Linda and Larry Drain
Support for mood disorders: Allen Doederlien shares information Thursday
By Linda Braden Albert | email@example.com | July 20, 2014
A series of presentations focusing on mental health issues that began in March at the Blount County Public Library will continue Thursday as Allen Doederlein, president of the Depression and Bipolar Support Alliance (DBSA), speaks on bipolar disorder and depression. The presentations, sponsored by NAMI (National Alliance on Mental Illness) Maryville, are free and open to the public.
Doederlein said, “Our headquarters are in Chicago, Ill., and yet, we are really all over the country and have some incredible and important affiliates in Tennessee. The work they do is entirely volunteer. It’s done as a labor of love and it’s done from a very personal place.”
The organization is by and for people who live with depression or bipolar disorder. “That lived experience informs everything we do,” Doederlein said. “We provide information that’s easy and understandable, not written in ‘medicalese,’ not confusing but gets directly to what these conditions are and what you can do to live and get well. We provide empowerment. These are conditions that can make people feel disenfranchised, that can carry great stigma. We want to make sure that people are strong advocates for themselves.”
Doederlein said another goal is to raise concerns and needs to elected officials but also on a more personal level. “Also in their work places and their families — anyplace people with mood disorders may find themselves, to say, let’s work collaboratively and constructively to make sure everyone does well,” he said.
DBSA support groups provide valuable assistance and education for those with mood disorders. Doederlein said, “Our chapters operate free, in-person peer support groups. That’s a group that meets without a doctor or clinical professional present, just the people with a lived experience. There’s a great deal of scientific literature that shows that peer-to-peer experience is greatly beneficial and helps people get well and stay well.”
About 53,000 people are reached nationally in a year by these peer support groups, he added.
Doederlein said Larry Drain, president of the NAMI (National Alliance on Mental Illness) Maryville and initiator of the mental health informational series, is a wonderful example of someone with a great deal of power and intellect who has been challenged by mood disorders.
“He had taken that lived experience and made something in terms of giving back to others,” Doederlein said. “When you think that there are people doing that all over the country, it’s really, really something. Larry’s not only done that in terms of support but also as an advocate.”
At the national level, 50 percent of the paid professional staff and volunteers must, by charter, have personal experience in dealing with mood disorders.
“That perspective informs everything that we do,” Doederlein said. “That’s really important. Very often in health-related education or advocacy, it will be doctors talking to doctors, not really related to a person getting herself or himself well. We make sure that’s at the center of what we do.”
Mood disorders include a spectrum of conditions, including depression and bipolar disorder. Doederlein said, “About 21 million American adults are estimated to be affected by depression and bipolar disorder. That breaks down to about 14 million affected by depression, and between 6 and 7 million affected by bipolar disorder.”
Mood disorders are challenging, but they can be managed and those with the disorders can thrive and contribute to society, Doederlein said. A prime example — Abraham Lincoln.
To learn more, visit the DBSA at www.DBSAlliance.org or attend Thursday’s presentation. It begins at 6:30 p.m. at the Blount County Public Library.
Exciting news is always welcome. One of our own steps out to bring national attention to those suffering due to lack of medical healthcare coverage. Links to articles in The Tennessean and USA Today are below.
The NBC Today show asked to interview Larry and Linda. The interview is expected to happen today. Airing of their interview is expected some time this week. Let's all send our best wishes and thoughts to this couple as they do all that they can to see that no one else needlessly suffers in like fashion.
Links to Larry and Linda's story:
The death of the Murphy Bill: On being the national spokesman
The Murphy Bill as we know is dead. The Republican leadership in the House announced a change in strategy. They basically decided to toss in the towel on the more controversial parts of the plan and try to see if they can move forward on elements that seem to have a greater consensus behind them. There may be CPR efforts yet but it appears done.
It was a bill in trouble from the start despite the massive pr campaign that tried so hard to say it wasnt so. It managed to unify groups that might not agree on what kind of reforms they wanted, but were absolutely sure what they didnt want and that was the Murphy Bill.
Part of the problem was Murphy himself. He assumed that as "the only psychologist in Congress" he was the obvious and deserved national spokesman for mental health reform. He wasnt. Being a psychologist certainly didnt qualify for the role. Neither did being a member of the House of Representatives. It seemed that Dr. Torrey annointed him and for some reason they both thought that mattered. In the end it was hard to know where he started and Dr. Torrey ended and that was perhaps a fatal flaw.
He didnt understand that leadership was built or that it was a two way street. He alienated people who had lived mental health reform their entire adult lives. He thought it was about them joining him and never seemed to know it was the other way around. And he never realized that trust was everything and that when he snuck AOT into the medicare bill he destroyed his chances of trust with people whose support he needed.
He was naive. The only people who believe federal laws change everything are federal lawmakers and most of them know better. To say that his law was going to prevent the next shooting was simply ego. He believed his own press clippings and his posturing before the dead were even buried just seemed like rank opportunism.
Mental health reform is an ongoing effort by many, many people with different values and priorities. Sometimes it is its own worst enemy. People who cant stand each other have a hard time standing together for anything. Murphy I hope has to some degree taught people they can find unity despite their differences. And maybe the fragile unity borne of him will be the biggest take-away from the entire thing.
He may indeed try again. He probably will. Dr. Torrey most surely will. He has won many, many short term victories and will doubtless win more, but the big prize has eluded him again. He is not the national spokesman he has annointed himself to be either.
Thanks for the support
by Larry Drain, hopeworkscommunity
The following organizations have offered support of "Dear Governor Haslam". They have put links to this site or printed the letters on their websites. I really appreciate it. I invite you or your organization to do the same.
Tennessee Health Care Campaign.
Tennessee Citizen Action.
Tennessee Disability Coalition.
Tennessee Chapter Depression and Bipolar Support Alliance.
WRITE GOVERNOR HASLAM TODAY
hopeworkscommunity | June 1, 2014
Helping me through my depression
Blogger, Kelley Baker, shares hints her family uses to help her through depression.
By Kelley Baker
Most of the time, I’m the one you call when you want someone to cheer you up. I like to dance. I love rock concerts, farmers markets, dogs and children. But there’s another side to me: I have been living with clinical depression since I was a child.
Thanks to treatment, coping tools and lifestyle changes—working from home, eating a natural diet—I am better now than I have ever been. Still, every so often I feel the depression returning. I have described it to my husband as a demon eating my brain.
I know it’s confusing for him as one day I seem fine and the next I am sad, distant, or even angry and pushing him away. And I know he wants to help me, but sometimes it’s hard for family members and friends to know what to do.
I had to learn how to be more open with my husband about how I’m feeling and what I need from him. These are some of the things I’ve shared with him:
Help keep clutter at bay. A person spiraling into depression may feel like they are slowing down while the world around them speeds up. The daily routine feels overwhelming: The mail stacks up, dishes pile up in the sink, laundry goes undone. It feels more and more impossible to keep up. Getting extra help with kitchen chores and other mundane tasks keeps things under control so everyone in the house is happier.
Pitch in on meal plans. People who are depressed tend to either eat too little or overeat—usually going for something less than nutritious. Plus, driving through the pick-up lane at a fast food restaurant or ordering a pizza feels so much more manageable than fixing a meal. Having someone make a healthy meal not only contributes to my physical and mental well-being, but also eases my “mom guilt” over what my kids are eating.
A simple ‘Do you want to tell me what you’re feeling?’ makes me feel less alone.
Ask how I’m feeling. If I am able to articulate what I am going through, it helps my husband understand what I am dealing with—and sometimes it helps me understand better, too. Unfortunately, I won’t talk about what I’m going through unless someone asks me. I don’t want to impose, or I don’t think they care. A simple “Do you want to tell me what you’re feeling?” makes me feel less alone.
