DBSA e-Update November 2015

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DBSA Works for Better Emergency Room Protocols

Today, as state and local social services budgets are slashed, hospital emergency rooms are experiencing more and more visits from people with mental health conditions. In Chicago alone, visits increased 37% over a four-year period (2009-2013). Many of these visits are traumatic for everyone involved: the person with lived experience, their family members, and medical personnel.

Traditionally, emergency room departments train doctors to assess patients and make decisions very quickly. Unfortunately, the default for treating people with psychiatric emergencies is “restrain and sedate”, or a quick infusion of medication and physical restraints. In 2014, the U.S. Commission on Civil Rights stated in their annual report that there were better ways of handling such situations and that if hospital staff and physicians received better training, care would improve.

DBSA has advocated for the needs and interests of people with mood disorders, their friends and families for thirty years. We are now a member of COPE, the Coalition on Psychiatric Emergencies, an unprecedented alliance of consumers, advocates and multiple disciplines of healthcare providers whose aim is to improve the emergency room treatment experiences for both visitors and healthcare providers. Further, Phyllis Foxworth, DBSA’s advocacy vice president, will be contributing a chapter to a new clinical textbook on the treatment of agitation. She will write about peer experiences while in the emergency room.

To help us move this important work forward, we need your opinions! We are now collecting information via survey about peer emergency room experiences during agitation episodes and want input from both peers and family members. Please take a few minutes to complete these short surveys. Remember, your experiences will help train new clinicians who can literally change what transpires in emergency rooms. As Dr. Scott Zeller, agitation specialist and COPE member says, “There is plenty of reason for optimism that solutions may finally be near.”

Take peer survey.
Take family survey.

Chapter Spotlight: DBSA Central Florida

The DBSA Central Florida Chapter is only in its first year of affiliation but already has several accomplishments to share! They now reach individuals in three counties through their support group offerings and are working toward starting another new group within the next month.

The chapter is particularly proud of its efforts to support people in a local correctional facility by starting weekly support groups for men and for women. In addition to sharing personal feelings, support, and information with each other, participants are creating wellness plans using information from DBSA’s Facing Us website. They are also setting up a lending library of wellness materials. The chapter is currently collaborating with correctional administrators to set up additional meetings for participants at the county’s mental health facility after their release. The chapter hopes to replicate this program in other counties.

Central Florida group leaders are also expanding their knowledge and skills. They have participated in Living Successfully with a Mood Disorder and peer support specialist facilitator trainings from DBSA as well as further trainings from WRAP. Cheryl Molyneaux, president of DBSA Central Florida, shared her thoughts about being a chapter leader: “In order to help others, I need to be accountable to myself and my wellness plan. Focusing outward helps me maintain my own wellness.”

To see what some of our other affiliates are up to, visit the Chapter Spotlights section of our website!

Depression and Bipolar Support Alliance
Parent Connection appears each month in the DBSA eUpdate. Here, parents and guardians can expect to find up-to-date information and resources about parenting children and adolescents with depression and bipolar disorder. We also feature news about Balanced Mind Parent Network online support communities, the Family Helpline and other family-focused programming.

Parent Connection: Managing Winter Stress

With winter approaching, there are many exciting things that you and your family may be looking forward to—time off from school, celebrations, special treats, family time, travel, and more. For children living with mood disorders, these changes to the normal routine can cause imbalance and stress. Here are a few quick tips on how to manage. 

  1. Maintain schedules as best as you can. Keep bedtimes, waking, and meal times the same as they usually are.
  2. Plan, but be flexible. Let your child know the expectations for the day, but understand that changes may be needed.
  3. For any special visits or events, share the need for flexibility with your family and friends. Let them know that you will do your best, but sometimes your family will need to adjust timing or participation levels.
  4. Create a signal with your child ahead of time indicating that a break is needed. Let your child know that feeling overwhelmed or uncomfortable is ok, and plan for some simple ways to take a break, either away from or at home: listen to music, go to a quiet room, take a walk together, draw, or any other activity that you can mutually agree upon.  
  5. Find support for yourself among family, friends, a support group, or an online community. Your wellness is important, too. Remember to build in time to relax and participate in self-care. 

