DBSA e-Update September 2016

Feature: Using Compassionate Language
Chapter Spotlight: Welcome to Our Newest Chapters
Parent Connection: Managing Fall Transitions
Young Adults, We Need Your Stories
Help Us Improve eUpdate!
Ask the Doc: What’s the difference between a mood disorder and a personality disorder?
Finding Wellness: Light Therapy
bp Magazine: When Noise Annoys
Training: Continuing Education Opportunities
From the Peer Leadership Center
Advocacy: Having Trouble Finding a Psychiatrist?

News from Our Advocacy Blog: Mental Health Parity
We Are Powerful: I Continue to Learn and Grow
Life Unlimited: Meet Karen
Allen’s Note: The Importance of Language
Wellness Tips: Beating Stress! Conquering Fear! Testing Ideas!
Save the Date

Using Compassionate Language

Language wields enormous power. Thomas Jefferson replaced the word “subjects” with “citizens” in the Declaration of Independence and a republic was born. Dr. Martin Luther King’s stirring cadences moved millions to march for civil rights. And, by and large, it has been words in the news coverage of the all-too-frequent mass shootings in this country that have led many to the conclusion that people with mental health conditions are violent and to be feared.

While we should always consider our word choices thoughtfully, DBSA believes we must be especially careful when we speak about mental health and the people living with mental health conditions. Words lead to stigma which is invariably followed by discrimination. While some people may intentionally use unkind labels to describe individuals with mood disorders, most are just unaware that their language choices are hurtful and often harmful. They fail to realize that their words make it that much harder for people living with these challenges to speak up, seek treatment, and find support.

DBSA recently published the guide 10 Ways to Combat Discrimination with Compassionate Language, in part as a response to the many requests we have received asking for direction on language and mental health. Whether you are a peer, family member, co-worker, clinician, or member of the media, we encourage you to read it, understanding, of course, that there are many differing and passionate opinions on this important topic. The guide focuses on these concepts:

1. Defy definitions 
2. Choose words thoughtfully 
3. Avoid distancing language
4. Separate the person from their condition 
5. Don’t make assumptions
6. Acknowledge the right of personal choice
7. Accept responsibility

And for the media:
8. Avoid sensationalizing
9. Portray people with mental health conditions realistically
10. Don’t assume mental health is a factor in violent crime 

As individuals and members of families, communities, workplaces, and the media, we each bear responsibility for our word choices. Please join us in working toward eliminating the stigma and discrimination surrounding mental health conditions by choosing language that is accurate, respectful, and caring.

Download the guide now (PDF).

Welcome to Our Newest Chapters!

DBSA is proud to announce that two new chapters joined the DBSA family this past summer: DBSA Oak Grove (Missouri) and DBSA Pocono Lake (Pennsylvania). We are thrilled to welcome them!

We are always looking for motivated individuals to start new chapters in their local communities. Currently, we are in need of chapters in Cincinnati, Ohio; Phoenix, Arizona; and Rochester, New York. If you or someone you know is located in one of these areas and is interested in starting a chapter, please contact us at startup@dbsallaince.org. To find a DBSA chapter in your own community, visit our Online Support Group Locator.

If you’d like to learn more about starting a chapter, remember that registration is now open for our “Start a Chapter” webinar which will take place on September 29. And to find out about serving as a chapter leader, you may request a complimentary copy of DBSA’s guide, Starting a DBSA Chapter.

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.

Managing Fall Transitions

September is here and there are so many wonderful things to celebrate—the start of a new school year, beautiful color changes in the leaves, delicious seasonal treats, and much more. While there are many reasons to enjoy the shift to autumn, change, particularly in our schedules, can be incredibly challenging. Here are some tips to help your family manage the pressures of the transition to fall:

  • Have wake up and bed times at the same time each day. It’s easy to stay up late and sleep in on the weekends, but it can make Monday morning feel particularly painful. A consistent schedule will help ensure that your family is able to wake up and get going throughout the week.
  • Set aside a time and place for homework each day. Create a special place for homework. This can be a desk area that your child helped decorate or, if it’s a shared space like the kitchen table, a basket of special supplies that can be brought out only during this time. Even if your child does not have homework on a particular day, stick to the schedule and have your child do a quiet activity like reading or drawing. By maintaining a consistent time and place for homework, the process will become more routine and less difficult to enforce over time.
  • Ask your child how they are feeling each day. Monitoring your child’s mood is helpful during transition periods so that you are easily able to identify any concerns that should be brought to the attention of your care team. To make it easy, download DBSA’s Wellness Tracker. This tool helps you record a variety of wellness-oriented items that can be printed as an easy-to-read chart at the end of the month.
  • Help your child find a stress management activity (and do this for yourself, too). New school routines can be stressful for everyone, and it’s great to have tools ready to go when you or your child feels stressed. There are many different activities you might use, including quick mindfulness meditation, quiet time in a bedroom, dancing to a favorite song, taking a walk, or writing how you feel.
  • Have some indoor activities planned. As the weather cools down, it can be hard to go from a lot of outdoor, energy-releasing activities to being indoors most of the time. Consider preparing a few activities that you can use when your child(ren) needs a directed activity to help alleviate boredom and channel excess energy. It may be helpful to have something prepared in a bag or just a list of activities. These activities could include building a fort, creating a sculpture with clay, writing a creative story, or indoor Olympics.
  • Remember that you need support. Parenting can be difficult without additional challenges. If your child is experiencing a mood disorder, remember that you are not alone. DBSA’s Balanced Mind Parent Network is an online community of individuals who share and want to support your experience. Learn more at a www.dbsalliance.org/BMPN.

Depression and Bipolar Support Alliance

Young Adults, There’s Still Time to Share Your Story!

Being diagnosed with a mood disorder as a teen can feel like a life sentence. Perhaps you remember this feeling when you were first diagnosed. To help teens envision a life beyond their diagnosis, DBSA is assembling an array of stories by young adults who have successfully navigated life with a mood disorder on their way into adulthood. These stories will be made available to teens under the program banner I’m Living Proof.

If you are between 18 to 35 years of age, experienced a mood disorder as a teenager, and are willing to share how your life has improved since then, please share your journey by submitting it at DBSAlliance.org/ImLivingProof. Stories will be accepted on a rolling basis, but there are some great incentives to get your story in early! The first five people to submit will receive a $100 Amazon gift card. Everyone who sends in a story by September 30, 2016, will be entered to win one of ten $50 Amazon gift cards. To qualify for any of these prizes, you must carefully follow the submission guidelines. Winners will be notified by email on or before October 15, 2016.

Help Us Improve DBSA’s eUpdate!

DBSA is always looking to improve the resources, programs, and tools we offer you. We’d like to hear your thoughts on our eUpdate newsletter—what you’re reading right now! Tell us how we’re doing, what you’d like to see more (or less) of, new topics we should cover, and more. Help us serve you better by taking our brief survey!

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

Ask the Doc: A family member was diagnosed with bipolar I disorder and with treatment has done extremely well. Just recently he has had serious problems at his job, with his wife and children, and he seems to lack self-awareness. A new doctor diagnosed him with a personality disorder. What’s the difference between a mood disorder and a personality disorder? How could there be two such very different diagnoses?

Diagnosing a personality disorder in someone who has a bipolar disorder is complicated. Personality disorder means an enduring and problematic pattern of behavior, especially in relationships with others. Theoretically, this disorder is distinct from mood symptoms like depression, mania, or hypomania. But a sharp distinction is only possible if the problematic pattern of behavior occurs when mood symptoms are completely resolved. Unfortunately, most people living with mood disorders are still waiting for the day when that happens. In reality, the theoretical distinction between personality disorder and a mood disorder is hard to find.

Diagnoses of personality disorder also have a complicated history. They were often seen as more psychological while mood disorders (like bipolar disorder) were seen as more biological. This view sometimes led to more blame and shame being attached to personality disorders.

Thinking about your relative, I will assume that the earlier diagnosis of bipolar disorder is correct. If someone has had a true manic episode, then we would make a diagnosis of type 1 bipolar disorder. True manic episodes are not symptoms of personality disorder. So the question is whether he has a personality disorder in addition to bipolar disorder.

