Cruel, disgusting, irresponsible: they all fit. But our guest writer prefers astonishing when it comes to how we treat our mentally ill. She’s been there, folks, and brings a powerful message.
Too many of the psych doctors I have experienced treat you like a number. Patient #567 with severe bipolar disorder…
Received an email from Ashley a week or so ago. Said she has a mental health blog in the works and wanted to know if I’d accept a guest post.
She sent me three, I chose one, and here we are. By the way, I love how she goes with “our mentally ill.”
Let’s get on it. The floor’s yours, Ashley…
Treatment of our mentally ill
What I have personally endured as a mental patient is nothing compared to what I have read of others. It is astonishing that the world we live in can still be so dark and cold – so misguided and tortured.
I can grasp that it is hard to understand the thoughts of one diagnosed with a mental illness. Why do we say what we say? Why do we react the way we do? Why is every case so different and unique?
I’m sure many of us who suffer with mental illness have asked these very questions ourselves. And for the most part, we don’t know.
All we know is the desperate need to feel better, to find a morsel of normalcy in a life scattered amongst the wind.
The mentally ill are mistreated and being misguided
Across America, the mentally ill are mistreated and being misguided.
Timothy Williams of the New York Times provides an example…
Mentally ill inmates in prisons and jails across the United States are subjected to routine physical abuse by guards, including being doused with chemical sprays, shocked with electronic stun guns and strapped for hours to chairs or beds.
How is this behavior acceptable? They don’t know how to handle the situation, so they resort to neglect and abuse.
My personal experience
I remember the countless doctors surrounding me, being the object of everyone’s attention. Yet, my voice went unheard.
They would murmur amongst themselves as to what they felt was “wrong” with me and what medication or therapy they were going to attempt next.
I felt like I was at a zoo – laid out, vulnerable, and unwanted – for all to see.
”Really, the only thing left for you is ECT.”
“If you slow down, open your mind and heart, and listen, you might just get to know me.”
A million times I told them what medications I already tried, but they insisted that I try them again. To no avail, of course.
And then this: “Really the only thing left for you is ECT.” That’s electroconvulsive therapy, in pretty terms.
I guess I agreed to it, but honestly the “therapy” wiped all memory of that. As well as god only knows what else.
All I know is the next few weeks, which are lost forever, were a total fog. Months went by and I still struggled to recall even the simplest of things.
I do remember a flash – getting rolled into a room, given medicine to fall asleep, then waking up scared in a room full of others in beds, all trying to remember why we were there.
Is ECT really a solution?
I personally think ECT is awful. There isn’t any proven evidence of why it sometimes works for patients. I think frying your brain until you can’t remember why you’re there isn’t the answer.
I find it appalling doctors are still doing this. It’s like they have given up and their last resort is to shock you until you feel better. Does that really sound like a solution?
I just don’t want anyone to lose who they truly are – what makes them human – in desperate attempts to find hope.
Overlooked and ignored
Too many of the psych doctors I have experienced treat you like a number. Patient #567 with severe bipolar disorder. depression, PTSD, blah, blah, blah.
I once read my medical chart when the doctor left the room. And it wasn’t pretty. Scary, in fact, to read. I wasn’t that person.
But to them nothing I said was real, which made it all the scarier for me. I was constantly overlooked and ignored like so many others.
There’s always hope for mental illness
There is always hope, the general public need to be educated more on mental illness. That would include our struggles and dangers, along with our triumphs and hard work, so we can be better not only for ourselves, but society.
Nothing will grow in darkness
Spread the word, and let’s get more help, better help, for our mentally ill. Let the world know your own personal experiences with mental health care.
Nothing will improve, nothing will grow in darkness.
We must push through to the light, carrying on for those who no longer can. We are people, and we deserve just as much respect and dignity as anyone else.
Knowledge is power. Speak up, stop the stigma.
That’s a wrap
No doubt, Ashley, astonishing is the right word. And thank you for writing such a powerful piece for us. My money says it’ll hit home for many Chipur readers.
Daylio: Features a mood diary and happiness tracker. Can export PDF or CSV documents to share, print, and analyze.
eMoods: Handles it all, and said to be a particularly good choice for bipolar disorder and PTSD. Enhances doc visits with detailed data exports.
MoodKit: Draws upon principles and techniques of cognitive behavioral therapy (CBT). Can be used to amp up professional treatment.
