a productive and rewarding life. We can learn from the LGBT community and their struggles with stigma and negative stereotypes. They have taught us that “coming out” by public figures and celebrities can decrease stigma. Another way of combating stigma is for my fellow mental health professions, psychiatrists and others, to take responsibility for examining the language that is used by the media and in our society. Words such as “lunatic,” “crazy person,” or “maniac” convey images of people who are out of control and dangerous rather than people who are experiencing a mental illness and deserve our compassion and support in getting effective treatments.  Mental health professionals and others can take an active role in drawing attention to language and advocating for more appropriate, compassionate and less stigmatizing language. Mental health care is an essential part of health care. Almost everyone will suffer from a mental health problem at some point in his or her lifetime.. But for people to be willing to access the mental health care they need, we have to continue the fight against stigma. <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgSrznyfQzhD3Paw16noGqeepe8gmuLiUa-hW4zLb7cKoV-1idKNCFaqIsUkz_Ha6kPa0uew25714tXiAt9houBjaZX6wFLhH2BzisT-Qe3oV8YPutVZIHdMUbrsRSzuhC0ffzC5oUzKFa6/s1600/shutterstock_190903178.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="113" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgSrznyfQzhD3Paw16noGqeepe8gmuLiUa-hW4zLb7cKoV-1idKNCFaqIsUkz_Ha6kPa0uew25714tXiAt9houBjaZX6wFLhH2BzisT-Qe3oV8YPutVZIHdMUbrsRSzuhC0ffzC5oUzKFa6/s320/shutterstock_190903178.jpg" width="320" /></a> If we are successful in addressing stigma, and we must be, then not only will we change the conversation, we will also change people’s lives and change the culture. We will finally reach the point where all of us can openly talk about someone’s death by suicide and encourage people with mental health problems to seek the help they need without fear of judgment or harmful repercussions. By Renée Binder, M.D., APA President

Renee Binder, MD APA President I was reminded recently of the death of an acquaintance who was at the top of her career when she died sudden...