Ultimately, diagnoses are only useful if they guide us to practical things that help. Our question regarding your relative would be what different advice we might give if the work and family problems are due to bipolar disorder or to personality disorder.

In either case, we would take a second look for other possible signs of mania or hypomania. Problems like unrealistic self-image, irritability, and impulsivity can certainly be symptoms of a personality disorder. But these symptoms more likely indicate mania or hypomania if they are accompanied by other typical mania symptoms, such as racing thoughts, rapid or pressured speech, and decreased need for sleep. If we see these other signs of mania or hypomania, then we would certainly ask whether medication treatment needs to be adjusted.

Whether we think work and family problems are due to a personality disorder or bipolar disorder, we would recommend counseling or therapy. Whatever the diagnosis or cause, working with a therapist to recognize and tone down problematic behaviors is likely to help.  For psychotherapy, specific diagnoses are less relevant or useful. Therapy should focus more on what you do (being easily irritated) than on what you are (having a personality disorder or a bipolar disorder).

Got a nagging question? Submit your questions to Ask the Doc online. Also, take a look through our Ask the Doc feature page, a comprehensive archive of past columns which may already have the answer to your questions.

Depression and Bipolar Support Alliance

Finding Wellness: Light Therapy

A few months ago we introduced a new series in eUpdate on proven ways to promote wellness using non-medical means. In previous issues we have discussed mindfulness and exercise. This month we’re looking at light therapy.

Can you imagine a therapy that combats depression, requires no medication, has minimal to no side effects, is relatively inexpensive, fast-acting, and has been proven to be effective? Too good to be true? It’s not.

Light therapy, or exposure to artificial light, has been widely used for a number of years to treat seasonal affective disorder (SAD). This disorder is a type of depression that occurs only at a certain time each year, usually fall or winter. Now, a recent Canadian study—one of the largest and most sophisticated studies of light therapy so far—as well as several earlier studies have shown that light therapy is an effective treatment for other types of depression and can be equal in effectiveness to medication.

During light therapy, you turn room lights on and then sit or work near a device called a light therapy box which gives off a bright light that mimics natural outdoor light. The box can sit on a table or desk while you watch TV, talk on the phone, eat, or even exercise. To be effective, the light needs to enter your eyes indirectly, such as from above eye level. Staring directly into the light is not necessary and can actually hurt your eyes. The active ingredient in light therapy appears to be the brightness or intensity rather than the color. Some full spectrum lights have the same color as sunlight, but are not bright enough to help with seasonal depression.

Light therapy sessions typically last from 15 to 30 minutes, depending on the intensity, or lux, of your light box and your particularly needs. Many people find the therapy most effective when done early in the morning—just after waking up—and report feeling its benefits in just a few days or a week. One important thing to remember is that, just like a regular antidepressant, light therapy can sometimes cause mania, so it is extremely important that you check with your clinician before starting light therapy.

Exactly why light therapy works isn’t yet known. What we do know is that there are several physiological effects from light. Blood levels of the hormone melatonin, which may be very high at certain times of day, are quickly reduced by exposure to light. And depending on when light is introduced, the body's internal clock—controlling temperature, hormone secretion, and sleep patterns—shifts ahead or is delayed. These physiological time shifts be the basis of the therapeutic response to light therapy.

There’s no substitute, of course, for fresh air, exposure to natural daylight, exercise, and a healthy, well-balanced diet. But consider adding light therapy to your daily wellness routine—it’s quick and easy.

Depression and Bipolar Support Alliance

bp Magazine: When Noise Annoys: Coping with Hypersensitive Hearing

Do sounds that other people ignore make you want to tear your hair out? Hearing hypersensitivity is a fairly common mood symptom with bipolar disorder. Read article.

DBSA Continuing Education Opportunities

DBSA is leading the way in preparing Veterans to support their peers in dealing with challenges can that arise after a return to civilian life. Our new Veteran Peers Navigating Moral Paradoxes training introduces Veterans to three valuable peer support tools. Following the recent launch of the online version of this course at the DBSA Peer Leadership Center, DBSA recently debuted a face-to-face version in Chicago in partnership with Volunteers of America Illinois and in Philadelphia as a pre-conference workshop at the International Association of Peer Supporters conference. If you would like more information on how you can bring this in-person course to your organization or area, please contact us at Training@DBSAlliance.org.