Worry Watch: Reportedly a good choice for anxiety disorders. Features a guided anxiety journal, coping techniques, mood journal tracker, and positive affirmations.
Bearable: From a user: “With Bipolar, ADHD, anxiety, and depression, this app has made it extremely easy to know, for myself, what to tell my mental health providers regarding my care – what will help me going forward.” Also works well for physical ailments.
Moodfit: Based on the relationship between thoughts, feelings, and behaviors. They say, “Help your therapist help you.”
Plenty more worksheets and apps where these came from. However, the ones I’ve shared receive a lot of attention and accolades.
And with the apps, doesn’t the ease of getting one’s provider involved make good sense? I mean, the more they know, the better they can help.
Work hard for the cause
No more blown appointments, okay? If we want to learn about ourselves and secure relief, we have to work hard for the cause – us.
Using mood, anxiety, symptom tracking is irreplaceable.
Antidepressants: always believed to be a go-to for treating anxiety disorders. New research says mindfulness-based stress reduction works just as well. I think we ought to talk about it, don’t you?
’It gave me the tools to spy on myself. Once you have awareness of an anxious reaction, then you can make a choice for how to deal with it.’
First a TCA, then a variety of SSRIs. I’ve been using antidepressants for anxiety disorders for 33 years.
But if that was my sole intervention, I’d have anxiety’d myself into insanity by now.
The results of a recent randomized clinical trial led by researchers at Georgetown University Medical Center caught my attention.
Mindfulness-based stress reduction is as effective as an antidepressant for treating anxiety disorders
To the bottom-line, the Georgetown team found that a guided mindfulness-based stress reduction program was as effective as using the SSRI antidepressant escitalopram (Lexapro) for the treatment of anxiety disorders – generalized, social, panic, specific phobias.
The work appeared in JAMA Psychiatry on November the 9th of this year.
Study first author, Dr. Elizabeth Hoge…
Our study provides evidence for clinicians, insurers and health care systems to recommend, include and provide reimbursement for mindfulness-based stress reduction as an effective treatment for anxiety disorders because mindfulness meditation currently is reimbursed by very few providers.
A big advantage of mindfulness meditation is that it doesn’t require a clinical degree to train someone to become a mindfulness facilitator. Additionally, sessions can be done outside of a medical setting, such as at a school or community center.
Let’s learn about it…
What is mindfulness-based stress reduction?
Mindfulness-based stress reduction (MBSR) is a therapeutic technique in which an instructor guides participants in weekly – typically one hour for eight weeks – practices like meditation and yoga in order to reduce stress levels.
It was founded in the 1970s by Dr. Jon Kabat-Zinn at the University of Massachusetts Medical School.
Kabat-Zinn developed it as an eight-week course to treat patients’ emotional and mental health, as well as chronic pain, when they hadn’t responded to traditional therapy.
The goal of MBSR is to bring people into the present moment so they can experience their thoughts and feelings non-judgmentally and avoid worrying about the past or future.
By the way, if you’d like to give it a go, make sure you connect with a qualified instructor. And if you’re using it to treat a physical ailment check in with your doc.
Back to the study…
Mindfulness-based stress reduction, antidepressants, and anxiety disorders: The study
“They say it’s just as good as an antidepressant. And it may even be fun.”
Between June 2018 and February 2020, the Georgetown team recruited 276 participants from three hospitals in Boston, New York City, and Washington, D.C.
They were randomly assigned to either the MBSR group or escitalopram.
The participants’ anxiety symptoms were assessed upon enrollment, completion of the intervention at eight weeks, and post-treatment at 12 and 24 weeks.
How it worked
MBSR was offered weekly for eight weeks. The protocol: two-and-a-half hour in-person classes, a daylong retreat weekend class during the 5th or 6th week, and 45 minute daily home practice exercises.
Escitalopram was flexibly dosed between 10 and 20 mg.
Mindfulness-based stress reduction, antidepressants, and anxiety disorders: The results
When it was all said and done, 102 patients had completed MBSR and 106 had completed their medication course. Not all of the participants got through their program, largely due to the pandemic.
The team used a validated assessment measure to rate the severity of symptoms across all disorders using a scale of 1-7 (7 being most severe).
Both groups saw a reduction in their anxiety symptoms: 1.35 points for MBSR and 1.43 for the antidepressant group. That’s statistically equivalent.
