Spirituality May Be Underused Tool in Treating Mental Illness

That is the title of this article I am reviewing today. "'New research suggests spirituality may offer benefits for people with mental health issues, but people may encounter barriers when reaching out for this help. Investigators from the University of Southern California School of Social Work discovered that spirituality is often an underused resource in urban communities. To resolve this shortcoming, and to cultivate spiritual resources that might have therapeutic value, associate professor Dr. Ann Marie Yamada worked with the Los Angeles County Department of Mental Health (LAC-DMH) to design and test a new spirituality-based treatment program. 'Stigma prevents many individuals experiencing schizophrenia or bipolar disorders from seeking spiritual or religious support from a faith-based community organization. It is difficult for some people to find a community where they feel comfortable and accepted,' said Yamada, co-author of the study with Dr. Andew Subica of the School of Medicine at the University of California, Riverside.'" I do not believe that you have to go to church and say you are one religion. I believe in God and the beginning of my mental illness I was more active in praying and meditation than now. I kind of shy away from letting anyone know that I believed in God because I was in the state hospital and I seen a lot of peoples illness was religion based and I did not ever want that to confuse my mental illness and religion in it.
The article goes on to say: "'These concerns may not be shared with mental health providers as they may perceive spiritual needs are not appropriate to discuss.' This stigma creates a gap when patients are unable to find spiritual support from either a health care provider or religious community. 'Within the urban community served by LAC-DMH, spirituality has been an underutilized resource. It is a great tool for addressing the health and recovery needs of the largely African-American and Latino patients served by the participating LAC-DMH agency,' Yamada said. It is essential, she noted, that investigators understand the significance of spirituality and religion in these cultures and respectfully acknowledge the philosophical differences in practices between both groups. In the program, 'The Spiritual Strategies for Psychosocial Recovery,' spirituality is used as a therapeutic tool to teach practical coping skills. 'After learning that there are few well-documented interventions that incorporate spirituality, Dr. Subica and I wanted to take the best practices already being used and add greater emphasis on coping skills that have been shown to be effective,' said Yamada.
Participants attended group therapy sessions that included breathing exercises, goal setting training, and group discussion to build both social and coping skills.'" I am Hispanic and I know that religion in our culture is what most achieve for. I just seen to many Hispanics that mixed their religion with their mental illness and I will not do that my mental illness is different that my spiritual beliefs.
The article ends: "'When people find the strength to improve their coping skills, they are more likely to adhere to their treatment plans and see themselves as active participants in their health and recovery. 'When people find the strength to improve their coping skills, they are more likely to adhere to their treatment plans and see themselves as active participants in their health and recovery,' Yamada said. Yamada hopes more innovative providers like LAC-DMH will explore the potential of spirituality-infused treatments. Many of the LAC-DMH-affiliated wellness and recovery centers already offer some type of spirituality-related activities that involve meditation, mindfulness or support groups. It’s just a matter of time, given that 80 percent of the adults sampled across California community mental health centers support integration of spirituality into mental health services, she said. The study included a small pool of participants, but early findings are promising and participants were consistently satisfied with the therapy sessions. Many patients described mood improvements and a feeling of empowerment and control over their conditions. 'I like having these tools because it helps me feel less tense,' said one woman in the program. 'During the week when we don’t have group, I can use them.' The success of the program suggests that health care providers and spiritual leaders could work together to address the needs of their communities. 'Involvement of both clinicians and religious leaders is one way to reduce the stereotypes held by both professions,' Yamada said. 'These stereotypes serve as barriers to developing mental health services that integrate spirituality effectively.' Understanding that spirituality can be a resource for many individuals, mental health providers are better equipped to offer comprehensive treatment. 'Ultimately, this intervention is about strengthening coping skills,' she said. 'Spirituality enhances personal hope through connection to a greater power that could be religious, but is fundamentally defined in whatever way has meaning to each participant.'"That fits when I am troubled I pray and it calms me down. I was also into positive thinking by Norman Vincent Peale who's positive thinking books are religious I have a lot of his books but when he died I had been donating to his church and they just started asking for to much money so I left them.  When I was at the state hospital I did not have much money and he sent me his pamphlets for  a dollar so I though when I made it I would donate to him because they helped me get through rough time including money. I could have made money no matter where I am at but the state hospital and me made a deal I stop hustling money and the would let me out of there so I stopped so I needed those pamphlets to help me cope.