The Power of Words: Addressing the Stigma of Mental Illness

8:27 PM Meme Art Studio 0 Comment

<div class="MsoNormal"> Jenna Bowen, medical student, University of Wisconsin</div> <div class="MsoNormal"> Reviewed by Claudia Reardon, MD <o:p></o:p></div> <div class="MsoNormal"> </div> <div class="MsoNormal"> <div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjKjuxnODpgE7CFNM3KjYSlmPQvRRiB9yA0DKS74XMm5FNduhys-T7ZWa55_y1JFQJhakrBfC8C1OCtqxe66n4lary5INE5Aamk9Lv_ahomdWqdNQcPxlZs9zr8Z60m7gH8_cAuidXArjF3/s1600/stigma+STOP.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="132" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjKjuxnODpgE7CFNM3KjYSlmPQvRRiB9yA0DKS74XMm5FNduhys-T7ZWa55_y1JFQJhakrBfC8C1OCtqxe66n4lary5INE5Aamk9Lv_ahomdWqdNQcPxlZs9zr8Z60m7gH8_cAuidXArjF3/s1600/stigma+STOP.jpg" width="200" /></a></div> Crazy.  Insane.  Deranged. Mad.  Lunatic. —Misused as nouns, adjectives and lay-diagnoses, their use perpetuates stereotypes of the wide variety of people who experience mental illness. <o:p></o:p></div> <div class="MsoNormal"> Maybe you know someone or, more likely, a number of people who experience depression, anxiety, bipolar disorder or other brain disorders.  According to the National Institute of Mental Health, 1 in 4 American adults and 1 in 5 American youth experience a form of mental illness every year. People with mental illness are teachers, accountants, neighbors, sisters, fathers and friends. Anyone you know could be experiencing mental illness, but afraid to come forward and be treated. Maybe that person is you.</div> <div class="MsoNormal"> People living with mental illness continue to have an identity that is beyond a diagnosis, similar to other medical conditions. While managing mental illness may be challenging at times—similar to challenges faced by people with diabetes, high blood pressure, or other medical illness— there is greater difficulty in getting the treatment needed because of feelings of shame and stigma surrounding mental illness. However, treatment for mental illness works. Research shows the majority (65 percent to 80 percent) of individuals with mental disorders will improve with appropriate treatment and ongoing monitoring. People with mental illness need to know that they will continue to be seen as people – your brother, best friend, daughter —and not “crazed” or “insane” if they appropriately seek help for a treatable medical condition that they happen to be experiencing.</div> <div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiz1k00z9VaJRnEm_-ZpKnnKsiziWlJtA42rTHdUlwknp-sIzieP3JaX7RE3cJaInwazB2l3DuxdYzvJjfDu1YGG_swNjrsc8zNcg1Cj4LGNHbKMSinvfFkQ9I1u2Ode8281unpzOrovTUW/s1600/Bring+Change+2+Mind+logo.JPG" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="137" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiz1k00z9VaJRnEm_-ZpKnnKsiziWlJtA42rTHdUlwknp-sIzieP3JaX7RE3cJaInwazB2l3DuxdYzvJjfDu1YGG_swNjrsc8zNcg1Cj4LGNHbKMSinvfFkQ9I1u2Ode8281unpzOrovTUW/s1600/Bring+Change+2+Mind+logo.JPG" width="200" /></a></div> Bring Change 2 Mind, an organization aimed to end stigma and discrimination surrounding mental illness, offers recommendations to reduce your impact on the stigma surrounding those with mental illness. <div class="MsoListParagraphCxSpFirst" style="mso-list: l0 level1 lfo1; text-indent: -.25in;"> </div> <ul> <li>Use "person first" vocabulary. When we say a person is schizophrenic, we make their mental illness fully define their identity. Instead, be clear that this is a disease that individuals manage and live with— "He is living with schizophrenia."</li> <li>Avoid the verb "suffers" when discussing mental illness. Instead, choose, "lives with mental illness" or "is affected by mental illness."</li> <li>There are many phrases and terms; "crazy," "nuts", "psycho", "schizo", "retard" and "lunatic" that may seem insignificant, but really aren't.</li> </ul> <div class="MsoNormal"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiG940P9p8vxnFgv45VK8I-2JPkhAQ2le401HZ82HPiuIZFdASxXOgJPHNtJGQvm6OHH9Tmb6pmWQBZgZYspqrEd9BZgM6YLpc9h_cEcAEGpa4fQ3PvuN3oeg3AOtAElnzdLryVSFOCi1X7/s1600/Bring+Change+2+Mind+group.JPG" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="130" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiG940P9p8vxnFgv45VK8I-2JPkhAQ2le401HZ82HPiuIZFdASxXOgJPHNtJGQvm6OHH9Tmb6pmWQBZgZYspqrEd9BZgM6YLpc9h_cEcAEGpa4fQ3PvuN3oeg3AOtAElnzdLryVSFOCi1X7/s1600/Bring+Change+2+Mind+group.JPG" width="400" /></a>Be an advocate for those that you know, and the many that you don’t know, who are living with some form of mental illness by breaking down stigma, and being conscious of language surrounding brain disorders. To learn more check out:<o:p></o:p></div> <div class="MsoListParagraphCxSpFirst" style="mso-list: l1 level1 lfo2; text-indent: -.25in;"> ·         <a href="http://bringchange2mind.org/get-involved/spread-the-word/">Bring Change 2 Mind</a> <o:p></o:p></div> <div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo2; text-indent: -.25in;"> ·         <a href="http://www.nami.org/Content/NavigationMenu/Take_Action/Fight_Stigma/Fight_Stigma_StigmaBusters.htm">NAMI – Stigma Busters</a> <o:p></o:p></div> <div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo2; text-indent: -.25in;"> ·         <a href="http://promoteacceptance.samhsa.gov/">Resource Center to Promote Acceptance, Dignity and  Social Inclusion Associated with Mental Health</a> (SAMHSA)<o:p></o:p></div> <div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo2; text-indent: -.25in;"> ·         <a href="http://www.psychiatry.org/advocacy--newsroom/newsroom/reporting-on-mental-illness">Mental Health Terminology:  Words Matter</a><o:p></o:p></div> <div class="MsoListParagraphCxSpLast"> </div>

anxiety bipolar disorder depression mental illness stigma The Power of Words: Addressing the Stigma of Mental Illness

J enna Bowen, medical student, University of Wisconsin Reviewed by Claudia Reardon, MD Crazy. Insane. Deranged. Mad. Lunatic. —Misused as...

