Why Are People With Schizophrenia Receiving Worse Health Care?

That is the title of this article.  Last week I did an article about health and came across this article and thought it would fit together. ”Physicians, health thyself.  May24th is Schizophrenia Awareness Day in Canada—and the month of May is Mental Health month—but a disturbing study just presented at the American Psychiatric Association (APA) meeting in San Francisco demonstrates just how prejudiced many health providers are towards those with serious mental illnesses.”  People with mental illness die earlier than the rest of the population and receive inadequate health care to because of the prejudice.

The article goes on to say it is not stigma: “We use the word stigma, but I would use a different word—prejudice,’ he said at a press conference. In our society, we don’t allow prejudice anymore based on a variety of factors, but we still, to whatever degree, tolerate prejudice when it comes to people with psychiatric conditions, and that has to change.   Dr Borenstein was referring to the results of a study presented at the APA by Dr. Dinesh Mittal, a psychiatrist at the Central Arkansas Veterans Healthcare System and associate professor at the University of Arkansas, in Little Rock, and his colleagues.” If professionals cannot act professional and treat all like they deserve to be treated in the right way.
What they did was make up a fictional person up with schizophrenia and without schizophrenia and with problems of hypertension, obesity, insomnia, and chronic back pain and had him return for a follow up visit seeking stronger medication for pain. “Overall, the health care professionals anticipated less adherence to medications in those with schizophrenia even though adherence rates between those with and without mental illness are similar.  Those with schizophrenia were less likely to be referred to weight management programs than those without. The researchers pointed out that weight management programs are as successful with those with schizophrenia as those without. Again, those with schizophrenia were less likely to be referred to sleep clinics but pain clinic referrals were equal.”  As I have said in earlier posts it is hard to lose weight but it can be done.  I am going slowly on losing mine.  Although sometimes of the year I lose and others I do not and do not know why.
Why is this so wrong?  The article says: “Those with schizophrenia were seen by the health professionals to have lower social functioning and lower competence to make treatment and financial decisions.  The researchers expected that the mental health professionals would do better than the primary care workers but that was not the case.  Both the psychiatrists and the primary care nurses had the lowest expectation that the schizophrenia patient would be able to understand educational material.” It is wrong we cannot all be lucky to know what to do when things are not going right such as our health.  I can understand that not all with a mental illness will have the knowledge or know where to get the knowledge to figure what to do when something goes wrong with our bodies.  Or for that matter the money to buy the books to figure what disease you have and what to do about it.
“Dr. Borenstein stated: On average, people with severe psychiatric illnesses such as schizophrenia end up dying at a significantly earlier age than other people due to medical problems. So it’s very important—and that’s why this study is an important study—that we make sure that people with psychiatric conditions like schizophrenia receive the best possible medical care along with their psychiatric treatment.”  Those doctors and such should treat everyone equal and help all that come to them to have the finest of care.  I as I have said I work on my health because I want to be around to be there for my youngest grandson who is only four years old right now.  I have had a doctor tell me I do not know what you are doing but keep on doing it.

Trauma

What is a trauma?  You hear about trauma almost every day.  Someone or some group of people are suffering from the trauma of a natural disaster, or a plane crash; not to mention rail disasters or auto accidents.  As these days and years progress, mass shootings are the cause of trauma not only for the victims yet for the loved ones of victims as well.  So how is trauma defined?  Simply, trauma is a disordered physical or behavioral reaction resulting from severe mental, emotional, or physical stress.  In short it is an emotional upset.  Post Traumatic Stress Disorder (PTSD) can develop following any traumatic event which may threaten either your safety or cause you to feel helpless.  Most people associate PTSD with soldiers who have been at war.  It is the most common cause of PTSD in men whom have fought in a war or have survived wounds or have gone through emotional stress; yet you should know that any overwhelming life experience can cause trauma especially when you don’t for see the experience and there is no control over the situation.  PTSD can affect people who witness catastrophic events, emergency rescue crew members, members of the police department and fire departments as well; even friends and family members whose loved ones have experienced a traumatic event.  It develops differently in each person, where it will develop, the hours or days after an experience, it may even take weeks, months or even years before the symptoms of PTSD appear.  Remember, any life shattering or emotional experience which leaves you feeling helpless or without hope can lead to trauma.