Parents seeking support from other parents may be interested in DBSA’s program, The Balanced Mind Parent Network (BMPN). It’s an online, family-focused community for parents of children with mood disorders with 24/7 access to information and support.

To learn more about DBSA’s Balanced Mind Parent Network, go to: TheBalancedMind.org

Depression and Bipolar Support Alliance
Greg Simon, MD, MPH, is a psychiatrist and researcher at Group Health Cooperative at the Center for Health Studies in Seattle. His research focuses on improving the quality and availability of mental health services for people living with mood disorders, and he has a specific interest in activating consumers to expect and demand more effective mental health care.


Ask the Doc

My daughter is a substance user and also shows symptoms of bipolar disorder. Which should be treated first?

The short answer is: both.

Abundant research shows that people with mood disorders are at high risk for substance use disorders. And it also shows that people with substance use disorders are at high risk for mood disorders. This has led to many chicken-and-egg arguments about which comes first or which is the true cause. Like the original chicken-and-egg argument, there is no single answer for every person or situation. Either one can cause or worsen the other.

Your practical question does have a single answer. Research has shown that combined treatment—addressing both mood disorder symptoms and substance use problems at the same time—is the most effective approach. In decades past, some psychiatrists believed that it was inappropriate to prescribe medications for a mood disorder, or even to diagnose a mood disorder, until someone had been clean and sober for months. We now know that such a restrictive approach is unnecessary and, possibly, even harmful. For example, people with depression who also abuse alcohol are more likely to decrease or stop drinking if they receive effective medication treatment for depression. 

People who have had problems with substance abuse should probably avoid potentially addictive medications, like benzodiazepines. But those medications are not generally recommended treatments for depression or bipolar disorder.

The same recommendation about combined treatment holds for counseling or psychotherapy. Many of the counseling approaches proven effective for treatment of depression or bipolar disorder can also help people decrease or stop using alcohol or drugs. The “active ingredients” of those approaches include recognizing and interrupting negative thoughts, increasing involvement in positive activities, and identifying “triggers” or situations that can increase risk for substance use and/or mood episodes.

Got a nagging question you want to ask a doc? Submit your questions online for a chance to get the answer. Check future DBSA eUpdates to see if your question was chosen. In the meantime, take a look through our Ask the Doc feature page, a comprehensive archive of past Ask the Doc features which may already be home to the answers you seek.

Depression and Bipolar Support Alliance

bp Magazine: My World, Tricked by Mania

No matter how good it feels, euphoric mania is destructive. Learn to identify and manage your warning signs to stay on track. Read article

DBSA at Carter Symposium on Mental Health Policy

DBSA asserted its voice last week at the 31st Annual Rosalynn Carter Symposium on Mental Health Policy in Atlanta, GA. This year’s theme was Help Wanted: Reshaping the Behavioral Health Workforce. DBSA Peer Support Services Vice President Lisa Goodale spoke to the audience of national leaders on the unique value of peer support services in integrated care settings, along with current challenges to the success of the peer workforce.

“Truly integrating healthcare does not simply mean making it more convenient to access.  End users must be placed as directors of their own healthcare. This assures their satisfaction with care and prioritizing the perspective of the person being served,” asserted Goodale. Among the peer workforce challenges identified were the need for a reliable and accessible system for training and certification of peer specialists, assuring fair and equitable salaries and meaningful career paths, and challenging workplaces to embrace a full and robust scope of practice for peer specialists.

Care For Your Mind

Lower premiums do not always lead to less expensive health insurance plans. What affect do high-deductible health plans had on your ability to access and afford mental health care? Learn more and take the DBSA survey.

Ben Vickers

Life Unlimited: Meet Ben Vickers

I developed major depressive disorder when I was eighteen, caused by severe social anxiety. Treatments failed, perhaps not unexpectedly, as most of them focused on the symptoms of the illness, and not the cause. I tried Cognitive Behavioral Therapy in an attempt to fix the underlying issue but that required effort. Since I had no energy, it too failed.