Encourage self-care. A lot of things fall by the wayside during a depression, including personal appearance. Brushing your teeth and taking a shower just don’t seem to matter—much less getting a haircut or going to the dentist. It all just seems too hard. That attitude can snowball quickly into greater feelings of worthlessness: “Now I’m such a mess, no one could ever love me.” Hearing something like, “I’m going to do the dishes, why don’t you go enjoy a bubble bath?” is often what I need to make me feel okay about doing something self-loving.
Offer a hug. Studies show that a sincere hug lasting longer than 20 seconds can release feel-good chemicals in the brain and elevate the mood of giver and receiver. The fact that people who are depressed often don’t want to be touched can make this tricky, but a hug from the heart, with no expectation of anything further, just may help.
Offer reassurance. Along with the feelings of worthlessness, anger and even guilt that are part and parcel of depression, there’s often fear of ending up alone because really, who would want to put up with these episodes forever? Being reassured I won’t scare away my family because I have an illness takes a huge weight off my mind.
Give a reality check. A never-ending loop of painful, destructive thoughts—“I’m unlovable, I’m a failure, I’m ugly, I’m stupid”—loop through the mind of someone with depression. When my husband reminds me how hard I worked to get a teaching credential, or tells me I’m a great mom or that he loves me, it helps me keep those kind of thoughts in check.
Remember the good. When I’m depressed, I sometimes forget that I was ever happy. Looking at pictures of vacations with my family, watching home movies, hearing things from my husband and kids that they like about me, reminds me that while I may feel sad or numb right now, I’ll get through it.
Why Can’t Doctors Identify Killers?
Will you speak???
When you strip away all the fancy words and the tons and tons of rhettoric about what the Murphy Bill says and simply ask yourself "What is the plan?" you get a few core ideas. What does Rep. Murphy think we actually need to do to serve the severely mentally ill? There are many other provisions of the bill that has nothing to do with what I am about to talk about. Many of them are the most positive features of the bill. But this is what I think the essence of the Murphy plan is. These are his bottom lines. These are his "new ideas."
He believes, in effect, that many of the severely mentally ill suffer from a defiency of psychiatric hospitalization. He seems to see that as the answer to so many people with "mental illness" being in jails and prisons. He thinks that way too many hospital beds are gone and it is time to increase hospitalization radically.
Perhaps I am wrong but I believe that ship has sailed. A mental health system with psychiatric hospitalization as its corner stone is not financially sustainable in this country. Insurance companies pay less and less for it. They do not see it as medically necessary but in the most extreme circumstances and then for brief periods of time. In Tennessee I believe most psychiatric hospitals are struggling to break even and most of them are losing that struggle. States are getting out of the business. They realize that a large hospital system leaves them unable to finance a community system and if you dont have a community system to serve the people coming out of the hospital what is the point of the hospital. If you look at how often and how quickly people leaving the hospital system end up back there you begin to realize the impact of disemboweling the community system. I cant even imagine the circumstances under which Tennessee would act to increase the beds in any kind of dramatic way, indeed in any way at all. It is far too little bang for way too many bucks.
His method for making psychiatric hospitalization possible is to remove the IMD exclusion on medicaid funding. Basically it makes it possible for medicaid to then pay for state psychiatric hospitals. One question comes to me immediately. If Congressman Murphy thinks that medicaid funding is such an important part of mental health reform why did he vote to repeal the ACA over 50 times? That bill through its provisions for medicaid expansion would have given millions of people with "mental illness" access to programs and services that if he has his way they will never access.
A couple of other questions come to mind. What about the people who dont have medicaid access? Many people with "mental illness" and particularly many people who are having serious problems in life simply dont have insurance. Another question is the response of states to finding out now that medicaid funds can pay for psychiatric hospitals. In most states that I am aware the medicaid program eats up a considerable portion of their state budget and I really question, particularly in the states that choose not to expand medicaid, how receptive they will be to finding out that medicaid expenses are about to soar through the roof. In Tennessee the most likely two responses are to adopt the private insurance definitions of medical necessity and decide not that many people need hospitalizations and/or cut benefits and provider payments to pay for any any expenses the increase in hospitalization is likely to cause. The provider rates for psychiatric care, at least in Tennessee, are so low that very few people will even provide services anyway and there is a serious real question about where the professionals to do all this treatment are to come from.
Even if you start to use medicaid funding it does not begin to pay for all the new costs. The state institutions in Tennessee for example are aging. There is a need for new buildings and new spaces if beds are added. Who pays for new hospitals?? What about the cost of new staff?? Who pays? I can only speak to Tennessee but there is no commitment to psychiatric hospitalization, especially on a massive scale, as the answer to anything by state officials, by mental health professionals. by anyone that I know and removing the IMD exclusion is unlikely to change that. The strong perception is that the community system is the most cost effective and effective means to help people meet their needs and that it is defiencies in that system that lead most to people falling through the cracks.
And even if it was possible would it work?? I know of no evidence, that other than providing a place for stabilization, that psychiatric hospitals work in any enduring fashion. They dont, if you look at return rates, even work well enough to keep people out of psychiatric hospitals.
I dont know but would be willing to hazard a guess that many of the "mentally ill" in the prisons and jails have had considerable psychiatric experience with little or no solid gains. Criminal behavior is not a symptom of mental illness and the "put them in the hospital" solution ignores things like poverty, drug addiction, racism, lack of work, homelessness and history of trauma and other adverse events that lead to someone actually committing criminal acts. The other thing to consider is not the degree to which "mental illness" causes criminal behavior but the extent to which incarceration causes "mental illness." Is treatment needed?? Are mental health resources needed and might for some people those resources be inpatient resources??? Of course. I wonder what percent of those people in jail would even meet the criteria for hospitalization?? I dont know the answers but tend to believe it is the lack of effective and accessible community resources that engender emotional involvement with the people they serve that is the root of the great numbers of "mentally ill" in jails and prisons.
Another core point of Murphy is that he believes that too many people get mental health services and that it is the "worried well " that are basically stealing resources that are better used by the severely mentally ill. Given the fact that most mental health systems have been starved and cut back over the last few years it seems a little like telling one person eating bread and water that the the person next to him is eating too much bread and water and not considering that the problem is the diet of bread and water. It is an argument of little integrity that resorts to an us vs. them argument as a pseudo explanation. It ignores totally the fact that state legislature after state legislature has sacrificed their mental health system on the fires of "financial responsibility" over the last few years.
There are without question people who are victims of a psychiatric system eager to diagnose every event in life as an enotional illness. There is a reason that pharmaceutical companies make money. But there are also people who struggle every day with serious mental health issues, trauma, and distress and to dismiss those people as dupes or malingers is stupid, dishonest and evil. If you think the biggest problem in the mental health system is that too many people need or are seeking help then you are a simple minded person not worthy of being taken seriously.
If you take the notion of "worried well" seriously it takes you to some strange places. How do you decide who is "worried well"? Who decides? Based on what criteria? What do you do to the "worried well"? Do you limit their access to services? How? How much and why? If you dont limit their access to services arent you being complicit in the people who need help being hurt?? And how much is all this going to cost?? Do we need programs to make sure that people who need services get them and another program to make sure those that dont are kept out. This is a treacherous notion that if you take serious leads to nightmares.
Another core notion is making assisted outpatient treatment a law in every state. They tell you that aot is a major problem solver but dont really explain why most of the 45 states that have it dont really use it. And they dont really explain why you need to make something a federal law that is already a state law. And they dont really explain why if 45 states can choose to have it 5 states cant.