There are three main types of symptoms for PTSD:  (1) Re-experiencing the event, (2) Avoiding reminders of the event, (3) Increased anxiety and emotional arousal.  Others symptoms which are common of Post Traumatic Stress Disorder are:  Anger, Guilt, Self Blame, Drug Addiction, Alcoholism, Mistrust, Hopelessness, Suicide, Alienation and Physical pain.  There are risk factors which involve the nature of the traumatic experience, risk which may increase your vulnerability.  A threat to your life or safety can ensure a traumatic experience and the more extreme, the greater the chances are of a person suffering from PTSD as a response.  Human inflicted harm or pain is more traumatic than the destruction bought about through nature, or a person’s ability to escape from such disasters or other traumatic events.  Two risk factors I have read about are: (1) History of mental illness and (2) Lack of coping skills; each involving escaping memories, avoiding memories and feelings and coping while under the onset of stress.

Treatment for PTSD consist of the person suffering from trauma to get involved in Cognitive-Behavioral Therapy which involves the patient exposing themselves to their thoughts and emotions of situations which would remind them of the certain traumatic experience.  Therapy involves indentifying thoughts about the event especially thoughts, that could be distorted or non-sensical and then replacing them to gain balance.  Medications relieve some symptoms such as depression or anxiety. 

Written by Donald S.

Health

I was reading a paragraph   that said people with mental illness die at least 15 to 20 years younger than the rest of the population.  That is down from the last time I wrote on this subject, then it was twenty five years younger than the rest of the population.  The main culprit is the weight gain associated with the side effects from the antipsychotics.  What it leads to is “… higher incidence of illnesses such as cardiovascular disease and diabetes.”  I know when I took moban I gained at least sixty four pounds.  Lately I lost twenty pounds easy.  Then I have gained seven pounds back.  I have been walking although that does not seem to help like it did before.

I had to get back on the treadmill in my building.  I am lucky I have a fitness center where I live and it is open twenty four hours a day. Besides the treadmill I do some weight lifting.  Although these seven are hard to get rid of and stay off so I can lose more.  I want to get to one fifty.  Until I started gaining weight the highest I had been was one forty.  I do not want to go all the way to that weight though.  I am still walking Tuesday through Sunday.  I go on the pretense that I am getting a movie or going grocery shopping.
I can get my daughter to take me grocery shopping although I do not unless I am carrying heavy stuff so I can get some exercise in.  Even if I do the treadmill in the morning, I know how hard it is getting the weight off.  I remember when I could eat anything and not have to worry about gaining weight.   You just have to keep trying after spending time with my grandsons yesterday I want to lose it even more.  Do they have the energy to run and play?  I am also more physically active when they are around.  I know it will take time for me to get where I want.  I will do it that is a goal I will try to keep and not forget about it.
The guy in the paragraph lost weight and is now back surfing.  I have labs done at least every three months to check that I do not have diabetes.  That is another reason I keep walking and exercising I do not want to get it.  I want to continue walking as long as I can in this life.  I need to continue to lead an active life that is the only way I will lose this weight.  You have to keep positive and just know that you can do this obstacle.

Emotional Intelligence

Self confidence, sensitivity, self awareness, self control, empathy, optimism and social skills, these are all a part of the qualities we desire in ourselves and all are a part of our Emotional Intelligence.  What is Emotional Intelligence and what has it to do with our Mental Health.  Emotional Intelligence in short is the ability we have in perceiving emotions in ourselves as well as in others.  Its controlling emotions and coping with emotional situations and many people fail to manage emotions with success as we may be closed to our own emotional attitudes or we may not be able to control our own emotional selves as in acting foolishly while we are under pressure.

In the mental health field, many consumers have lost touch with their own awareness and their ability to control their emotions.  With the many people who are diagnosed especially with schizophrenia, manic depression and depression, they find it hard to control themselves, yet with treatment, these people find it remarkable that they have learned not only self control, yet have build up their confidence and self-esteem as well.  Being a mental health consumer, with a diagnosis, I have to understand my emotions can lead me astray.  I have to learn to understand another person’s emotions, facial gestures, voice and posture.  I must know when to think and what emotions are particular to thought and how to control my negative emotions, such as anger or being despondent.