For a long while I had wanted to go backpacking and use it as exposure therapy to treat the social anxiety. I dissuaded myself for years but when it became clear that I was not getting well, I finally committed to the trip. There was nothing to lose, after all.

In 2012 I began a six-month backpacking trip around Asia. It was an opportunity to face my social fears, repeatedly, every day. Cafes had intimidated me, so I went to one each morning for breakfast. Restaurants had frightened me, so I went to one every lunchtime, and again in the evening. Bars had made me particularly nervous, so I went out for a few drinks every night. I had always avoided talking to other people, if at all possible, so I talked at every opportunity. Where I had always said ‘No’ to invitations and new experiences, I now said ‘Yes’ and experienced as many things as I could afford. The trip healed me completely of social anxiety which, in turn, healed most of the depression. It was the most miraculous transformation.

In 2015 I fell into depression again, this time as a result of life events. I knew that my previous method of recovery could not help here—I didn’t need exposure therapy. What I needed was an opportunity to retreat from life and to think through my issues. The Camino de Santiago beckoned. It’s a pilgrimage—a backpacking endeavor where participants walk 750 km across the north of Spain. It’s open to everyone regardless of their religious beliefs.

I went to Spain and started my Camino, a long walk broken down into short daily stages. Each one completed provided a daily boost to my self-esteem and I also benefited from socializing with the other walkers. I was always one step outside of my comfort zone and I had time to think. Once again, I recovered from depression. The Camino is a loving, safe and supportive environment and I recommend it.

I maintain a blog called the Depressed Backpacker and have written a book with the same name. I hope to encourage others to participate in this form of recovery. There's nothing to lose and everything to gain.

Depression and Bipolar Support Alliance
Allen Doederlein
DBSA President

Allen's Note

This month’s eUpdate contains so many examples of why I’m immensely proud, and thankful, to work for the Depression and Bipolar Support Alliance. You see in this eUpdate practical tips for individuals, and parents of individuals, who are dealing with mood-related symptoms and issues, including those related to this often cold and complicated time of year. You see the call to action to be part of research into unmet needs and potential issues for people with mood disorders in our survey about high-deductible insurance plans. You see the drive to transform aspects of treatment that need to work better for us in the work we’re so proud to be doing in relation to emergency psychiatric care. You see the inspiration of a Life Unlimited, and you see the extraordinary difference a chapter can make even in just a short time in our spotlight on DBSA Central Florida.

I am just in awe of the work done by our chapters, volunteers, staff, and board—and I feel honored and grateful to be in your fine company. Thank you to all of you, and to our community of supporters across the world, who make wellness possible for so many. Together, we will reach many more . . . we’re only just beginning!

Here’s to a wonderful Thanksgiving!

Depression and Bipolar Support Alliance

Wellness Tips from Peers

Visit the Facing Us Clubhouse to get more tips, create your own tips, track your wellness, and connect with peers. Joining the Facing Us Clubhouse is easy and free.

Try to remember that just because you think something, that doesn’t mean that it’s true. Instead of dwelling on these thoughts and accepting them as truth, acknowledge that they’re just thoughts, not facts.

Turn Negatives into Positives
Inspirational Quotes
One of the advantages of being disorganized is that one is always having surprising discoveries. –Winnie the Pooh

Don’t underestimate the battles you’ve won. Sometimes just getting out of bed (even if you get back in again) is a major accomplishment.

Depression and Bipolar Support Alliance

Save the Date

December 1, 2015
#GivingTuesday is December 1. Coming just after the Black Friday and Cyber Monday shopping days, it’s become an international movement, intended to encourage and amplify small acts of kindness in local communities around the world. DBSA would greatly appreciate your support on #GivingTuesday. Because generous donors have stepped forward, your gift will be matched, dollar for dollar, up to $50,000, giving you double the impact! Please help—your generosity may save a life. www.DBSAlliance.org/GivingTuesday

December 11, 2015
9th Annual Educational Conference for Mental Health Professionals
Sponsored by Yellowbrick
8 AM–12:15 PM
Evanston, IL
Learn More