I think the truth is that most states who are not willing to throw $32 million a year at it like New York find it more irrelevant than anything. It costs too much and does too little and in an environment of increasingly limited resources is not something that a lot of people are going to turn to to solve many things. And none of this even begins to touch on the questions of choice and coercion that so many people find so fundamentally troubling.
Another core notion of the Murphy Bill is that too many people complain about the human rights of people in the system being important and those people need to be quiet. It would basically eviscerate the protection and advocacy programs like Paimi and legislate away their voice. The idea that people in the system dont need protection is naive and self serving and something you might figure a psychologist or psychiatrist might come up with. Ask anybody in the system. See how safe they feel in the system.
The final key element is to do away with the notion of recovery and the best way to do that is to cut the legs out from under Samsha. Samsha is as close to a boogeyman as there is in this play. They are blamed for everything bad that has happened or will happened. The fact that thousands of people have found recovery to be a real thing is explained away by saying they probably didnt need help anyway or that they are in a remission that would have happened anyway regardless of what they did. If you dont like what you see it works really well to convince yourself that it was really something else.
Samsha is blamed for many things it doesnt decide about. The state of Tennessee decides what kind of services it will offer the people it serves....not Samsha.
Like I said at the start there is more to the Murphy Bill than what I have described here. He took a lot of peoples good ideas and made them part of his bill. None of them seem though to be core elements that define the bill and that is a shame. He has told people he will work with them on a better bill but no one knows what that means because he has compromised on nothing. I have been told by a lot of people I know that is bill is in trouble and very unlikely to be passed as written. I dont know how true that is, but know it is in everybodies best interest to know the bottom lines of what he proposes and decide what that means for them and the way they would like to see the mental health system change.
hopeworkscommunity | May 16, 2014
What is borderline personality disorder?Borderline personality disorder is a serious mental illness marked by unstable moods, behavior, and relationships. In 1980, the Diagnostic and Statistical Manual for Mental Disorders, Third Edition (DSM-III) listed borderline personality disorder as a diagnosable illness for the first time. Most psychiatrists and other mental health professionals use the DSM to diagnose mental illnesses.
Because some people with severe borderline personality disorder have brief psychotic episodes, experts originally thought of this illness as atypical, or borderline, versions of other mental disorders.1 While mental health experts now generally agree that the name "borderline personality disorder" is misleading, a more accurate term does not exist yet.
Most people who have borderline personality disorder suffer from:
According to data from a subsample of participants in a national survey on mental disorders, about 1.6 percent of adults in the United States have borderline personality disorder in a given year.2
Borderline personality disorder is often viewed as difficult to treat. However, recent research shows that borderline personality disorder can be treated effectively, and that many people with this illness improve over time.1,3,4
What are the symptoms of borderline personality disorder?According to the DSM, Fourth Edition, Text Revision (DSM-IV-TR), to be diagnosed with borderline personality disorder, a person must show an enduring pattern of behavior that includes at least five of the following symptoms:
Suicide and Self-harmSelf-injurious behavior includes suicide and suicide attempts, as well as self-harming behaviors, described below. As many as 80 percent of people with borderline personality disorder have suicidal behaviors,7 and about 4 to 9 percent commit suicide.4,7
Suicide is one of the most tragic outcomes of any mental illness. Some treatments can help reduce suicidal behaviors in people with borderline personality disorder. For example, one study showed that dialectical behavior therapy (DBT) reduced suicide attempts in women by half compared with other types of psychotherapy, or talk therapy. DBT also reduced use of emergency room and inpatient services and retained more participants in therapy, compared to other approaches to treatment.7 For more information about DBT, see the section, "How is borderline personality disorder treated?"
Unlike suicide attempts, self-harming behaviors do not stem from a desire to die. However, some self-harming behaviors may be life threatening. Self-harming behaviors linked with borderline personality disorder include cutting, burning, hitting, head banging, hair pulling, and other harmful acts. People with borderline personality disorder may self-harm to help regulate their emotions, to punish themselves, or to express their pain.8 They do not always see these behaviors as harmful.
When does borderline personality disorder start?Borderline personality disorder usually begins during adolescence or early adulthood.1,9 Some studies suggest that early symptoms of the illness may occur during childhood.10,11
Some people with borderline personality disorder experience severe symptoms and require intensive, often inpatient, care. Others may use some outpatient treatments but never need hospitalization or emergency care. Some people who develop this disorder may improve without any treatment.12
Studies suggest early symptoms may occur in childhood
What illnesses often co-exist with borderline personality disorder?Borderline personality disorder often occurs with other illnesses. These co-occurring disorders can make it harder to diagnose and treat borderline personality disorder, especially if symptoms of other illnesses overlap with the symptoms of borderline personality disorder.
Women with borderline personality disorder are more likely to have co-occurring disorders such as major depression, anxiety disorders, or eating disorders. In men, borderline personality disorder is more likely to co-occur with disorders such as substance abuse or antisocial personality disorder.13
According to the NIMH-funded National Comorbidity Survey Replication—the largest national study to date of mental disorders in U.S. adults—about 85 percent of people with borderline personality disorder also meet the diagnostic criteria for another mental illness.2
Other illnesses that often occur with BPD include diabetes, high blood pressure, chronic back pain, arthritis, and fibromyalgia.14,15 These conditions are associated with obesity, which is a common side effect of the medications prescribed to treat borderline personality disorder and other mental disorders. For more information, see the section, "How is borderline personality disorder treated?"
What are the risk factors for borderline personality disorder?Research on the possible causes and risk factors for borderline personality disorder is still at a very early stage. However, scientists generally agree that genetic and environmental factors are likely to be involved.
Studies on twins with borderline personality disorder suggest that the illness is strongly inherited.16,17 Another study shows that a person can inherit his or her temperament and specific personality traits, particularly impulsiveness and aggression.18 Scientists are studying genes that help regulate emotions and impulse control for possible links to the disorder.19
Social or cultural factors may increase the risk for borderline personality disorder. For example, being part of a community or culture in which unstable family relationships are common may increase a person's risk for the disorder.1 Impulsiveness, poor judgment in lifestyle choices, and other consequences of BPD may lead individuals to risky situations. Adults with borderline personality disorder are considerably more likely to be the victim of violence, including rape and other crimes.
How is borderline personality disorder diagnosed?Unfortunately, borderline personality disorder is often underdiagnosed or misdiagnosed.20,21
A mental health professional experienced in diagnosing and treating mental disorders—such as a psychiatrist, psychologist, clinical social worker, or psychiatric nurse—can detect borderline personality disorder based on a thorough interview and a discussion about symptoms. A careful and thorough medical exam can help rule out other possible causes of symptoms.
The mental health professional may ask about symptoms and personal and family medical histories, including any history of mental illnesses. This information can help the mental health professional decide on the best treatment. In some cases, co-occurring mental illnesses may have symptoms that overlap with borderline personality disorder, making it difficult to distinguish borderline personality disorder from other mental illnesses. For example, a person may describe feelings of depression but may not bring other symptoms to the mental health professional's attention.