 Emotional Intelligence is different than cognitive intelligence, which is the ability to reason, read, write and have logic.  You are not using the emotional parts of your brain to solve equations, to build structures or dial a phone number; the thought that emotional intelligence is a structure, which links the emotional abilities with other capabilities that includes our mental thinking abilities.

Howard Gardner in 1999 stated that “there are multiple intelligences in addition to abstract reasoning, such as musical and kinesthetic intelligence.”  He also stated there are two types of abilities that resemble emotional intelligence, (1) interpersonal intelligence (understanding the feelings and intentions of others) and (2) intrapersonal intelligence (your awareness and discrimination of your own feelings).”  In understanding my positive emotions, I would feel good about myself not only in this present time yet also I would have positive hope for the future.  The reality of the change of ideals, self-esteem, awareness, and empathy becomes such with the control of emotions and the bearing of  knowledge that I am working with such as I struggle to migrate from the negative approach to one which is more positive.

Written by Donald S.

Trouble Sleeping? It May Affect Your Memory Later On

That’s the title of this article.  It has to do with the how many times you awaken during the night. “The amount and quality of sleep you get at night may affect your memory later in life, according to research that was released today and will be presented the American Academy of Neurology’s 64^th Annual Meeting in New Orleans…”  It affects your memory later in life. “Disrupted sleep appears to be associated with the build-up of amyloid plaques, a hallmark marker of Alzheimer’s disease, in the brains of people with memory problems… Further research is needed to determine why this is happening and whether sleep changes may predict cognitive decline.”  It is disrupted sleep that seems to be the problem.

My memory has never been a problem.  Especially numbers, although lately if I try to remember something I always forget one thing.  I remember it before it becomes a problem.  Although it is not too worrisome for me, I sleep and do not wake up that many times a night. It goes on to say: “Researches tested the sleep patterns of 100 people between the ages of 45 and 80 who were free of dementia.  Half of the group had a family history of Alzheimer’s disease. A device was placed on the participants for two weeks to measure sleep.  Sleep diaries and questionnaires were also analyzed by researchers.”  It is good to note they had a family history of Alzheimer’s.
The article goes on to say: “After the study, it was discovered that 25 percent of the participants had evidence of amyloid plaques, which can appear years before the symptoms of Alzheimer’s disease begin. The average time a person spent in bed during the study was about eight hours, but the average sleep time was 6.5 hours due to short awakening in the night.”  What is causing them to awaken during the night?  They do not answer that question.  I rely on my memory so that would be hard on me if I was ever to lose it.  I do make a list when I go to the store as I would forget something if I did not.
It must be different than just having insomnia. “The study found that people who woke up more than five times per hour were more likely to have amyloid plaque build-up compared to people who didn’t wake up as much. The study also found those people who slept ‘less efficiently’ were more likely to have the markers of early stage Alzheimer’s disease than those who slept more efficiently.  In other words, those who spent less than 85 percent of their time in bed actually sleeping were more likely to have the markers than those who spent more than 85 percent of their time in bed actually sleeping.”   Do they get less than 85 percent of sleep every night?
What are they going to do with this information? “The association between disrupted sleep and amyloid plaques is intriguing, but the information from this study can’t determine a cause-effect relationship or the direction of this relationship.  We need longer-term studies, following individual’s sleep over years, to determine whether disrupted sleep leads to amyloid plaques, or whether brain changes in early Alzheimer’s disease lead to changes in sleep, … Our study lays the groundwork for investigating whether manipulating sleep is possible strategy in the prevention or slowing of Alzheimer’s disease.”  Only my grandfather had dementia.  None of my other family members lived long enough to know if they would have any other diseases or stuff wrong with them.  I just have to stay exercising and do the right things and I am sure I will be alright.