The mean for both groups at enrollment was 4.5. So we’re looking at a drop in anxiety symptoms right at 30%.
A valuable perspective
A 52-year-old female participant shared that she began practicing MBSR techniques 10 years ago and it’s transformed her life.
Interesting – she was selected for an MBSR study after responding to an advertisement asking, “Do you worry?”
Maybe you’ll connect with what she had to say…
I didn’t think of myself as anxious — I just thought my life was stressful because I had taken on too much. But I thought, ‘Yeah, I do worry.’ There was something excessive about the way I responded to my environment.
It gave me the tools to spy on myself. Once you have awareness of an anxious reaction, then you can make a choice for how to deal with it. It’s not like a magic cure, but it was a lifelong kind of training. Instead of my anxiety progressing, it went in the other direction, and I’m very grateful for that.
But you know what? Dr. Hoge emphasizes that in spite of the fact that MBSR works, not everyone is willing to devote the time and effort to make it happen.
Hey, I get it. Popping a pill is a whole lot easier. But it doesn’t provide much in the way of self-insight or life-coping techniques.
More work to be done
Hit your app store and you’ll find all sorts of guided meditation apps. As convenient as they are, Hoge points out that the team doesn’t know how apps compare with the full in-person, weekly group class experience. That calls for some work.
Additionally, the team conducted a second phase of the study during the pandemic that involved moving the treatments to an online videoconference. They want to analyze its efficacy.
Finally, the team hopes to explore the effects of MBSR on sleep and depression.
What do you think?
There you have it. Mindfulness-based stress reduction is as effective as an SSRI antidepressant.
I’m not the least bit surprised. You?
So the question is will we give it a go? And keep in mind, it can be used as a primary or complementary treatment.
Truth, according to 19th century French writer and journalist, Jean-Baptiste Alfonse Karr: “Plus ça change, plus c’est la même chose.” That would be “The more things change, the more they stay the same.”
I can’t even begin to express how much the world, and its inhabitants, have changed since I was a kid.
It’s “that time of the year” again. Dare I say holiday season?
This one’s my 68th, and I’ve been delivering “that time of the year” messages on Chipur for 13 years.
And it’s always dicey business. I know all too well it can be a difficult six weeks for those of us wrestling with a mood or anxiety disorder.
Yet, it can be a time of sweet reflection and joy.
Either way, recognizing the holiday season is important.
The more things change, the more they stay the same
I can’t even begin to express how much the world, and its inhabitants, have changed since I was a kid. Really, since the internet began to explode some 30 years ago.
As a collective, we’ve become well-informed, sophisticated, and savvy. Unfortunately, full of ourselves and downright mean often tag along.
But you know what? In spite of monumental changes, things have stayed the same in many ways. At least the things that matter – love, kindness, concern for others, giving of self, and more.
But seeing the sameness is difficult if we’re unwilling to acknowledge and remove going along with the times facades.
However, if – when – we do it, we begin to know who we are and who we can be.
Let’s be true
Hey, handle the next six weeks in a manner that’s right for you. If that means ignoring the hubbub, so be it.
But let’s be true to ourselves, to those with whom we’re close, and those who need us. And if we have a rough go emotionally or mentally, we can’t throw in the towel. I mean, hope is everlasting.
How to cope with ADHD? Whether it’s for you or your child, therapy and meds may work well. But we can’t ignore complementary interventions. For instance, brown noise.
’If you are drowsy (low arousal) or panicked (high arousal), then your attention and focus will be poor. Arousal has to be just right to maximize performance.’
Hot on the trail of new and helpful subject matter, a recent Psychology Today article grabbed my attention.
”Brown Noise and ADHD: What’s the Scoop on the Latest Buzz?”, was written by Joel T. Nigg, PhD. A clinical psychologist, researcher, and author, Dr. Nigg is a world-renowned expert on attention-deficit/hyperactivity disorder (ADHD).
Let’s have a look at his take on the impact of brown noise on ADHD.
By the way, I’m thinking you know it affects adults as well as children.
What is brown noise?
Dr. Nigg begins by noting the recent buzz over reports touting the benefits of brown noise for ADHD.
Okay, but what is it?
Interesting: “brown” has nothing to do with color. Brown noise is the sound created by Brownian motion, discovered by 19th century Scottish botanist Robert Brown.