No single test can diagnose borderline personality disorder. Scientists funded by NIMH are looking for ways to improve diagnosis of this disorder. One study found that adults with borderline personality disorder showed excessive emotional reactions when looking at words with unpleasant meanings, compared with healthy people. People with more severe borderline personality disorder showed a more intense emotional response than people who had less severe borderline personality disorder.6
What studies are being done to improve the diagnosis of borderline personality disorder?Recent neuroimaging studies show differences in brain structure and function between people with borderline personality disorder and people who do not have this illness.22,23 Some research suggests that brain areas involved in emotional responses become overactive in people with borderline personality disorder when they perform tasks that they perceive as negative.24 People with the disorder also show less activity in areas of the brain that help control emotions and aggressive impulses and allow people to understand the context of a situation. These findings may help explain the unstable and sometimes explosive moods characteristic of borderline personality disorder.19,25
Another study showed that, when looking at emotionally negative pictures, people with borderline personality disorder used different areas of the brain than people without the disorder. Those with the illness tended to use brain areas related to reflexive actions and alertness, which may explain the tendency to act impulsively on emotional cues.26
These findings could inform efforts to develop more specific tests to diagnose borderline personality disorder.6
How is borderline personality disorder treated?Borderline personality disorder can be treated with psychotherapy, or "talk" therapy. In some cases, a mental health professional may also recommend medications to treat specific symptoms. When a person is under more than one professional's care, it is essential for the professionals to coordinate with one another on the treatment plan.
The treatments described below are just some of the options that may be available to a person with borderline personality disorder. However, the research on treatments is still in very early stages. More studies are needed to determine the effectiveness of these treatments, who may benefit the most, and how best to deliver treatments.
PsychotherapyPsychotherapy is usually the first treatment for people with borderline personality disorder. Current research suggests psychotherapy can relieve some symptoms, but further studies are needed to better understand how well psychotherapy works.27
It is important that people in therapy get along with and trust their therapist. The very nature of borderline personality disorder can make it difficult for people with this disorder to maintain this type of bond with their therapist.
Types of psychotherapy used to treat borderline personality disorder include the following:28
One type of group therapy, Systems Training for Emotional Predictability and Problem Solving (STEPPS), is designed as a relatively brief treatment consisting of 20 two-hour sessions led by an experienced social worker. Scientists funded by NIMH reported that STEPPS, when used with other types of treatment (medications or individual psychotherapy), can help reduce symptoms and problem behaviors of borderline personality disorder, relieve symptoms of depression, and improve quality of life.32 The effectiveness of this type of therapy has not been extensively studied.
Families of people with borderline personality disorder may also benefit from therapy. The challenges of dealing with an ill relative on a daily basis can be very stressful, and family members may unknowingly act in ways that worsen their relative's symptoms.
Some therapies, such as DBT-family skills training (DBT-FST), include family members in treatment sessions. These types of programs help families develop skills to better understand and support a relative with borderline personality disorder. Other therapies, such as Family Connections, focus on the needs of family members. More research is needed to determine the effectiveness of family therapy in borderline personality disorder. Studies with other mental disorders suggest that including family members can help in a person's treatment.33
Other types of therapy not listed in this booklet may be helpful for some people with borderline personality disorder. Therapists often adapt psychotherapy to better meet a person's needs. Therapists may switch from one type of therapy to another, mix techniques from different therapies, or use a combination therapy. For more information see the NIMH website section on psychotherapy.
Some symptoms of borderline personality disorder may come and go, but the core symptoms of highly changeable moods, intense anger, and impulsiveness tend to be more persistent.34 People whose symptoms improve may continue to face issues related to co-occurring disorders, such as depression or post-traumatic stress disorder.4 However, encouraging research suggests that relapse, or the recurrence of full-blown symptoms after remission, is rare. In one study, 6 percent of people with borderline personality disorder had a relapse after remission.4
MedicationsNo medications have been approved by the U.S. Food and Drug Administration to treat borderline personality disorder. Only a few studies show that medications are necessary or effective for people with this illness.35 However, many people with borderline personality disorder are treated with medications in addition to psychotherapy. While medications do not cure BPD, some medications may be helpful in managing specific symptoms. For some people, medications can help reduce symptoms such as anxiety, depression, or aggression. Often, people are treated with several medications at the same time,12 but there is little evidence that this practice is necessary or effective.
Medications can cause different side effects in different people. People who have borderline personality disorder should talk with their prescribing doctor about what to expect from a particular medication.
Other TreatmentsOmega-3 fatty acids. One study done on 30 women with borderline personality disorder showed that omega-3 fatty acids may help reduce symptoms of aggression and depression.36 The treatment seemed to be as well tolerated as commonly prescribed mood stabilizers and had few side effects. Fewer women who took omega-3 fatty acids dropped out of the study, compared to women who took a placebo (sugar pill).
With proper treatment, many people experience fewer or less severe symptoms. However, many factors affect the amount of time it takes for symptoms to improve, so it is important for people with borderline personality disorder to be patient and to receive appropriate support during treatment.
How can I help a friend or relative who has borderline personality disorder?If you know someone who has borderline personality disorder, it affects you too. The first and most important thing you can do is help your friend or relative get the right diagnosis and treatment. You may need to make an appointment and go with your friend or relative to see the doctor. Encourage him or her to stay in treatment or to seek different treatment if symptoms do not appear to improve with the current treatment.
To help a friend or relative you can:
How can I help myself if I have borderline personality disorder?Taking that first step to help yourself may be hard. It is important to realize that, although it may take some time, you can get better with treatment.
To help yourself:
What if I or someone I know is in crisis?If you are thinking about harming yourself, or know someone who is:
For more information on borderline personality disorderVisit the National Library of Medicine's:
For information on clinical trials
National Library of Medicine clinical trials database
Information from NIMH is available in multiple formats. You can browse online, download documents in PDF, and order materials through the mail. Check the NIHM website for the latest information on this topic and to order publications. If you do not have Internet access, please contact the NIMH Information Resource Center at the numbers listed below.
National Institute of Mental Health
Science Writing, Press & Dissemination Branch
6001 Executive Boulevard
Room 8184, MSC 9663
Bethesda, MD 20892-9663
Phone: 301-443-4513 or 1-866-615-NIMH (6464) toll-free
TTY: 301-443-8431 or 1-866-415-8051 toll-free
Differentiating Borderline Personality Disorder from Bipolar Disorder
By BERNADETTE GROSJEAN, MD
Borderline personality disorder (BPD) and bipolar disorder frequently co-occur (numbers range from 8% to 18%), although they are distinct clinical entities (Paris J et al, Compr Psychiatry2007;48(2):145–154). A proper diagnosis guides the most effective treatment, but you’ve probably faced the difficult challenge of diagnosing these conditions, which share several clinical features.
BPD can be described by four types of psychopathology: affective disturbance, impulsivity, cognitive problems, and intense, unstable relationships. What’s most important—in addition to seeing that your patient meets DSM-IV criteria for BPD—is to establish that patterns of affective instability, impulsivity, and unstable relationships have been consistent over time. Thus, obtaining a detailed history is crucial. Also, the key features we see in BPD, such as dissociation, paranoia, and cognitive problems, are often affected by the patient’s environment and, particularly, his or her relationships. A patient might have a history of rapid and sudden deterioration when relationships change—such as threatening suicide after a breakup or severe mood swings when separated from her family. Generally, the more intense or significant the relationship is, the greater the risk of chronic stress and mood dysregulation.
Many of the same features are seen in patients with bipolar disorder, such as dysphoria, hyperactivity, impulsivity, suicidality, and psychotic symptoms. As a result, borderline patients with this cluster of symptoms are often misdiagnosed with bipolar disorder, possibly because of the effectiveness of psychopharmacological treatments for such symptoms. In fact, a more thorough assessment might show that these patients actually suffer from a personality disorder. In one study, more than one third of those misdiagnosed with bipolar disorder met DSM-IV criteria for BPD (Zimmerman M et al, Compr Psychiatry2010;51(2):99–105).