Anti-Psychotics Don't Kill Patients. Lack Of Health Care Does

That is the title of this article I am reviewing today. "In my last blog post, I talked about the shameful way that many with schizophrenia are treated (or not treated) for their other co-existing medical problems, like diabetes. There is ample evidence that this lack of proper medical treatment and the failure to exercise preventative measures for conditions like cardiovascular disease results in a shortened life span. The latest research just released from California show that women with serious mental illnesses are not routinely screened for cervical cancer compared to women without mental illness. Despite the weight of all this evidence, the common belief among the anti-psychiatry, anti-medication group is that this reduced life expectancy for those with serious mental illness is the result of the medication they are given. That was one of the comments on my previous blog and it is the opinion of journalist Robert Whitaker of Mad in America fame." Which I disagree with if I had not started medication I would still be mentally ill.  If you want to go to groups and you think that will cure you go for it. I for one am thankful for the medication it allows me to work and do whatever I feel like it in society.
The article goes on to say: "'The question we should be asking is what is mortality for those who do not take anti-psychotic medication, which is the standard starting treatment for people diagnosed with schizophrenia. If anti-psychotics are responsible for the shortened life span, then not taking them when diagnosed should result in less mortality. The answer to that can be found in one commentary published this month, in the Lancet, and a study published in Schizophrenia Bulletin. Mortality is quite a bit higher in those not properly treated with anti-psychotics than in those properly treated.
In the British Journal, the Lancet, author Cherrie Ann Galletly states that 'Mortality in patients with schizophrenia seems to be highest among those who do not take antipsychotic drugs.' The shocking extent of that mortality was demonstrated in a new U.S. study that just appeared in Schizophrenia Bullentin. Michael Schoenbaum and colleagues examined the long-term patterns of treatment for those with health insurance in the U.S. aged 16-30 receiving a first observed diagnosis of psychosis in 2008-09. They limited their sample to only those with health insurance because, sadly, not having health insurance is itself a barrier in the U.S. to receiving proper medical care. Those identified for the study were followed for a year to find information on mortality, treatment and health resource utilization.'" People with mental illness have to find treatment if they have insurance.  I do not how long I will live although I take precautions as to have insurance for my grand kids and daughter. Like I told the cancer doctor I am not afraid to die because I am prepared for that day.  Although most people with mental illness can not afford to get medical treatment or even psychiatric treatment if they do not have insurance or someway to get medication and treatment.
The article ends: "They found 154,322 people with psychotic illnesses. However, they limited their study to only those with a psychotic diagnosis while aged 16-30, continuous insurance coverage for the 12 months prior to diagnosis and 12 months after and a second psychosis diagnosis. This group comprised 1357 people. The second group was made up of 5488 people who had insurance at the time of diagnosis, but not for a year before and after and had only the one diagnosis. Almost two-thirds of the people (61 per cent) did not fill their prescriptions for anti-psychotics in the year after diagnosis and 41 per cent did not receive any psychotherapy. Mortality for this group was anywhere between 24 times to 89 times greater than comparable for those aged 16-30 in the general U.S. population. The authors commented that 'in the general population, only individuals over 70 years of age have all-cause mortality approaching the rate we observed among young psychosis patients here.'
The study also found that there was very little medical oversight of these patients and only 'modest' psychosocial treatment. Those who died in the 12-month period received the least amount of outpatient care. Premature death for those with schizophrenia is complex and not as simple as the anti-psychiatry crowd suggests. It results from a combination of poor treatment and preventative care these people receive from the medical system, and the failure to treat their mental illness appropriately and aggressively. In the U.S., it appears to be confounded by the lack of universal health care.'" Yes I do know it is hard for people because when I was on social security and had medicaid they put me on so much medication and I had to get off it when I recieved regular insurance and now it is starting all over so much medication and it is expensive regardless if a person has insurance. I for one am watching what happens in the healthcare field with a new President.

