DBSA e-Update June 2016

Advocacy in Action
Welcome to Our Newest Chapters!
Parents Advocate on Capitol Hill
Art Van Bonus Challenge This Week Only! (June 14-22)
DBSA Releases Results of Agitation and Emergency Care Peer & Family Surveys
Participate Now in the Mood Disorders and Employment Survey!
Ask the Doc
Finding Wellness: Exercise
bp Magazine: Bipolar, You, and Your Psychiatrist
DBSA Rolls Out Moral Paradoxes Course for Veterans
From the DBSA Peer Leadership Center 
National Mental Health Reform Legislation Revitalized Again!
Care for Your Mind
DBSA VP Featured Speaker at Congressional Briefing 
We Are Powerful!
Life Unlimited: Meet Chuck Fink
Note from Allen
Wellness Tips from Peers
Save the Date

Advocacy in Action!

DBSA works hard to improve the lives of people living with mood disorders. We provide help for individuals through our support groups, tools and resources, peer specialist training, and many other programs. We also offer support in another very important way—we advocate for peers as a community, bringing your stories to mental health public policy decision-makers, such as legislators and government agencies, and virtually any other entity whose actions may affect the quality of life for peers. 

Phyllis Foxworth, our advocacy vice president, leads DBSA’s national, state, and local advocacy efforts. Under her guidance, six DBSA Grassroots Organizations (DBSA GOs), made up of peer advocacy volunteers, also work to increase access to care and end discrimination. Our efforts are having a real impact and we’re rapidly gaining greater clout. Here are some of our recent wins.

  • National Legislation Supporting Peer Specialists  DBSA has advocated for inclusion of workforce development funding in national mental health reform legislation. We worked with Senator Blumenthal (D-CT) to introduce the PEER Act—legislation that would mandate peer specialists be employed at 25 Veteran Health Administration (VA) hospitals and facilities in a primary care setting during a two-year pilot program.
  • State Advocacy  Included in the work of DBSA state grassroots organizations (GOs) is advocating within state legislative bodies. As a result of their work, the recent budget for the state of Florida recognized a significant increase in state funding for mental health programs. In Illinois, a bill that prevents commercial insurance plans from engaging in step therapy, sometimes known as fail-first prescribing practices, will be sent to Governor Bruce Rauner for signature.
  • Federal Agencies  Understanding that a great deal of mental health policy is executed through federal agencies, DBSA shared the voice of peers at two FDA hearings and provided comment to Congressional oversight committees representing the Centers for Medicare and Medicaid Services (CMS).
  • National Hill Days  DBSA advocates once again traveled to Washington D.C. to visit with their elected officials. Advocates partnered with the American Association of Child & Adolescent Psychiatry (AACAP) in April and the National Council for Behavior Health in June to tell their stories and ask for increased funding for mental health programs at the national level.
  • Mental Health Parity  DBSA deploys community education and outreach consultants to educate the wider community on maximizing their health insurance benefits by understanding their rights under national mental health parity laws. As a member of the ParityTrack coalition, DBSA supports efforts to pass state legislation that strengthens this national legislation. Working with a national professional guild, DBSA will be kicking off a campaign this summer that will bring awareness to the insufficiency of in-network mental health providers, a hallmark of many health insurance plans.
  • DBSA Out and About  Lisa Goodale, DBSA vice president of peer support services spoke at the first ever congressional briefing devoted to the role of the peer specialists. DBSA trained peer specialist Susan Haggard and DBSA president Allen Doederlein were invited to the White House to discuss their work and talk about the value of peer support for the live-streamed series, Making Health Care Better.

We are proud of these accomplishments and especially proud of our GOs and everyone who so faithfully responds to our advocacy action alerts directed to legislators. But there is still so much to be done on behalf of peers and we need you! It is your voice and your stories that so often turn indifference into understanding, and then to action.

To learn more about advocating for mental health, go to our Advocacy Center. You’ll find an advocacy toolkit there as well as information on current issues, DBSA’s stance on those issues, and our grass roots organizations. Then register at the Advocacy Action Site to get started.  Working shoulder to shoulder, we truly can make a difference for our community!

Welcome to Our Newest Chapters!

DBSA has added six, brand-new chapters so far in 2016!  We welcome them to the DBSA family!