In BPD, mood changes are generally short-lived, lasting only for a few hours at a time. In contrast, mood changes in bipolar disorder tend to last for days or even weeks or months. Mood shifts in BPD are usually in reaction to an environmental stressor (such as an argument with a loved one or a frustration in the waiting room), whereas mood shifts in bipolar disorder may occur out of the blue. Some clinicians consider BPD an “ultrarapid-cycling” form of bipolar disorder, but there’s little evidence to support this link (Gunderson JG et al, Am J Psychiatry 2006;163(7):1173–1178). Patients with BPD might rapidly cycle through depression, anxiety, and anger, but these mood shifts rarely involve elation; more often, the mood shifts are from feeling upset to feeling just “OK.” Likewise, the anxiety or irritability of BPD should not be mistaken for the mania or hypomania of bipolar disorder, which usually involve expansive or elevated mood.
At a more existential level, patients with BPD—particularly younger patients— often struggle with feelings of emptiness and worthlessness, difficulties with self-image, and fears of abandonment. These are less common in bipolar disorder, where grandiosity and inflated self-esteem are common, especially during mood episodes. And while both conditions may include a history of chaotic relationships, a patient with BPD may describe relationship difficulties as the primary—or sole—source of her/his suffering, while the bipolar patient may see them as an unfortunate consequence of his behavior.
A pattern of self-harm and suicidality often serves as a cue for diagnosing BPD (but are not necessarily required). But both can be seen in bipolar disorder, too. In BPD, suicide threats and attempts may occur along with anger at perceived abandonment and disappointment. Patients often explain these impulses as a way to be relieved of pain, or to “stop their thinking,” more so than to end their lives, per se. Patients with BPD may experience “micropsychotic” phenomena of short duration (lasting hours or at most a few days), including auditory hallucinations, paranoia, and episodes of depersonalization. However, patients generally retain insight, and can acknowledge that “something strange is happening” without strong delusional thought. When psychotic symptoms occur in bipolar disorder, they happen in the context of a mood episode, they tend to last longer, and patients may be unable to reflect on their behavior.
Accurate diagnosis of BPD and bipolar disorder can be difficult, but it’s essential for proper treatment and optimal outcome. Remission rates in BPD can be as high as 85% in 10 years (Gunderson et al, Arch Gen Psychiatry 2011;68(8):827–837), particularly with effective psychotherapeutic treatments (Zanarini MC, Acta Psychiatr Scand 2009;120(5):373– 377). Unfortunately, such treatment is not always available. Some medications can be used in BPD, such as an SSRI for impulsivity, severe and persistent depression and/or suicidality, or an atypical antipsychotic for recurrent dissociative symptoms or disinhibition. However the only consensus seems to be that medications should be used as adjuncts to psychotherapy (Silk KR, J Psychiatric Practice 2011;17(5):311–319). The long-term use of a mood stabilizer or atypical should be reserved for known cases of bipolar disorder.
TCPR’s VERDICT: Clinicians sometimes think of a BPD diagnosis as pejorative (chronic and untreatable) and may be reluctant to disclose it, but patients and their families often find it helpful to be informed of the diagnosis. Similarly with bipolar disorder, accurate diagnosis often determines prognosis and effective treatment. For the clinician, however, it’s imperative that you make the proper diagnosis in these two often overlapping, but fundamentally quite distinct, conditions in order to optimize your patients’ outcomes.
If the mental health system was sane…
There would be a range of services availible reflecting the human needs of those it serves.
Those services would be availible to those that need them.
Those services would be based on what works, not what makes money, reflects any particular philosphy or interest, and not because it is what we are used to doing.
Asking for help would not label someone, brand them, be a cause of shame, a source of discrimination. Asking for help should not be a problem.
It would realize that lack of a place to live, lack of food, lack of adequate clothing, lack of a job are frequently barriers and problems for the people they serve and address them in a direct and effective manner.
It would know that inadequate health and inadequate health care are common problems for the people they serve and be part of an effort to serve the entire person in an integrated fashion.
The goal would be to empower, educate, and support people towards gaining control over their lives so as to maximize their chances of leading happy, meaningful and successful lives.
This would not be empty words, but a passionate conviction that fuels and structures everything done in the system.
It would not mistake the people it serves for the labels it places upon them.
It would know that the most important thing about help is that it is what you do with people and not what you do to them. It would see itself as partnering with the people it serves.
It would know that people can say no and that not be a symptom of illness or distress.
It would view peoples values, hopes, thoughts, and aspirations as a source of strength and not a symptom of illness.
It would take substance abuse ultimately seriously. Drinking and drugging are the two primary ways people with mental health issues try to treat themselves.
It would make sure that one of the core experiences that someone seeking help has is contact and interactions with others who have dealt with similiar issues. It would treat seriously the idea that you can learn from the experience of others and them from you.
It would not tell people who have hard times or more problems they have failed or are failures.
It would take the issue of trauma seriously. Knowing how people have been hurt and not being part of hurting them further should be cornerstones of the system.
It would treat the issue of what happens in jails and prisons to people with mental health issues as a moral outrage and the impulse to do something about it as a moral necessity.
It would be honest about the risks and benefits of psychotropic medication. Help people to make real and informed choices.
It would treat families as important and not as irrelevant or a threat to what it is doing.
It would treat justice as a driving force and value in everything it does.
It would be honest with the people it serves about what it doesnt know if it wants them to have trust in what it does know.
It would attack the issue of suicide with passion. No one should ever feel like death is the best solution to life.
It would tell people that no problems make you less human,
It would view hope as realistic and know that when they dont they do more harm than good.
Target Zero to Thrive This April
DBSA targets raising expectations for mental health treatment.
A month-long social media campaign, Target Zero to Thrive, challenges mental health care professionals, researchers, and individuals living with or affected by mood disorders to raise treatment goals to complete remission—to zero symptoms.
Of course the first priority for treatment is ensuring a person living with depression or bipolar disorder is out of crisis. However, too often the end goal established for successful long‐term care is for the person to maintain a stable mood. Better, or even stable, is not always well. Every person deserves the opportunity to not just survive but thrive, and to do that we need to ensure true wellness is the end‐goal for mental health treatment.
Consider this, successful treatment for cancer proceeds with the goal of removing every cancerous cell—to achieve complete remission. Why then, do we consider treatment for depression or bipolar disorder to be successful when symptoms persist, even if the person is considered to be stable?
The cost of settling for reduced symptoms is simply too great. It is, in fact, a matter of life and death—for when symptoms persist, individuals who have mood disorders are:
DBSA President Allen Doederlein shares, “Living with a mood disorder can damage hope and lower expectations; so a person may not expect or think they deserve a full life. We, as peers, clinicians, researchers, and family, need to help them expect and achieve more—by raising the bar for treatment. Targeting zero symptoms may seem like a formidable goal, but there are over 21 million reasons and Americans living with depression or bipolar disorder to make it a goal worth pursuing!”
(1) Am J Psychiatry. 2000 Sep;157(9):1501-4.
(2) J Clin Psychiatry. 2007 Aug;68(8):1237-45.
(3) Bipolar Disord. 2004 Oct;6(5):368-73.
(4) Psychiatr Serv. 2013 Dec 1;64(12):1195-202. doi: 10.1176/appi.ps.201200587.
Submitted by Jennifer Dochod, Legislative Liasion for DBSA Tennessee. The brief summary by Mr. Murphy's office highlights the points in the proposed Bill he drafted.
for the 18th District of Pennsylvania
Short Summary of The Helping Families In Mental Health Crisis Act (H.R. 3717)
Ensuring Psychiatric Care for Those in Need of Help the Most Rep. Tim Murphy, PhD
Mental illness does not discriminate based on age, class or ethnicity. It affects all segments of society. More than 11 million Americans have severe schizophrenia, bipolar disorder, and major depression yet millions are going without treatment as families struggle to find care for loved ones.