Exercise Can Ease Psychosis in Young People

That is the title of this article I am reviewing today. "'Exercise has been shown to significantly reduce symptoms of first-episode psychosis in young people, according to a new study at the University of Manchester in the U.K. 'This was only a pilot study, but the improvements, particularly in psychiatric symptoms, were dramatic,” said lead author and doctoral student Joseph Firth. “Personalized exercise at local leisure centers seems to be a cost-effective and successful way to help these young people recover.'  When young people are diagnosed with psychosis, the long-term prospects are typically poor with high rates of relapse, unemployment, and premature death.  Many patients also experience rapid, unwanted weight gain due to the antipsychotics they are prescribed.'"If it can help then for sure they should do it.  I walk for exercise I do not know if there is any benefit other than I do not gain weight and even lost a lot by walking.
The article goes on to say: "'Although exercise has been found to be an effective treatment for people with long-term schizophrenia, there have been no studies showing its effects on psychiatric symptoms in young adults with early psychosis, until now. For the study, the researchers recruited 31 people ages 18-35 who had been referred to local mental health centers for treatment.  With the participants help, the researchers designed personalized exercise routines which were carried out under supervision for 10 weeks at local recreation centers. 'Establishing an exercise regime for people with psychosis is likely to be much more effective when they are younger, and in the earliest stages of treatment. Getting people into a routine early on also helps set habits for life, which can make a huge difference to their long-term physical and mental health,' Firth said.'"My illness came on when I was already twenty seven.  To have it younger and go through relapses and everything would be hard and if exercise helps that would be great.  The reason I do not see any difference in me is I do not suffer from symptoms by last relapses was in 1994 because they had lowered my medicine. I am lucky in my illness because I do not have problems with my mental illness.
The article ends: "'The study participants actually exceeded the target amounts of exercise, achieving 107 minutes of vigorous exercise training each week for 10-weeks. This compares favorably with exercise programs in healthy populations as well as in schizophrenia. 'Personalizing exercise training to the activities which patients find most motivating helps them stick to their program,' said Firth.
At the end of the 10-week period, the participants completed a variety of standardized mental and physical health tests. The researchers compared their results to those of a control group of seven people being treated by mental health services without an exercise program. The findings showed that the exercise group experienced a 27 percent reduction in psychiatric symptoms on the standardized tests, much better than the control group. Their brain function also improved, and they achieved a slight reduction in body weight — going against expected weight gain from normal treatment.
'By reaching people early on, exercise can provide a healthy and empowering add-on treatment for young people with psychosis. This could massively improve their social functioning and mental health, hopefully preventing long-term disability from ever arising,' Firth said.'" I do know that when I take a day off from work the day is long and my aunt who is retired tells me the same thing so anything I believe that can improve the lives of those who suffer from this illness is great. I used to work out in the fitness center where I live there I would lift weight also.  Although now that we have new mangement they want to charge to workout I will not pay so I just walk now.

What Drives the Myth That the Mentally Ill Are Dangerous?

That is the title of this article I have reviewed today. "Why does the general public continue to believe that mentally ill people are more dangerous than those without mental illness? Scientists at the University of Basel and the University Psychiatric Clinics Basel sought to find out how dangerous the general public considers mentally ill people to be and which factors influence this perception. Although a small number of mental illnesses can lead to a relatively increased risk of violence, most people with mental disorders are not violent." I will admit I was violent before I had this mental illness because I used to drink and always ended up in jail.  Since I had this mental illness since 1989 I have not went to jail or even been stopped by the police.
The article continues: "'People with mental illnesses suffer from severe social stigma and often avoid necessary treatment because of it. In addition to the actual symptoms of disease, societal discrimination leads to further conditions such as anxiety, stress, and low self-esteem among those affected. 'We want to understand whether the stigma arises from noticing symptoms or from finding out that somebody has had psychiatric treatment,' said Professor Christian Huber. To this end, they surveyed 10,000 people in the Swiss canton of Basel Stadt. The respondents had to estimate how dangerous they considered people in a number of fictional case histories to be. Half of the cases portrayed symptoms of various mental illnesses (alcohol dependency, psychosis, borderline personality disorder), while the others reported on the location where psychiatric treatment took place (general hospital with psychiatric wards, psychiatric hospital, psychiatric hospital with forensic wards). In the case histories describing only the location of the treatment, as well as in those featuring a description of symptoms and behavioral problems, the patients were generally regarded as dangerous. A description of symptoms led to a stronger attribution of danger; people with symptoms of alcohol dependency were perceived as particularly threatening. Treatment in a general hospital, however, was associated with a lower dangerousness attribution.'" There it is alcohol make people dangerous even when they are sober and not. I am sorry I for one do not tell people I have a mental illness they start treating you different.
The article ends: "'Furthermore, it was found that people who had had personal contact with psychiatry or with psychiatric patients in the past generally rated the potential for danger as lower.
The study, which appears in the journal Scientific Reports, shows that how patients are treated in psychiatry influences the prejudices they have to deal with. Indeed, treatment in a psychiatric unit, which is included in a general hospital, was associated with a lower dangerousness attribution than treatment in a specialized psychiatric clinic. Moreover, people who had personal contact with psychiatry or with psychiatric patients in the past generally rated the potential for danger as lower.
The authors of the study argue that contact between the general public and mentally ill people should be encouraged in order to break down prejudices. 'Our results show that campaigns to destigmatize public perception should be realistic about the low risk that people with mental illnesses pose.'
And a shift in inpatient psychiatric treatment from independent clinics to general hospitals with psychiatric wards could encourage destigmatization, they added.'"People have to get to know us, because we are no different except we have a mental illness and some do not have the memory or other things to pass as they call normal.