  • DBSA ABQ Metro (NM)
  • DBSA Belle Mead, Carrier (NJ)
  • DBSA Bucharest, Romania
  • DBSA Mid Minnesota
  • DBSA New Dawn of Greater Jacksonville (FL)
  • DBSA Spirit Realm DeSoto County (MS)

Have you ever thought about starting a DBSA chapter to offer support, education, and inspiration for peers living with depression or bipolar disorder? Now is the time! You can learn more about becoming a chapter leader by requesting a complimentary copy of DBSA’s guide, Starting a DBSA Chapter, or contact us at startup@dbsalliance.org. To find a DBSA chapter in your community, visit our Online Support Group Locator.

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 Helpline and other family-focused programming.

Parents Advocate on Capitol Hill

This April, 11 parents and children joined DBSA in the American Academy of Child and Adolescent Psychiatry’s (AACAP) Hill Day to promote child and adolescent psychiatry on Capitol Hill. The first day included training on key issues that are barriers to care for children, followed by a visit with AACAP members to parents’ congressional representatives and their senators.

One parent, who has a son living with bipolar disorder, was particularly moved by the opportunity to speak with legislators. She shared with them a photo of her son and gave specific examples of his experience of living with a mood disorder. Afterward, she told DBSA that psychiatric professionals, elected officials, and their staff members sincerely want to know the true faces of people affected by a mental health condition. She explained why these conversations are so important. “It’s easy to make assumptions,” she said, “so it’s very impactful to see that these are normal kids fighting an abnormal battle.” 

Now in her sixth year of participating in Hill Day, this parent has learned a lot about the political process, noting that it is complex and slow. “That’s the intended purpose,” she says, “the reason our government was set up this way. It’s to make sure that more than one side to every issue is realized, discussed, and evaluated, pros and cons.”

This mom is also a participant in the Balanced Mind Parent Network, a DBSA program that guides families raising children with mood disorders to the answers, support, and stability they seek. BMPN is a family-focused community for parents of children with mood disorders with 24/7 access to information and support.

Depression and Bipolar Support Alliance

Art Van Bonus Challenge this Week Only! (June 14-22)

Help DBSA thrive! This week Art Van adds a $50 bonus to the first 300 online donations of $50 or more through its Art Van Challenge. We need your help right now!

Depression and Bipolar Support Alliance

DBSA Releases Results of Agitation and Emergency Care Peer & Family Surveys

DBSA’s survey program is part of our ongoing effort to communicate the viewpoints of individuals who are living with depression and bipolar disorder. Our most recent surveys, Agitation and Emergency Care, were designed to provide insight into emergency care from the perspective of people who have experienced an agitation episode or crisis and the family members who have assisted them. Results clearly showed that increased attention must be paid to patient rights regarding consent to treatment and treatment options; emergency department staff need better training on how to treat mental health conditions and the people who live with them; and access to psychiatrists needs vast improvement. Read survey summary (PDF).

Participate Now in the Mood Disorders and Employment Survey!

Have you experienced stigma from workplace colleagues? Have you disclosed your mental health condition to a supervisor? There’s still time to participate in our Mood Disorders and Employment survey. If you currently hold a job, have had a job in the last twelve months, or are actively looking for a job, you are eligible to participate. The survey is open until August 10, with results available on the DBSA website in late fall 2016. 

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

I have chronic depression and have used the same antidepressant for 20 years.  Lately it seems like it’s not working so well. I’m very sensitive to all medications and the three new antidepressants I’ve tried (different types) have made me terribly ill, even at a tiny dose. What are my options?

Your experience that an antidepressant seems to wear out after several years is, unfortunately, fairly common. At this time, we don’t understand the biology of antidepressants “pooping out” (as some have called it). But we certainly know that it happens. If it does, we first ask if there’s some underlying reason—like a major loss or stressful event, some other health problem, using alcohol or street drugs, or a change in some other medication. If there’s a specific reason, then there may be a way to turn things around, like counseling to deal with a stressful situation or cutting down on alcohol use.

It’s also important to be sure that an “old faithful” medication is at the most effective dose. Increasing the dose is simple, usually safe, and often helpful. Recent research shows that the most effective doses of many antidepressants may be higher than those doses recommended in the past.