Peer specialists are welcome to participate in a special track at the DBSA Leadership Forum on November 12, in Akron, Ohio. Workshop topics will include the role of peers in helping others overcome persistent negative self-talk and strengthening protective factors with peers who are experiencing suicidal feelings.

On different note, DBSA is very proud to be partnering with DBSA West Virginia and Volunteers of America Greater Los Angeles in bringing peer specialist trainings to various locations across the country in the coming months.

Depression and Bipolar Support Alliance

From the Peer Leadership Center

September 22, 2016, at 11 a.m. CST
Live Discussion Chat: National Peer Specialist Certification
Open to certified peer specialist members and peer supporters 

Chat live with your peers about the hot topic of national peer specialist certification. Join us on the Discussion Boards via the Member Portal here. NOTE: members must be logged in to access.

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 membership and take advantage of resources, networking, education, and employment.

Depression and Bipolar Support Alliance

Are you having trouble finding a psychiatrist?

Accessing care from a psychiatrist can be challenging. There are a limited number of psychiatrists in this country and health plan networks often cover only a few in a particular area, if any at all. There can also be problems contacting a provider; phone numbers may be incorrect or disconnected. Additionally, many psychiatrists may not be accepting new patients or won’t accept your insurance. After one or two tries, many people give up.

DBSA wants to hear about your experiences with making an appointment with a psychiatrist. Please click this link to share your story. Then visit our advocacy website and subscribe so that you can get the results of this survey as well as action alerts about what you can do to help improve the system.

If we are to improve our health care system, individuals must be able to access needed care. People who cannot get care often end up at an emergency room, where they face overpriced services, long wait times, or no care at all. This affects personal well-being and leads to higher costs for everyone.

To see a psychiatrist, you may have to invest extra effort—be persistent! You may need to make multiple calls and you’re likely to get care sooner if you’re flexible about who you see. Finally, you should contact your insurance provider and your state’s insurance regulators to report any problems. You can find a list at Parity Track.

News from Our Advocacy Blog: Mental Health Parity

Mental health parity may be federal law, but is it being implemented at the state level? Care for Your Mind examines the issue and shares how you can get involved. Read more.

Depression and Bipolar Support Alliance

We Are Powerful: I Continue to Learn and Grow

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; September’s theme is I Continue to Learn and Grow. For all of us, it’s just so easy to settle into our comfort zone but over time, we can grow bored and reluctant to take on the risks that make life interesting. Let too much comfort, for too long be the spark that tells you it may be time to take on a new challenge.

To see what’s happening with We Are Powerful, check out the DBSA Facebook page where you will find several posts about it each week.

Depression and Bipolar Support Alliance
Karen Trudel

Life Unlimited: Meet Karen Trudel

I’ve always excelled in everything I’ve tried. In grade school, I swam on the YMCA swim team. Every time I dove into the pool to race or practice racing, I beat my own best time. But no one knew how anxious and depressed I was; I had very few friends. Even after graduating from high school as a member of the National Honor Society and then college with summa cum laude honors, I was still very sad and anxious. I’d also functioned on very little sleep in college and didn’t understand why.

I moved to another state after college graduation, trying to run away from my depression and anxiety, but that only made things worse. I had a really tough time managing a full-time job and started to see a psychiatrist. One day, I was at rock bottom and called my doctor, saying I wanted to hurt myself. Ten minutes later, the police were knocking on my door. They took me to the hospital and I don't remember much after that. My parents were called and my family was great about taking me back home to live them. (I hadn’t been an easy child to raise—the illness was there but there wasn’t yet a diagnosis.)

Once home, I had a really significant stay at a hospital that lasted for a month. I thought I was someone else entirely and was convinced that the police were coming to get me. It was there that I was finally diagnosed with bipolar disorder with psychosis not otherwise specified. I was paranoid, thinking that the nurses were trying to poison me with my meds. They finally gave me injections to help me feel better. I would not eat, so they kept up my nutrition with an IV. 