Why Do People With Schizophrenia Die Prematurely?

That is the title of this article I reviewed today. "Schizophrenia affects approximately 1% of the US population. This serious psychiatric illness is characterized by psychotic symptoms (hallucinations and delusions), cognitive symptoms (difficulties with attention, memory, and decision making), and negative symptoms (withdrawn behavior, low speech output and content, and diminished motivation).
Although there is no cure for schizophrenia, treatment can decrease symptoms. Currently, these treatments include medications and psychosocial interventions. Many individuals with schizophrenia can work, live independently or with limited assistance, and enjoy life. Unfortunately, some individuals have symptoms that do not respond to treatment and interfere with their ability to lead independent lives and comply with treatment. Persons with schizophrenia have a greatly diminished life span. In general, people with this disorder die more than 25 years earlier than the general population. In other words, these individuals can only expect to live about 70% of the normal life span. Why do they die early?"That is a drag that a person cannot live out a full life.  I know I want to especially now that my great grandson was born.  I want to get to know him. When you have schizophrenia you have to worry about your health and take care like exercise.
The article goes on to say: "In a paper recently published in JAMA Psychiatry, Mark Olfson and colleagues set out to answer this question. They examined reasons for premature mortality in a group of over 1 million people with schizophrenia covered by Medicaid, the largest insurance provider for persons suffering from schizophrenia in the U.S. They identified causes of death for over 65,500 of the 74,000 people who died during the study period and found that individuals with schizophrenia had an increased rate of death across all ages and all demographic groups when compared to the general population. What were the causes of death in these individuals? Olfson and colleagues found that both natural causes and unnatural causes of death were increased by over three-fold. The most common causes of death were cardiovascular disease, cancer (particularly lung cancer), diabetes, influenza, accidental deaths, and suicides. The large majority of deaths (almost 55,750) resulted from natural causes. However, the rates of death from suicide and accidents were also substantially elevated"I do not know if my lung cancer was caused my schizophrenia or it runs in my family. I have to say that because my mom just had breast cancer so it probably runs in the family.  My aunt also died from lung cancer.  Suicide I guess I should put up articles about hope because you do not have to have a mental illness to commit suicide. My ex-wife did because she thought she could not go through life being alone all she needed was a day and the argument she had would have been forgotten.  I blame myself a lot because some one you once loved was unhappy.  How did I contribute to that. Everyone gets depressed once in awhile but there is so much to live such as grand kids.
The article ends: "Smoking is a significant risk factor for a number of diseases on this list. It has been known for a long time that a large majority of persons with schizophrenia smoke. In fact, the rate of smoking for individuals with schizophrenia is more than twice the rate observed in individuals without schizophrenia. Many are also very heavy smokers. This increased rate of smoking accounts for some of the increased death rate, but not all of it. Can something be done to decrease premature death in people with schizophrenia? Helping individuals stop smoking would greatly improve life expectancy. Premature deaths from cardiovascular disease can also be reduced by treating high blood pressure and high cholesterol levels. The effects of diabetes and cardiovascular disease can also be diminished by regular exercise, eating right, and, in those who are obese, weight loss. Health care professionals should routinely screen for suicidality, depression, and use of alcohol and other drugs of abuse, and recommend treatment when appropriate. Encouraging individuals to minimize their use of alcohol and marijuana may lead to a decrease in accidental deaths and deaths from suicide. Treatments for drug addiction can help a number of individuals avoid premature death.
Although implementing the above recommendations may be a challenge in persons with psychotic illnesses, such treatment programs can and do work in this population. Investing in educational and psychosocial resources will save lives. It is important that families and friends of people living with schizophrenia not give up and continuously encourage their loved ones to engage in programs that include smoking cessation, drug cessation, exercise, healthy eating, maintenance of healthy body weight, and control of high blood pressure and high cholesterol." It did not matter that I quit smoking nineteen years ago I still got lung cancer.  I was a heavy smoker though. I have high blood pressure but it is controlled my two medicines. Which personally I do not like taking all kinds of medication the cost and having to take all those medicines.