If those steps aren’t appropriate or aren’t effective, then changing medication can certainly be helpful. We do know that trying a different medication or adding a “booster” medication both have a reasonable chance of success. And if a second medication isn’t helpful, it’s reasonable to try a third or even a fourth. While we know that trying a different medication can work, we don’t yet know much about which one is best. Research about choosing the best specific medication for any individual has not yet provided much useful guidance. For now, the best we can do is to be persistent and logical about trying a different medication and giving it enough time to work.

It may seem discouraging that the newer medications you’ve tried have all caused you problems or side effects. But that situation is actually more hopeful than if they were all ineffective at a full dose. If a first medication "fails" because of side effects, that means that a different medication has a higher chance of working, compared to that first medication that just doesn’t work).

In general, we recommend combined treatment (antidepressant medication and psychotherapy) for people with more recurrent or chronic depression. When multiple antidepressant medications really have been ineffective, there are other physical treatments, like transcranial magnetic stimulation or vagal nerve stimulation that may be effective.

Got a nagging question you want to ask a doc? Submit your questions online for a chance to get the answer. Check the next DBSA eUpdate 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

Finding Wellness: Exercise

A few months ago, we introduced a new series in eUpdate on proven ways to promote wellness using non-medical means. In April, we discussed mindfulness. This month we’ll look at the value of exercise.

We’ve all heard it—from our doctors, maybe from a spouse, and even from the First Lady of the Land—get up and get moving! For those of us with mood disorders, this is doubly important. While exercise helps prevent heart disease, diabetes, and other things we’d like to avoid, it also has an anti-depressant effect on mood, irrespective of age or whether you use a gym or your own living room for exercising.

Most studies thus far have focused on exercise and individuals with depression. Results have been so positive that the American Psychiatric Association now recommends exercise as a treatment for this condition. And while a positive correlation between exercise and bipolar disorder still needs further research, few would argue that exercise is a terrific idea for anyone who wants to maintain wellness.

So how to start? In their studies, researchers tested aerobic exercise like walking, running, and biking, all of which showed an anti-depressive effect. Resistance training also seems quite promising. Exercising at least three times per week is recommended for 45 to 60 minutes per session. And while you may see improvement in your mood in about four weeks, the greatest benefit comes after ten to twelve weeks.

And, of course, the challenge: how to keep your exercise program going over the long term. Michael Otto PhD, a specialist in cognitive-behavioral treatment, says one way to stay motivated is to use multiple motivators. Yes, there are mood benefits to exercising, but what finding other things—like pleasure to keep you going? 

An avid runner, Otto at one point found his own motivation flagging. He decided to think of something else he really wanted that he could combine with running—something that would make him look forward to his next run. For him, the additional motivator was audio books. In addition to getting a good run, he was also able to catch up on his "reading". Rather than thinking of yourself as motivated or not, Otto recommends, thinking of yourself as having lots of motivations to exercise and then coming up with several. Then, when you’d really rather be a couch potato, one of these motivators will likely be the pull that gets you moving.

This month, our We Are Powerful campaign theme is “I Take Care of My Health”. What better way to join the campaign than working some exercise into your life? If you haven’t been a big exerciser up until now, it doesn’t matter how much or how little you do right now—just get started!

Depression and Bipolar Support Alliance

bp Magazine: Bipolar, You & Your Psychiatrist

Is your relationship with your psychologist, psychiatrist or therapist all that it can be? Here’s how building a productive partnership can be a team effort. Read article

DBSA Rolls Out Moral Paradoxes Course for Veterans

Most Veterans feel discomfort when returning to civilian life, regardless of where or how they served. Military service changes people and can cultivate paradoxes, or contradictions, within them that may lead to mental health or substance use conditions.

On August 25, DBSA will offer a one-day peer training course designed to assist both Veterans and their supporters in understanding the key role of peers in helping their fellow Veterans successfully address these paradoxes. The course will also introduce participants to three valuable tools to help Veterans resolve the paradoxes in their lives. 

Registration for this course is open now and must be completed by July 25, 2016. The fee is $99. An abbreviated version of this course is also available online to members of the DBSA Peer Leadership Center.

Depression and Bipolar Support Alliance

From the DBSA Peer Leadership Center 

June 16 Live Discussion: Ethics and Peers
For certified peer specialist and peer supporter PLC members
Ethical boundaries in the peer role can be complex. Discuss these challenges with your peers and exchange ideas during our live chat on the PLC Discussion Boards via the Member Portal here. It will begin at noon CST. Members must be logged in to access. Not a PLC member? Register Today!