A New Psychiatric Tool

The patients of mental health and family members concerned about mental health seem to be in a state of confusion, because the figure head of the Federal agency which finances mental health research has issued a statement about the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders The Director of the National Institute of Mental Health has led us to understand that the current DSM.V needs a newer classification system, involving biology, not just psychiatric opinion and definition. The problem with this is that it will take another 10 years to have a defined biology based manual. The Director made aware that the new revision of the reissued DSM.V since 1994 is “mostly modest alterations.”

Shortcomings of a Psychiatric Bible - NYTimes.com
I have peaked and scanned the DSM and I found that I could look at all my friends quite differently, even past acquaintances and if I chose to define their lives and my own as well, I would not see any one quite the same as if I first met them. I was told it’s the frequency of what you do which is defined as a possible illness, not that you act a certain way or respond in a certain way. What the DSM defines is diagnosis about symptoms that are associated with a certain disease, yet it does not on an objective laboratory scale or measure, say for instance blood count or other kinds of biological measurements. There has not been produced any such data which is needed to design a manual based on any such biology of the human body or any cognitive measures involving the biology of a person with any particular mental illness. At one time the NIMH began a program to finance research in biology, genetics, neuroscience and cognitive science, of which their goal was to help scientist define disorders by their causation rather that defined symptoms. The DSM (diagnostic manual) remains a tool to guide clinicians to diagnose disorders and treat their patients. Having understood that the biology of the human brain and body itself is being suggested as a part of all symptoms as well in our physical state of well being, changes how we see our education through psychology and psychiatry as consumers, leading us into a different aspect of learning about ourselves and our relationship to the environment in which we live in.

Written by Donald S.

Belief in God Tied to Greater Psychiatric Treatment Response

Well this article just fell into my lap this morning.  Last night I finished watching the last of the Bible series.  I had recorded it to watch at my leisure.  I was thinking how I would write that I believe in God although I do not believe in religion.  I could call myself Catholic if I want to drink.  Religion just makes it harder to believe because of all their rules.  I open up the news looking for something to write about and here is an article.

It says: “Belief in God, but not religious affiliation, is associated with a greater likelihood of treatment response among psychiatric outpatients, according to a study published in the April 25 issue of the Journal of Affective Disorders.”  They used to call me lucky because I would get out of so many cases against me.  I have seen miracles and as I have said I read positive books by Norman Vincent Peale.  I still can quote scriptures from those books my heart they helped me so much.  I was a very negative person.  If a miracle happen to me once and I would try the same thing again.
As for recovery I would not have recovered if it had not been for my belief in God.  How do you get by all those lonely times, your family not around and also I did not have my daughter while I was at the State Hospital.  She did not come around until three years after I was released.  “The researchers found that among treatment responders, belief in God was significantly higher compared with non-responders.  Greater reduction in depression and self-harm and greater improvements in psychological well-being also correlated significantly with higher levels of belief.  The correlation between belief and changes in depression and self-harm persisted even after controlling for age and gender.  The relationship between belief in God and depression was mediated by perceived treatment credibility/expectancy, but not by emotional regulation or community support.  Religious affiliation was linked to treatment credibility/expectancy, but did not impact treatment outcomes.”  Where do you think my hope comes from?  It is my belief that God will work things out sometimes a lot slower than I liked.
Although things always work out for the best, as always in A.A you are asked to believe in a higher power.  To succeed you always have to believe in something.  I was brought up religious and it has always just been there for me.  As I have said I have seen miracles where my own lawyer did not know how I was not charged. You would have to be there to understand.  Without those magazines from Norman Vincent Peale about people who went through tough times and came out alright, I cannot say that my time at the State Hospital would have went a lot harder and longer.
I do not force anyone to believe I am just telling my story of recovery and what I believe that keeps me going.  I am not doing so badly.  I believe that if you think positive and work towards what you want you will achieve it. No matter what mental illness you have there is always hope that they can find a medication that will help you to achieve what you want out of life there is always hope. One reason I have never talked about it is I have seen many people with mental illness that believe that they are or have been talked to God.  I separate the two in my life.