Why Do People With Schizophrenia Die Prematurely?

That is the title of this article I am reviewing today. "Schizophrenia affects approximately 1% of the US population. This serious psychiatric  illness is characterized by psychotic symptoms (hallucinations and delusions), cognitive symptoms (difficulties with attention, memory, and decision making ), and negative symptoms (withdrawn behavior, low speech output and content, and diminished motivation). Although there is no cure for schizophrenia, treatment can decrease symptoms. Currently, these treatments include medications and psychosocial interventions. Many individuals with schizophrenia can work, live independently or with limited assistance, and enjoy life. Unfortunately, some individuals have symptoms that do not respond to treatment and interfere with their ability to lead independent lives and comply with treatment. Persons with schizophrenia have a greatly diminished life span. In general, people with this disorder die more than 25 years earlier than the general population. In other words, these individuals can only expect to live about 70% of the normal life span. Why do they die early? In a paper recently published in JAMA Psychiatry, Mark Olfson and colleagues set out to answer this question. They examined reasons for premature mortality in a group of over 1 million people with schizophrenia covered by Medicaid, the largest insurance provider for persons suffering from schizophrenia in the U.S. They identified causes of death for over 65,500 of the 74,000 people who died during the study period and found that individuals with schizophrenia had an increased rate of death across all ages and all demographic groups when compared to the general population." Does it include people who have no symptoms?  Why do they die if they are getting general health physicians.  What is the cause?
The article goes on to say: "What were the causes of death in these individuals? Olfson and colleagues found that both natural causes and unnatural causes of death were increased by over three-fold. The most common causes of death were cardiovascular disease, cancer (particularly lung cancer), diabetes, influenza, accidental deaths, and suicides. The large majority of deaths (almost 55,750) resulted from natural causes. However, the rates of death from suicide and accidents were also substantially elevated. Smoking is a significant risk factor for a number of diseases on this list. It has been known for a long time that a large majority of persons with schizophrenia smoke. In fact, the rate of smoking for individuals with schizophrenia is more than twice the rate observed in individuals without schizophrenia. Many are also very heavy smokers. This increased rate of smoking accounts for some of the increased death rate, but not all of it. Can something be done to decrease premature death in people with schizophrenia? Helping individuals stop smoking would greatly improve life expectancy. Premature deaths from cardiovascular disease can also be reduced by treating high blood pressure and high cholesterol levels. The effects of diabetes and cardiovascular disease can also be diminished by regular exercise, eating right, and, in those who are obese, weight loss." Lung cancer I already had that I was not worrying about dying from it I just did not want to be sick from it.  It was terrible and having a lung taken out is worse although I did not have to do chemotherapy that I was happy about.  I have high blood pressure and even though I walk and lost weight I still have high blood pressure.
The article ends: "Health care professionals should routinely screen for suicidality, depression, and use of alcohol and other drugs of abuse, and recommend treatment when appropriate. Encouraging individuals to minimize their use of alcohol and marijuana may lead to a decrease in accidental deaths and deaths from suicide. Treatments for drug addiction can help a number of individuals avoid premature death. Although implementing the above recommendations may be a challenge in persons with psychotic illnesses, such treatment programs can and do work in this population. Investing in educational and psychosocial resources will save lives. It is important that families and friends of people living with schizophrenia not give up and continuously encourage their loved ones to engage in programs that include smoking cessation, drug cessation, exercise, healthy eating, maintenance of healthy body weight, and control of high blood pressure and high cholesterol." Anyone can stop doing drugs and alcohol they just have to hit rock bottom.  That is what happen to me I could go no lower and alcohol just made me end up in prison or the state hospital the latter I really hate and that is what helped me.  I do not want to go back to the state hospital it is worse than jail or prison. To many head games there.

Weight loss on antipsychotics is possible: study

That is the title of this article I am reviewing today. "'By Kathryn Doyle | NEW YORK
NEW YORK (Reuters Health) - The drugs people take to help ease serious mental illnesses often contribute to weight and blood sugar problems - but researchers say a lifestyle intervention can be helpful on both fronts. The so-called 'antipsychotic drugs' that patients take to control their symptoms tend to stimulate hunger and thirst and cause metabolic changes. But in a new test of a year-long intervention, people taking these drugs for illnesses like schizophrenia or bipolar disorder were able to lose weight and improve their blood sugar levels. 'The results are somewhat surprising because people with serious mental illnesses have many barriers to losing weight,' said lead author Carla A. Green, of the Center for Health Research at Kaiser Permanente Northwest in Portland, Oregon. 'That is really important because people with serious mental illness are already at much higher risk for obesity and obesity-related disease and they have a reduced life expectancy because of this.'