Spreading Hope!

12:50 AM Meme Art Studio 0 Comment

By Matt Goldenberg D.O. <o:p><span style="font-family: "Times New Roman","serif"; font-size: 12pt; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin;">@docgoldenberg </o:p> “You treat a disease, you win, you lose. You treat a person, I guarantee you, you'll win, no matter what the outcome.” <o:p></o:p> <div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgGAuBL1SprzxDOE6jkkG1n5lpnddYDCnow2P4Jmhh0WvdglAt7K0fztqvqHWmTcmrLFYSiE9TP9dtiYVDhR_Qc-RsMERORHontoEuZrMJO3PBZt_0nUdWMIvc9ewQ0mvQFzJPe9_7XQQrL/s1600/patch-adams-553248l.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgGAuBL1SprzxDOE6jkkG1n5lpnddYDCnow2P4Jmhh0WvdglAt7K0fztqvqHWmTcmrLFYSiE9TP9dtiYVDhR_Qc-RsMERORHontoEuZrMJO3PBZt_0nUdWMIvc9ewQ0mvQFzJPe9_7XQQrL/s1600/patch-adams-553248l.jpg" width="133" /></a></div> <div class="MsoNormal" style="margin: 0in 0in 10pt;"> I whole-heartedly agree with that statement. However, I cannot take credit for those words. Those are the words of Robin Williams, or more specifically, the words of his character in Patch Adams. I want to discuss the disease called depression. I will start by first discussing the diagnosis and the signs and symptoms of depression. I will then follow up with my thoughts on the various treatment options for depression and the strategies I employ with my patients to improve their outcomes. None of my thoughts and suggestions should serve in place of a formal consultation with a mental healthcare provider. However, I hope shedding light on mental health diagnoses like depression will lift the veil and social stigma on these chronic diseases that impact so many people. Psychiatry has come a long way in the last decade. This is a time of continued discovery and increasing public awareness. The leaders of our professional organization, the <a href="http://www.psych.org/File%20Library/Advocacy%20and%20Newsroom/Presidents%20Messages/Summergrad-2014-AM-Opening-Speech.pdf" target="_blank">American Psychiatric Association (APA), have suggested that we as mental health professionals are under a microscope</a>. I agree that we are and I also strongly believe that we are up for the challenge. School shootings and celebrity suicides and overdoses have increasingly put a focus on mental health. Psychiatry has significantly improved the outcomes, treatment options and the prognosis of patients with mental illness. However, we still are unable to decrease the prevalence of the diseases we treat or prevent them. We know that the brain changes during an episode of depression and our treatments help it to return to normal (see the image below). Although we are getting closer, we still currently do not have widely accessible blood or imaging tests that can confirm our diagnosis or localize the area of disease.<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgjHTc9LL0rGLMe7XKQOE8onH6uIwnyX6cgVdFxYuMOOK1kosrLV8_KrIZMITeThL099IFIRdkdOdeJqk2Sbs7JghO9ow0WjeSCGtMJqHRlL5SHn0oZaHKcSi2ho1Li_6dMsMZi_SZLZFKY/s1600/Manbrainimgae.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="160" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgjHTc9LL0rGLMe7XKQOE8onH6uIwnyX6cgVdFxYuMOOK1kosrLV8_KrIZMITeThL099IFIRdkdOdeJqk2Sbs7JghO9ow0WjeSCGtMJqHRlL5SHn0oZaHKcSi2ho1Li_6dMsMZi_SZLZFKY/s1600/Manbrainimgae.jpg" width="200" /></a></div> <div class="MsoNormal" style="margin: 0in 0in 10pt;"> I can say with certainty, however, we are able to accurately diagnose patients. We are able to identify medications, psychotherapies and other treatments that patients with a specific diagnosis or cluster of signs and symptoms often benefit from. There is strong evidence that our treatments decrease symptomatology and disability and improve quality of life, clinical outcomes and a patient’s prognosis. Psychiatrists are trained to view the patient as a “whole person”. Psychiatry is a field of medicine whose assessment by definition includes all of the biological, psychological and social aspects of a patient’s life. We listen for the psychological and social factors that can contribute to