To understand why so many go without treatment, the Energy and Commerce Subcommittee on Oversight and Investigations launched a top-to-bottom review of the country’s mental health system beginning in January 2013. The investigation revealed that the approach by the federal government to mental health is a chaotic patchwork of antiquated programs and ineffective policies across numerous agencies.
Not only is this frustrating for families in need of medical care, but when left untreated, those with mental illness often end up in the criminal justice system or on the streets. The mentally ill are no more violent than anyone else, and in fact are more likely to be the victims of violence than the perpetrators, but individuals with untreated serious mental illness are at an increased risk of violent behavior. Tragically, undertreated mental illness has been linked to homicides, assaults, and suicides.
The Helping Families In Mental Health Crisis Act (H.R. 3717) fixes the nation’s broken mental health system by focusing programs and resources on psychiatric care for patients and families most in need of services. The legislation:
EMPOWERS PARENTS AND CAREGIVERS
What the investigation found:
Physicians are often unwilling to share or receive information with loved ones about an individual who has a serious mental illness and is experiencing a psychotic break because of complicated federal rules on communicating with immediate family members and caregivers. This scenario is especially problematic for parents of young adults with mental illness because psychosis begins to manifest between ages 14 and 25.
Clarifies Health Information Portability and Accountability Act (HIPAA) privacy rule and the Family Educational Rights and Privacy Act so physicians and mental health professionals can provide crucial information to parents and caregivers about a loved one who is in an acute mental health crisis to protect their health, safety, and well-being.
2332 Rayburn House Office Building | Washington, DC 20515
The Helping Families in Mental Health Crisis Act (H.R. 3717), Rep. Tim Murphy 2
FIXES THE SHORTAGE OF INPATIENT PSYCHIATRIC BEDS
What the investigation found:
There is a severe lack of inpatient and outpatient treatment options. Seventy years ago, the country had 600,000 inpatient psychiatric beds for a country half the size. Today, there are only 40,000 beds.
What the legislation does:
Increases access to acute care psychiatric beds for the most critical patients by making two narrowly tailored exceptions to the Institutions for Mental Disease (IMD) exclusion under Medicaid. The IMD exclusion is what originally caused the shortage of psychiatric beds.
ALTERNATIVES TO INSTITUTIONALIZATION
What the investigation found:
Approximately forty percent of individuals with schizophrenia do not recognize they have a mental illness, making it exceedingly difficult for them to follow through on a treatment regimen.
REACHING UNDESERVED AND RURAL POPULATIONS
What the investigation found:
The delay between a first episode of psychosis and the onset of treatment averages 110 weeks. Early diagnosis and medical intervention improves outcomes dramatically, but there is only one child psychiatrist for every 7,000 children with a mental illness or behavioral disorder.
What the legislation does:
Modeled on a successful state project in Massachusetts, the bill advances tele-psychiatry to link pediatricians and primary care physicians with psychiatrists and psychologists in areas where patients do not have access to mental health professionals.
DRIVING EVIDENCE-BASED CARE
What the investigation found:
The federal government spends $125 billion annually on mental health, but there is little interagency coordination on programs, nor does the federal government collect data on how mental health dollars are spent or whether those dollars are resulting in positive health outcomes.
What the legislation does:
Creates Assistant Secretary for Mental Health and Substance Use Disorders within the Department of Health and Human Services to coordinate federal government programs and ensure that recipients of the community mental health services block grant apply evidence-based models of care developed by the National Institute of Mental Health. The Assistant Secretary will ensure federal programs are optimized for patient care rather than bureaucracy.
The Helping Families in Mental Health Crisis Act (H.R. 3717), Rep. Tim Murphy 3
What the investigation found:
STABILIZING PATIENTS BEYOND THE ER
Access to physician-prescribed medication is vital for vulnerable individuals in avoid acute mental health crisis. Current policies that permit only “one drug” per therapeutic class policy ignore the clinical needs of individuals with mental illness who rely on vital, non-interchangeable prescription drug therapies.
What the legislation does:
Protects certain classes of drugs commonly used to treat mental illness so physicians have prescribe the right medication for those on Medicare and Medicaid similar to the protected classes for persons with epilepsy and cancer.
ADVANCES CRITICAL MEDICAL RESEARCH
What the investigation found:
The National Institute of Mental Health measures public health outcomes to develop medical models of care. For example, the Recovery After Initial Schizophrenia Episode (RAISE) project shows earlier intervention with treatment for a person at risk of developing full-blown schizophrenia allows patients to lead functional lives. The NIMH also excels at basic medical research, but lacks the financial resources.
What the legislation does:
Authorizes the BRAIN research initiative at the National Institute of Mental Health and encourages the agency to undertake additional research projects on serious mental illness and self- or other-directed violence.
HIGH QUALITY COMMUNITY BEHAVIORAL HEALTH SERVICES
What the investigation found:
Community Mental Health Centers receiving funds from the federal government receive lower reimbursements federal insurance programs than comparable care facilities.
What the legislation does:
Applies rigorous quality standards for a new class of Federally Qualified Community Behavioral Health Clinics (FQCBHC), requiring them to provide a range of mental health and primary care services.
DEPARTMENT OF JUSTICE REFORMS
What the investigation found:
Between twenty and fifty percent of the incarnated system inmates have a mental illness. Mental health courts have provided a cost-effective and responsible alternative to incarcerating the mentally ill.
What the legislation does:
So patients are treated in healthcare system and not warehoused in the criminal justice system, the bill reauthorizes mental health courts and requires the Department of Justice to collect more data on interactions between the police and the mentally ill. The bill also authorizes Byrne Justice Assistance Grants (JAG) to be used for mental health training of law enforcement and corrections officers.
The Helping Families in Mental Health Crisis Act (H.R. 3717), Rep. Tim Murphy 4
BEHAVIORAL HEALTH AWARENESS FOR CHILDREN AND TEENS
What the investigation found:
Despite increased medical and scientific research into the nature and source of serious mental illness, a mental illness stigma persists.
What the legislation does:
The Department of Education, working with mental health stakeholders, will undertake a national campaign aimed at reducing the stigma of severe mental illness in schools. The bill also reauthorizes the Garrett Lee Smith suicide prevention program.
INTEGRATES PRIMARY AND BEHAVIORAL CARE
What the investigation found:
Low-income individuals with serious mental illness and addiction disorders have high incidences of cancer, heart disease, diabetes and asthma. Untreated depression increases the risk of chronic diseases, and can double the cost of healthcare for health disease and diabetes. Integrating mental healthcare providers into electronic medical records systems will result in better coordinated care for patients as well as cost savings.
What the legislation does:
Extends the health information technology incentive program to mental health providers so they can communicate and work with primary care clinicians.
INCREASES PHYSICIAN VOLUNTEERISM
What the investigation found:
Health centers and mental health clinics are experiencing a staff shortage. Clinicians and healthcare professionals can volunteer at federal free clinics, but federal legal barriers and the high cost of medical malpractice insurance prevent them from doing so at community health centers and mental health clinics.
What the legislation does:
Eliminates federal legal barriers under the Federal Tort Claims Act preventing physician volunteerism at community mental health clinics and federally-qualified health centers.
REFORMS THE SUBSTANCE ABUSE & MENTAL HEALTH SERVICES ADMINISTRATION
What the investigation found:
Unauthorized in the last decade, the Substance Abuse and Mental Health Services Administration has lacked mission focus. Grant programs are not evidence-based or guided by the best available medical science.
What the legislation does:
Emphasizes evidence-based treatments, sunsets unauthorized programs, and strengthens congressional oversight of all federal behavioral health grants.
by Larry Drain
GOP Newtown bill hits impasse | TheHill
It sounds based on reports like these that the Murphy Bill is not going to pass as written. Things change I know, but it looks that way. There is I understand a democratic bill being written by Rep. Barber. Things dont seem to look really great. The really interesting thing is that it might not matter rather or not the Torrey crowd thinks they have made a great case. It may only matter whether or not they find common ground with people up to now they have shown no interest in finding common ground with. Rhettoric that they are so good with may not be their friend. Winning the battle may cause them to lose the war.