Gene Helps Overcome Depression

There have been studies of animals and humans that may give thought that certain mental illnesses, such as depression, can be treated with a new aspect: gene therapy.  It is known that depression strikes at least one in 15 adults across the nation, yet there has been a study in mice and human brain cells which finds a lack of a protein named p11, which might play a role in depression.  Fixing that particular gene would produce those certain proteins which could affect depression. 

Psychological disorders anymore are being seen as brain disorders.  Most depression drugs used in these modern times, affect brain levels of a certain hormone called serotonin, which has been linked to the p11 protein in its effects on mood.  Mice have been bred to have depressive symptoms, then “by infecting their brain with a virus carrying a gene for the protein”, scientist are able to alleviate the depressive symptoms.

 Humans have been used in these studies that have Parkinson’s disease.  As the mice have been treated, they began to respond and behave like normal mice and in the experiments in human brain cells, those people who were depressed showed a lack of the protein.  These experiments though showed that there is a new way to treat depression, as well as the possible production of new drugs to curtail the disorder.

Certain doctors look to drugs rather than a direct treatment to the brain, especially through gene therapy; this is safer for treating depression.  Seemingly the design of drug molecules which would deliver the p11 protein or other compounds to a particular place in the brain would have to be done so without affecting other parts of the human body or brain, where the protein might serve otherwise different purposes.  “No single thing probably causes any human disease, yet the study author, goes on to say, but we can say there is evidence here of a role of this protein in depression.” 

Donald S.

Catherine Zeta-Jones: Her History of Mental Illness

She is back in the news as she has went back to a treatment center for her Bipolar II disorder that is what this article says.  Another news story  says she goes in periodically for a preemptive step to ensure that she continues to be in good health.  She also was absent this past Saturday from the 2013 White House Correspondents Dinner, which her husband Michael Douglass attended.  She has been candid with her mental illness.   She talks about her struggles with this disease.

She first went public about her mental illness in 2011: “After her husband, Michael Douglas, received the good news that his Stage IV throat cancer was gone that January, she couldn’t fight a lingering depression. In April of that year, she checked into a mental health facility in Connecticut and during her five-day stay there, she was diagnosed with bipolar II disorder, a mental illness marked by prolonged periods of depression alternating with episodes of mild mania.” It is good that she lets people know that she has this disease.  It can lessen some of the stigma associated with mental illness.
It is a disease a lot of us do not understand because we have never went through it or understand going through highs and lows I would guess.  I know my mental illness some would not understand also.  The article goes on to talk about why she discloses:  “This is a disorder that affects millions of people and I am one of them,’ the actress told People at the time.’ if my revelation of having bipolar II has encouraged one person to seek help, then it is worth it.  There is no shame in seeking help.’”  That is encouraging to people to get help if she can so can others.  I know from experience the shame was on me.  It was hard to face my old friends even though they did not know what I was going through.
My breakdown came in prison I was already in the hole or as they call it segregation.  One if my friends were already on the other side of the cellblock that I was on.  The other friends did not know what was going on with me.  They told me they would help me though whatever I was going through.  I was taken to the hospital in Canon City.  The doctor asked where I would like to go to back to Buena Vista or where.  I told him right there behind the walls.  I did not want to go back and face my old friends.  I saw one of my friends from Buena Vista when I was out for about ten years already.  He waited until I was finished shopping at a store and came to speak to me.
He never brought up what happened just told me about his life.   I told him that I had been out about ten years and then we said goodbye.  The shame of this mental illness was mine.  Catherine Zeta-Jones says it best: “Everyone has things going on and we deal with them the best we can, ‘ she continued. ‘We can’t jump from rooftops shouting, you know, about, I have this, look at me, victim.’ No. We all have issues in life and I’m really happy that I have great friends, great support, and that’s all I can do.”  I guess I should have heard that before.  One reason I gave up all my old friends and I do not know if they would understand.  I would do anything for any of my friends that is the type of person I am.  Yes I have done time for a friend and did not snitch.  For me to go on being free I had to give them up.  A friend’s mom told me once it is not you it is your friends.  I did not understand that at the time.  How could that be they never go to jail or get in trouble just me? I am glad I read this article it is time someone lets people know they get help for a mental illness.