disease. Oftentimes, the “whole story” can be more telling than only focusing on specific symptoms of a given disease. There is a saying, throughout all fields of medicine, that “most patients have not read the textbook.” In other words, patients usually do not present exactly as the textbook says they should. Stress and psychological factors can mimic chest pain, shortness of breath, gastrointestinal problems and a whole host of other diseases. If we do not step back and get the whole story, we can miss the root cause or the exacerbating factors of many manageable diseases which are of the mind. Many of the diseases we treat, such as depression, are chronic illnesses which require lifelong treatment. Our treatments can improve a patient’s mental health and coping skills and decrease their symptomatology and substance use. We know through decades of research that these are modifiable risk factors for suicide. Therefore, Psychiatrists have the training and tools necessary to decrease a patient’s risk of attempting suicide. Our treatments have the potential to not only significantly improve the lives of our patients, but also the lives of their families and everyone who comes into contact with them. Anyone who tells you otherwise is misleading, misinformed or both.</div> <div class="MsoNormal" style="margin: 0in 0in 10pt;"> <span style="font-family: "Calibri","sans-serif"; font-size: 12pt; line-height: 115%; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> <span style="font-family: "Calibri","sans-serif"; font-size: 11pt; line-height: 115%; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">I hope this information and the blogs to follow will give you hope. Mental illness can include symptoms which can be devastating and complications which can be <a href="http://psychiatry.org/suicide" target="_blank">life-threatening</a>. However, it is important to state again, these are treatable diseases. If you or someone you know, would like to talk to someone, call your primary care doctor or your insurance company for a referral to a Psychiatrist. A true multi-disciplinary team also includes therapists, psychologists, nurses and social workers. You are never alone. You can call the national suicide helpline 24 hours a day, seven days a week (1-800-273-TALK (8255) or visit <a href="http://www.suicidepreventionlifeline.org/">www.suicidepreventionlifeline.org</a>). There are also local crisis lines likely available in your area and are an internet search away. If you are ever feeling unsafe, or fearing for the safety of a loved one, you can call 911 or go to the nearest emergency department.</div> It is time for everyone to understand that there is no shame in getting help for depression, much as there is no shame in getting help with diabetes or high cholesterol. Even if you have never suffered from depression, there is a lot you can learn. <div class="MsoNormal" style="margin: 0in 0in 10pt;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgtFwzBHqAnEjwkZBsUAwCX-AeHgooaLfCwYGVJTaTLFY1jGr8SovFrHlaH083SEvR7Lwdjpcj-C-7URLPVGLz-iMW8ZaLkr-NFOcnzW-xK90YoP7ZtPsgqqt6keYsGc4psxnedLQPpzON9/s1600/Depressed_NotDepressed+brain+image.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgtFwzBHqAnEjwkZBsUAwCX-AeHgooaLfCwYGVJTaTLFY1jGr8SovFrHlaH083SEvR7Lwdjpcj-C-7URLPVGLz-iMW8ZaLkr-NFOcnzW-xK90YoP7ZtPsgqqt6keYsGc4psxnedLQPpzON9/s1600/Depressed_NotDepressed+brain+image.jpg" width="200" /></a></div> Together we can raise awareness and spread truth and hope. I know that if we spread knowledge, and ignore the misinformation, we will overcome the complacency and ignorance that is so pervasive today. That is how we can best honor those we have lost. That is how we can best prevent the next death from mental illness and addiction. <o:p></o:p> <div class="MsoNormal" style="margin: 0in 0in 10pt;"> </div> <a class="twitter-share-button" data-count="horizontal" data-related="APAPsychiatric" data-via="APAHealthyMinds" href="http://twitter.com/share">Tweet</a><script src="http://platform.twitter.com/widgets.js" type="text/javascript"> </script>