The next few weeks, next few months may be interesting. Common ground.... what a weird approach to American politics.
hopeworkscommunity | April 23, 2014
More on our speaker series
We recently announced the beginning of our speaker series in Blount County sponsored by Maryville Nami. Our first speaker on March 20 will be Sita Diehl National Director of State Advocacy for Nami national. I am very excited today to announce our second speaker today. On April 24 Doug Varney Commissioner for Dept of Mental Health and Substance Abuse will be coming to speak in Maryville. Tentatively his topic will be the scourge of drug abuse, particularly prescription drugs and meth, their relationship to mental health issues and efforts by the state to address these issues. It should be a great and informative evening. Please do all you can to spread the word about both of these presentations.
It is unacceptable that people who are suffering from and struggling with mental health issues in their life be at risk of injury, trauma, assault or even death in their interactions with police officers whose only training as "being a good police officer" leads them to a course of action that produces tragedy. There is ample evidence that CIT training (Crisis Intervention Training) makes a difference. The "Memphis Model" has made an impact in many communities both large and small. Tragedies may continue to happen, but to expect and accept them as the cost of doing business as normal is simply and deeply wrong.
A few days ago I talked with a man whose 39-year-old "mentally ill" son had been attacked, beaten up and tasered by police in this community who "were doing their job." Over the last few days I have spent a lot of time thinking about other incidents I either have direct knowledge of or I have heard about. And it has left me deeply troubled.
There are lots of people to blame and many people seem intent on solving the problem by trying to figure out who to blame. I hear people talk about needing more psychiatric hospitals, more coercive treatment options etc. I dont think there are really going to be an appreciable increase in psychiatric beds regardless of where you stand on the argument, rather you think it is a good idea or not. Financially it simply not an option. Arguments that vastly increasing AOT (assisted outpatient treatment) can solve the problem are not honest or realistic.
Someone will be the next Kelly Thomas. Someone will be the next person a police officer faces on the street corner or in their home or in the jail. It is happening right now. It will be happening in a few minutes. It will be happening tomorrow. And what stops it from being someone you know, someone you care about, or even you.
It is pointless to bemoan the fact that police are being asked to do things they are not trained to do and then do absolutely nothing about providing them that training. It is as unfair to the officer who is trying to do the best he can as it is to the person he is trying to deal with.
As far as I know the decision to implement CIT training is a local decision and depends very much on the financial resources of that community as well as the commitment to training that local officials may have. Many communities, like the one I live in, have gotten officers involved in a piecemeal fashion but they are largely at the mercy of who offers the training and when.
Again, no one should be the victim of where they live. I have been following in recent days the effort of New York state to deal with the same issue. The proposal that is currently being fought over is whether or not to include in the state budget funds for what they are calling a "center of excellence for CIT training." The idea, as I understand it, is for the state to establish a resource that could help communities access CIT training in a way they can afford and in a way that is most effective to them. It shifts the burden of the argument from "is it practical? Can we afford to do it?" to "Can we afford to not do it?"
It is too late for anything like that to happen in Tennessee this year, but is not to late to start the conversation. Several other states already have chosen to establish something like "a center of excellence for CIT." Some have found access to federal funding. Others have found grants from other sources.
In the end, it not only saves lives but also saves money because of the injuries and traumas it prevents.
A couple of days I had a post which included a video of the beating of Kelly Thomas. I made myself watch the video several days before the post and was horrified. If you havent watched the video and still doubt the importance of what I am talking about watch the video yourself. I have also seen videos of other beatings from virtually all over the country. It is more than a Tennessee problem but it is a Tennessee problem.
In the days and weeks that follow I will be revisiting this conversation over and over. I am by no means anywhere close to an expert. If you think you know more than me on the subject there is a good chance you are correct. My goal is to start a conversation, a widespread conversation, in Tennessee that prepares the ground to talk about this issue not as one that affects isolated localities but every person in this state.
It is a conversation I hope you will join.
Larry Drain, hope works community blog
Mental health issues topic of presentations
By Linda Braden Albert | firstname.lastname@example.org | Posted 14 hours ago
A series of presentations on mental health issues will begin Thursday at the Blount County Public Library. The first presentation is by Sita Diehl, past executive director of the National Alliance on Mental Illness (NAMI) Tennessee and currently national director of state advocacy for NAMI National.
Larry Drain, recently named president of NAMI Maryville, said, “When they asked me to take the job, I really wanted to figure out a way not only to help NAMI but to help the community. Every day, nowadays, when you read the paper or watch TV or whatever, in one way or another, mental health issues are there. There’s a lot of bad information, misinformation, so the idea I had was that if we could bring a series of people to Maryville to talk about mental health issues, that would be a real, real positive thing for this community.”
Diehl’s current position entails her traveling from state to state, organizing efforts to make outcomes for mental health possible in each state, Drain said. “I’ve known her for years, and she was the very first person I asked. Her topic will be about finding support, whether you’re a family member, whether you’re somebody with a mental illness. She will talk a lot about NAMI, some about the mental health system in Tennessee. There will be a question and answer period after she gets through talking. Anybody who comes will be enriched by her.”
On April 24, Doug Varney, commissioner of mental health and substance abuse services for the state of Tennessee, will speak on mental health and drug addiction. Drain said, “I think he will talk some about prescription drugs and meth, what the state is trying to do to deal with some of these things. Especially in Blount County, it is such a live issue. ... He knows the topic inside out.”
Additional speakers in upcoming months include Ben Harrington, executive director, East Tennessee Mental Health Association; Scott Ridgeway, director, Tennessee Suicide Prevention Network; Allen Doderlain, national president, Depression and Bipolar Support Alliance; Pam Binkley, recovery coordinator, Optum Health, who will talk about emotional first aid; Lisa Ragan, director, Office of Consumer Affairs, Tennessee Department of Mental Health, who will speak on peer support, recovery, etc.; and Elizabeth Power, a nationally known expert on post-traumatic stress disorder. Mental health professionals from Blount Memorial Hospital have also been invited to speak.
Drain said, “I think this will be a quality addition to the Maryville community and I hope lots of folks will come. ... For a lot of folks here, the whole area of mental health, mental health treatment, the resources involved and things like that are so confusing. My hope is that all these speakers can shed some light, bring some facts and really help people in the Blount County area.”
Larry Drain, hopeworkscommunity
Alternative to Meds Center
By: Ericka G.
The script for my success journey had already played out in the optimistic stage of my mind prior to this life-changing breakthrough. Before this perceived notion of accomplishing the most profound discovery, there lied a mental environment of opposing views. The pivotal dynamic contrast that lied dormant was the hopelessness marked by my former psychiatrist’s repetitive voice relaying that psychotic medication intake would be for a lifetime. But something deep within surpassed this voice and rang out louder representing hopefulness with the confidence to know that holistic alternatives existed with healthier ways to manage my symptoms. Therefore, I launched a mission in search for this non-conventional approach through a few browse searches on Google and suddenly a vision was birthed to one day attend the “Alternative to Meds Center”. As anticipation rose to meet the eager embrace of new found hope, the circling theme that dominated my thoughts involved the declaration of healing that stood me right in the face the night before my arrival. This arrival of recovery victory existed prior to packing my bags and stepping on the soil of Sedona, Arizona to embark upon this outstanding program here at ATMC. With the proper mindset and motivated perception, the stabilizing tone was set for past frustration to become whole manifestation.