It’s also referred to as Brownian noise and red noise.
According to Nigg, brown noise is full-spectrum, meaning it contains all frequencies in equal measure across the spectrum of audible sound.
In that regard, it’s similar to white noise, but the sound is lower and richer.
Brown noise bennies
It’s said that brown noise facilitates a calm and focused mental state for tasks like studying and writing. And it’s believed to induce relaxation because of its fit with the brain at rest.
For anxiety disorder sufferers – frequently on the lookout for threats – brown noise may support calming, sleep, and concentration in the midst of all the external and internal alarm hubbub.
And research has shown that brown noise can also soothe ringing in the ears, even to the extreme of tinnitus.
Wanna’ hear it? Here’s an hours’ worth from Arianna Elizabeth’s YouTube channel, Bright & Salted Yoga…
ADHD and brown noise: The science
We’re going to review some important and interesting information, so let’s handle a few definitions first…
Cortical: having to do with the brain’s cortex – the thin gray matter outer layer of the brain responsible for intelligence, personality, planning and organizing, processing sensory input, and more.
Arousal: the state of physiological activation or cortical responsiveness associated with sensory stimulation.
Attention: a state in which cognitive resources are focused on certain aspects of the environment rather than others, and the central nervous system is in a state of readiness to respond to stimuli.
Yerkes-Dodson law: performance increases with physiological or mental arousal, but only to a point. When levels of arousal become too high, performance decreases.
Optimal arousal theory
Okay, among the scientific theories behind why brown noise may help with ADHD, Dr. Nigg submits that the optimal arousal theory is the only one that’s ADHD-specific.
He explains that the notion of optimal cortical arousal for attention and performance dates back to the Yerkes-Dodson law in 1908.
The bottom-line: optimal performance depends on optimal arousal. Nigg simplifies…
If you are drowsy (low arousal) or panicked (high arousal), then your attention and focus will be poor. Arousal has to be ‘just right’ to maximize performance.
Makes sense, right?
Individual variation in stimulation sensitivity
It also makes sense that the optimal level of arousal isn’t a universal constant – it can’t be the same for everyone.
That means it’s about the nature of the task and individual variation in stimulation sensitivity.
There was a time when psychologists ran with the idea that individual differences in arousal dependency were attributable to the personality types extrovert and introvert.
Though it didn’t stick, it led to a vigilance regulation model to conform to knowledge of the neural bases of attention and alertness.
As a result, Nigg points out, a large body of electrophysiological work has suggested that many children with ADHD are characterized by low cortical arousal.
And when it’s addressed, their attention and behavior come into focus.
The frontal cortex
Frontal lobe: the approx 3 mm outer layer is the frontal cortex
The scene of the action is the brain’s frontal cortex. Dr. Nigg suggests we think of it as the driver of a car. When it’s tired, the car weaves on the road.
Keep in mind, when the frontal cortex is under-active, the entire brain isn’t well-regulated. There’s just too much chaos.
But when it “wakes up,” it can suppress the rest of the brain, allowing maximum attention to the task at hand.
On the other side of the coin, Nigg says it appears a subset of children (and adults?) with ADHD are over-aroused. They would be expected to have their attention worsen with brown noise.
A few small studies have suggested children with ADHD may benefit from white noise. It could be an option for the over-aroused.
Dr. Nigg’s work suggests the arousal model works for a particular subset of children with ADHD who can be phenotypically (by observable traits, such as height, eye color, and blood type) characterized.
You can see why this type of clinical differentiation helps resolve discrepancies as to whether or not there is optimal arousal.
ADHD and brown noise: The doc’s final thoughts
Dr. Nigg acknowledges that actual studies of the effects of brown (and white) noise on ADHD are few and use small samples.
As a result, science can’t confirm if brown noise is a placebo effect or if it has a true attentional benefit.
That said, Nigg states that as long as ear damage doesn’t occur from the volume being too loud, the risks are low. So if it seems to help, he believes there’s little harm in using it.
Dr. Nigg looks forward to larger, more systematic studies of brown and white noise in ADHD, as well as individual differences studies regarding who benefits and who doesn’t.
The power of sound
How to cope with ADHD? We know the primary players, but we can’t turn our backs on complementary interventions – like brown noise.
Never downplay the power of sound when it comes to regulating the brain.