Become a Peer Leadership Center Member
Join forces with the leading community of peer support! The Peer Leadership Center is dedicated to advancing the field of peer support and the peer provider workforce. Memberships are available for both individuals and organizations. Sign up now for a free account.

Depression and Bipolar Support Alliance

National Mental Health Reform Legislation Revitalized Again!

After a quiet winter and spring, mental health reform legislation appears to have taken on new life. On May 26, Senators Chris Murphy (D-CT) and Bill Cassidy (R-LA) hosted a summit on mental health in support of the Mental Health Reform Act (S. 2680).

DBSA board member Hakeem Rahim participated on one summit panel, titled the Price of Inaction. In his remarks he noted the value of peer support and DBSA for creating and maintaining wellness. Adding to the momentum, Rep. Upton (R-MI) and Rep. Pallone (D-NJ), who provide leadership in the House Energy and Commerce Committee, signaled that they were hammering out a bi-partisan compromise to the Helping Families in Mental Health Crisis Act, also known as the Murphy bill. DBSA advocacy kicked into immediate action and sent a letter to both representatives, asking that language around peer support and mental health parity be retained in the final version of the bill. Read the letter.

Are we on the verge of a breakthrough? Not so fast, say many mental health advocates. This legislation presents the opportunity to enact generational change with the potential to move the millions of people living with untreated or under-treated mood disorders into thriving lives of wellness. But without the necessary funding, the bill loses its impact. So while there is much to be excited about, we can’t allow mental health reform to be merely a symbolic gesture; in supporting legislation without funding we gain nothing.

Subscribe to the DBSA advocacy platform to stay informed on this rapidly evolving topic. DBSA will let you know when the time is right to contact your elected officials, asking them to either support or oppose the legislation.

News from Our Advocacy Blog

Community partnership is critical for supporting the VA in delivering mental health care to our nation’s Veterans, says Dr. Sanjai Rao of the San Diego VA Medical Center. Learn what you can do.

Depression and Bipolar Support Alliance
Lisa Goodale
DBSA Vice President
Peer Support Services

DBSA VP Featured Speaker at Congressional Briefing 

Lisa Goodale, DBSA Vice President of Peer Support Services, was one of three featured speakers at a May 18 congressional briefing on the value of peer specialists. While there have been many briefings on mental health in America and Veterans’ health care, this was the first to focus specifically on the role of the peer specialist. This invitation reflects DBSA’s growing national prominence as the go-to source for the peer perspective.

Titled Combatting PTSD in Veterans with More than Pills: The Rise of Peer Specialists in the VA, the briefing was organized by Congressman Tim Ryan (D-OH). In addition to Lisa, the other speakers were Dr. Jeffrey Burk, director of the National Mental Health for Psychosocial Rehabilitation and Recovery Services at the VA Central Office in Florida and certified peer specialist Todd Harwood.

Currently, more than 1,100 trained peer specialists work in VA hospitals and facilities, in both one-on-one and group settings. Evidence shows that people using their services experience improved relationships with health care providers, better engagement in their own care, and an increased ability to manage symptoms.

The current demand by Veterans for mental health services far outstrips the supply. Innovative solutions, like peer specialists, offer greater accessibility and an opportunity for the VA to improve the quality of life for many more Veterans and their families.

Depression and Bipolar Support Alliance

We Are Powerful!

DBSA launched in January a year-long campaign, We Are Powerful, exploring the tremendous personal power we each have but may have forgotten or not yet discovered. Peers, parents, and families are encouraged to embrace or reclaim this personal strength in their own lives, the lives of others, and the world. 

As part of the campaign, we are looking at a different aspect of personal power each month; June’s theme is I Take Care of My Health. We sometimes forget how important our physical condition is to our mental health—it’s really central to the path to wellness.

What can you do this month to make an improvement—however big or small—in your health? Read Finding Wellness: Exercise for a great idea! Then sound off about your accomplishments on Power Points, Friday, June 24!

Depression and Bipolar Support Alliance
Chuck Fink

Life Unlimited: Meet Chuck Fink

I define my life by one never-ending belief: I believe in me. That belief has guided me from hell into a fulfilling life based on resolve, personal growth, and learning.

During my school years, I left a trail of clues about my depression through photographs. Family pictures and class photos always showed me on the very end of a row with my eyes downcast, or me leaning away from my family with a look of unhappiness. High school, however, seemed to spark a turnaround. I was class president, in the top ten percent of my class, and the recipient of scholarships. I was Big Man on Campus!