My road to wellness actually began when I got on medication. This was the very first step in a long process—I’ve tried many treatments. The medication helped bring me out of a psychotic state and since then I’ve used all kinds of therapies, medications, and ECT to get to where I am today. Looking back, I think the scariest part of my journey was when I didn’t know who I was anymore or who I could trust. But I wouldn’t trade my experiences for the world because I’m proud of the person I’ve become.

I currently work as a peer advocate, supporting people as they learn more about themselves. It’s the best job I’ve ever had. I can relate to them and talk about what has worked for me. Maybe someone will follow my lead and feel more positive about their life. Today, just as I’ve always done, I’m constantly trying to improve.

Read more inspiring stories here.

If you would like to participate in our Life Unlimited feature by sharing your story, please submit your contact information.

Depression and Bipolar Support Alliance
Allen Doederlein
DBSA President

Note from Allen

The topic of language can be a minefield within the mental health advocacy community. Many of us have particular and firm beliefs about language and how it shapes conceptions of mental health conditions. As a result of this diversity of opinion, discussions of appropriate language can become heated and contentious, and a topic we shy away from rather than embrace.

I had not been exposed to debates about mental health language until I began to conceive of myself as an advocate. I really didn’t think much about the topic back when I was “just” a person with a mood disorder and not yet a proud member of the DBSA family. When I first heard the word consumer, for example, I didn’t actually understand (until someone clued me in) that this word referred to me. I now understand the origins of the term and people’s passionate views, both in favor of and against its usage.

For me, it’s odd to think of myself a consumer. That sounds more like something a marketing company might call me as they try to sell me soup or a new brand of detergent. And as I often joke, if I think of being a consumer in the sense of purchasing something, I would never choose to buy depression. (There are many things I might want in my shopping cart, but depression is not one of them, believe me!) Yet if someone else prefers consumer as a designation, I would never begrudge them that choice, especially considering the extraordinary advances in understanding and treatment of mental health conditions that were made possible by the women and men who made up the consumer movement.

We at DBSA felt that it was incredibly important to address language, even though it can be tricky as it was for me in the case of “consumer.” There are matters of personal choice involved in how things are phrased. Language can also present potential barriers to accessing care and understanding that wellness is possible. If people experience significant personal shame about their condition and what it’s named, they are less likely to seek help. Their expectations of what is possible for them may also be lowered. Empowering, person-centered language, we contend, can be part of how expectations are raised from better to well, and from surviving to thriving.

It was with all of this in mind that we created 10 Ways to Combat Discrimination with Compassionate Language. The ideas and suggestions within this new piece are meant to be a framework for how we can help others understand the importance of language—how language can open up and honor people, rather than constricting and demeaning them. We hope you’ll find it a useful tool to share with others, and maybe even a challenge to some of your own ways of describing what it means to experience depression or bipolar disorder.

Depression and Bipolar Support Alliance

Wellness Tips from Peers

Managing Stress
When I get overwhelmed with emotional stress, I can calm myself down by doing a jigsaw puzzle or playing “solitaire” mah-jongg. (I pretend to be all four players!)  Putting my brain into problem-solving mode steers it away from emotional triggers.

Don’t Leave—Lean!
“We conquer our anxieties by fighting our instinct to run away from the things that trigger our anxious minds and bodies. If we are afraid of something, we must move toward the very thing that scares us, and embrace it until it no longer holds that power over us. If you want to get over the fear of heights, you must seek high places. Lean into your fears the next time you want to run away from them and one day you will possess a new level of freedom that is both mental and physical.”from Zenren Quotes

Flow of Ideas
I am having lots of ideas right now. I like the advice that says if you have a new idea, wait a week before acting on it or even talking about it with someone else.

Visit the FacingUs.org 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

DBSA I to We Tour
University of Washington
Seattle, WA
October 2, 2016

Destination Dignity March
Washington DC and virtual
October 10, 2016
Global Peer Supporters Day
October 20, 2016

DBSA Veteran Peer Specialist Training
Los Angeles, CA
October 24-29, 2016

DBSA Leadership Weekend
Sheraton Suites Akron/Cuyahoga Falls
Cuyahoga Falls, OH
November 11-12, 2016