A number of medication side-effects, including weight gain, deter some people from taking their prescribed antipsychotics, Green said. 'Our study showed that if given the right tools, they can lose similar amounts of weight as people without severe mental illnesses,' she told Reuters Health by email. Clozapine (FazaClo), olanzapine (Zyprexa), quetiapine (Seroquel) and risperidone (Risperdal), which treat schizophrenia, bipolar disorder or other mental illnesses, have all been linked to increased risk of weight gain. Green and her team studied 200 adults who’d been taking antipsychotic medications for at least a month and who had a body mass index (BMI) of at least 27. BMI is a measure of weight relative to height; the cutoff for “overweight” is 25. (You can calculate your own BMI here: 1.usa.gov/XcVMat.) '" I know I once weighed 214 lbs when I was on Moban.  My new medication is Geodon and it is weight neutral.
The article goes on to say: "'They explain in the American Journal of Psychiatry that patients were randomly assigned to an 'intervention' group that participated in the new program, or a comparison group that just got their usual medical care. In the intervention group, participants attended weekly two-hour group meetings for the first six months of the study. At each session, they met with mental health counselors and nutritionists; each meeting also included 20 minutes of physical activity.

In addition, participants recorded what and how much they ate, how much they slept and how much they exercised, with a goal of at least 25 minutes of moderate activity per day. The intervention was focused on improved diet with more vegetables, fruits, and low-fat dairy, moderate caloric restriction, increased exercise primarily from walking, stress management, and improved sleep, Green said.

For the second half of the year, the participants met to discuss strategies for maintaining weight loss.

The comparison group did not participate in the weight loss or maintenance interventions.

People in the intervention group lost an average of about 10 pounds over the duration of the study. Those in the comparison group also lost some weight, but much smaller amounts, the authors write.

In the intervention group, 40 percent of participants lost at least five percent of their initial body weight, and 18 percent lost at least 10 percent of their initial weight. Over the course of the year, fasting blood sugar levels went down in the intervention group, but they went up in the comparison group. Use of antipsychotic drugs in the U.S. has been on the rise since the 1990’s, especially among kids (see Reuters story of August 7, 2012 here: reut.rs/1ph77xl). The intervention resulted in a relatively modest weight loss, and did not depend on the type of medication, said Dr. Daniel J. Mueller, who has done research on ways to improve psychiatric drug treatment at the Center for Addiction and Mental Health in Toronto. Individual motivation is key when addressing weight loss, Mueller told Reuters Health by email. Although patients with serious mental illness face more difficulties, some will be motivated enough to overcome them, he said. 'Some doctors will now routinely start treatment with relatively weight neutral antipsychotics first, like aripiprazole (Abilify) or ‎ziprasidone (Geodon), if they work,' he said.'" I lost weight by walking and cutting in half the portions I eat.  I know go from 175 lbs up to 180 lbs.  I watch what I eat and also watch how much I sleep because if I do not sleep at least eight hours a night I am hungry and tired throughout the day.
The article ends: "But the drugs that work the best on average also have high weight gain risk, like clozapine and olanzapine, or at least moderate risk, like risperidone, Mueller said. 'In our qualitative interviews, we found that group support was one of the most important components of our intervention,' Green said. 'Many of our participants said they benefited from the camaraderie of others who faced the same challenges, and this may be particularly important among people with serious mental health problems because they tend to be more socially isolated.' People taking antipsychotics can talk to their doctors about weight gain and medication alternatives, weight management programs and support groups while increasing physical activity, decreasing calories and portion size, she said. 'Perhaps more importantly, lifestyle change programs of this type are not routinely offered in community mental health centers because the programs focus on physical health concerns and this makes reimbursement for those services difficult if not impossible in mental health settings,' Green said. That makes it hard to provide lifestyle change programs in the places where people with serious mental illnesses are most likely to be able to take advantage of them, she said.'" Yes they have to have support to continue losing weight.  It is not easy to lose weight. It is easy to put in on though.  I was skinny until I stopped smoking and then I was buying new pants every month.