College began a different kind of turnaround. In 1970, I experienced the first of what was to be six, three-month hospitalizations, marked by trips to the “quiet room”, my arms and legs shackled to the bed; a suicide attempt (the most successful failure of my life); and, in total, seven hospitalizations that sapped away a year-and-a-half of my life. Much of this was the result of ineffective treatment because of a misdiagnosis of paranoia schizophrenia. I fault no one. My behaviors could have easily been translated into that diagnosis by any professional.

In 1978, I received what I consider a gift: the diagnosis of bipolar disorder. With medication and a dedicated psychiatrist, my life turned a corner. I found the positive me. My seventh hospitalization lasted only two weeks instead of three months. I also landed a job as an advertising representative for a daily newspaper. The meds worked—I was growing.

These changes did not come easily. I worked diligently with my psychiatrists and took my meds without fail. I held several jobs, but none for long. I dated and married while still misdiagnosed; the marriage lasted nine months.  Nothing seemed to stick for very long except my condition. Then I found the best medicine—I met a pretty, smart, lively young woman. We married after a year and we’re now entering our thirty-sixth year of matrimony. Cindy loves me for who I am; for both of us, my diagnosis doesn’t define me. We have two wonderful sons and life is good.

I started an organizational development business from which I retired seven years ago. Since then, I’ve acted, performed stand-up comedy, and I’m on the storytelling circuit. But perhaps my true legacy has come from my depression. I have founded groups for men dealing with transitional issues in retirement. We strictly avoid offering therapy. That said, we disclose issues of personal importance and bond through breakfasts and social activities. Many said this wouldn’t work—I’d heard that before! We currently have 12 groups of 130 men. 

So, what have I learn? Simply this: to never, ever stop believing in myself. I never stopped taking meds and I never missed an appointment with a therapist. Today, I love growing and learning, even at 66. I always believed I would live a good life and I have. You can too!

Depression and Bipolar Support Alliance
Allen Doederlein
DBSA President

A Note from Allen

We at the Depression and Bipolar Support Alliance join the international community of individuals who mourn the tragic loss of 49 people in Sunday's shooting at the Pulse nightclub in Orlando, Florida. In the wake of such unfathomable devastation, it's likely that many of us may face depression or anxiety even more acutely than usual as we contemplate yet another senseless act, fueled by the cruel cocktail of hate and guns.

If you are struggling personally, there are resources for you, and you are not alone.

You may also read and hear numerous articles, stories, and comments linking acts of violence, like the one in Orlando, to mental health conditions. While this can be for most of us incredibly aggravating and frustrating, we have facts on our side—and the opportunity to educate individuals who erroneously make this link. People with a diagnosable mental health issue are significantly more likely to be victims of violence than perpetrators; only four percent of violent crimes are enacted by people with a mental health diagnosis, such as depression or bipolar disorder.

You can be a vital force for transforming mistaken prejudices and discrimination against people who have mental health conditions.

  • Share your own experience, and hard facts like those above, about the truth of how mental health and violence really don't intersect as people often say they do.
  • Be part of the conversation on this and other mental health topics at DBSA'S  Care for Your Mind blog.
  • Sign up for DBSA advocacy alerts or be part of a DBSA-GO in your area.

Again, we at DBSA extend our love, light, and positive energy to the Orlando community and to all of us who pick up the pieces after yet another unspeakable national tragedy. We are stronger, together, than the darkness of hate and violence.

Depression and Bipolar Support Alliance

Wellness Tips from Peers

Positive Thinking
Inspirational Quotes
I am my own worst enemy with negative self-talk. Today, I am taking a stand. For every negative thought, I’ll think of one solution to turn it into a positive thought, even if it’s no more than a smile to myself.

Enjoy the moment; live in the present
Inspirational Quotes
Live in the present and enjoy each moment of your life—time is something you’ll never get back.

One Small Decision
Build one small decision for wellness on top of another. Health will come.

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.

Depression and Bipolar Support Alliance

Save the Date

Veteran Peers Navigating Moral Paradoxes Training
August 25; Blue Bell, PA 

DBSA Core Peer Specialist Training
September 19-23; Richmond, VA

DBSA Veteran Peer Specialist Training
October 24-29; Los Angeles, CA