Though healing had already taken place, I forged a goal to become totally medication free to avoid the pulsating cardiac distress fueled by the side effects of Geodon. In addition, I didn’t want to play a prolonged game of Russia Roulette by taking a risk on a harmful medication that could cause future health issues. Stable and highly productive the last 8 years, through the collective effort of remaining true to my faith in God as I properly managed my symptoms, I gained the blessing of being hospital-free during this duration. This all-inclusive, holistic approach in addressing every angle of total well-being produced excitement coupled with enlightenment and elevation. With a willing and open receptiveness, I became a thriving “sponge” with the drive to advance my knowledge of the program’s teachings, tools, and training. From the moment I started the program, the enlightening mode of taking advantage of every nugget of information to better equip myself for mental health and physical wellness became the focal point of my positive interaction. Every aspect of the program especially the counseling has propelled me to new levels of understanding the greater need for self-care through diligence and improvement all in making me a more polished individual. The beneficial knowledge I received concerning the importance of supplementation to the health-conscious meals to the intensive detoxification process worked hand and hand to cohesively promote total restoration, mental clarity, and longevity. With these practices, the collaborative effort of the staff’s supportive attitude and expert awareness of the best solutions to all of my needs made this an exceptional experience. My gratitude continues to deepen, most importantly, to Mr. Lyle Murphy for making his vision a staple reality that would be successfully influential in making a difference for so many of us.
Medicare Rule Changes May Restrict Drug Choices for Seniors
The CMS decisions about which drugs to protect were supposed to be based on whether the drugs were needed to prevent increased doctor visits, hospitalizations, persistent disability, incapacitation or death that would otherwise occur within seven days if the drugs were not given. The choices about which drugs to remove from protection fail that test because, with acute mental illness, seven days without medication could easily lead to hospitalization, incapacitation or death. The same constraint exists for some 500,000 transplant patients. Seven days without the right medication could result in transplant rejection.
The quote above is from the article linked. My jaw dropped when I read it. CMS is proposing to drop certain drug classes from the status of protected medication. The idea is to save money. The article says it may save around 10% I believe.
My jaw dropped when I read the criteria. It basically says that if doing without a drug for 7 days wont kill you, incapacitate, or put you in the hospital you really didnt need it to the point where your access to the medication is guaranteed to begin with.
WHAT ABOUT THE EIGHTH DAY??
Is it just me or does this not sound simply stupid, simply arbitrary and simply mean? How in the world do you decide as a matter of cost containment that if someone doesnt die fast enough that dont really need a medication? Who should have that kind of power?? Should anyone??
I read all the stuff about percents...percents of cost...percents of savings. There is another "p" word-- PEOPLE. Somehow it seems like it got lost.
Larry Drain at HOPEWORKSCOMMUNITY
ACA Enrollment Ending Soon -
Hi folks, we just want to remind everyone that the enrollment period for Patient Protection and Affordable Care Act is drawing to a close for this season. The last day to enroll will be March 31st. To be covered by April 1st, the last day to enroll is even earlier - March 15. Enrollment will start up again November 15th and go through January 15th.
Below are links to Tennessee events and resources you might contact for enrollment assistance. Please forward this email to anyone and everyone you know who needs assistance or needs to hurry up and get covered already!
If you've already enrolled we'd love to hear from you. Click here to share your story and tell us about your enrollment experience.
Thanks everyone and best of health to you from all of us at THCC
By: Tennessee Health Care Campaign
Scott Walker Emails: Former Top Aide Wrote
'No One Cares About
Chris GentilvisoThe Huffington Post02/22/14 11:31 AM ET
Wednesday's release of thousands of pages of emails from Scott Walker's tenure as Milwaukee County Executive show a former top aide wrote that "no one cares about crazy people."
Back in 2006, the Milwaukee Journal Sentinel reported on the death of Cindy Anczak. The 33-year-old woman died of starvation complications while being treated at the Milwaukee County Mental Health Complex for bipolar disorder.
According to the Center for Media and Democracy's PR Watch, Anczak's parents filed a legal complaint in October 2010, which was brought by Walker staffers to the attention of then-Deputy Chief of Staff Kelly Rindfleisch.
"Totally coincidental to the election," replied Walker campaign advisor RJ Johnson, about the timing of the filing.
"Corp council [the County's attorney] wants to offer 50-100k," emailed Rindfleisch.
"Ok - any time after Nov. 2nd would be the time to offer a settlement," replied Keith Gilkes, who headed Walker's campaign.
"Barrett is going to make this the center of his campaign," Rindfleisch wrote in another email.
"yep and he is still going to lose because that is his base," replied Joan Hansen, a County official.
"Yep," Rindfleisch wrote. "No one cares about crazy people."
The AP noted on Wednesday that Rindfleisch was convicted in 2012 of felony misconduct in office for doing campaign work for a GOP lieutenant governor candidate on government time. She was sentenced to six months in jail and three years of probation, and is appealing her conviction on the grounds that Fourth Amendment rights were violated.
"Most of those would be four or more years old and they've gone through a legal process ... a multi-year extensive legal process by which each and every one of those communications was reviewed by authorities," Walker told reporters in Madison on Wednesday. "I'm confident that they reviewed them and they chose to act on the ones they've already made public."
A very personal plea for medicaid expansion: a letter to the governor
Dear Governor Haslam:
But my decision to write this letter is about much more than the peer support centers. In your state of the state message you talked a couple of times about the importance of government giving good customer service. You seemed to put a lot of stock in that idea. It was not the first time I have heard you speak about it. The decision to fund peer centers was a great example of good customer service.
My hope is that you will consider my request in the light of that concept. I am in a desperate situation and without your help I dont know where to turn.
I want to ask you to reconsider your stance on medicaid expansion. I know you are in a tough spot. Anything that makes the Tea Party mad faces great obstacles in Tennessee and few things make them angrier than health care reform. Perhaps what I am asking you is impossible for you to politically do. Several people have told me it is.
As I said my situation is desparate. Let me take a minute to describe it.
I have been “free” of health care insurance for many years. It is a freedom I would gladly lose. I have been told that I need surgery. The surgery is a minor one that thousands of people undergo every year. No insurance means no surgery. The doctor tells me the lack of surgery though may not be a minor thing though, that in fact if my condition should become an emergency my life may be in danger. I pray every day not to die a preventable death. Many people have far more dangerous situations than me and face far more immediate risk. Being poor should never, at least not in Tennessee be the cause of anyone’s death. And without action on your part it will be though.
My desperation though is not based purely on issues of my health. It goes far deeper than that.
My wife is disabled and has been on TennCare for a while. She is a TennCare miracle. Without it she would have died long ago. Even with all her progress without it she would no live a month. In order to save her insurance and in a very real sense her life after 32 years of marriage we have had to separate. I dont know, without TennCare expansion we can ever live together again.
The situation is very complex, but let me share it with you as briefly as I can. My wife receives SSI for disabilities. Recently I took retirement from Social Security. It was the worst decision I have ever made.
We found out that in Social Security’s eyes, even though our combined checks left us below poverty, we made far too much money. Linda lost over $700 and her check was reduced to $20 a month. I told Social Security that I would have to get a job in order for us to survive. We figured without her check we had about $40 to live on for the month of January and we just cant live like that. Who could??
Social Security told us that since her TennCare was disability based and not income based (like it would be if TennCare was expanded) that if I made over $85 a month her TennCare would be lost.
I love my wife and wont let her die. The day after Christmas we separated. The hope is that with a separate address she can regain her SSI check. My hope is to move as close to her as possible. Right now I do not see how we can ever live together again.
You do not make the rules for Social Security and none of that is your fault. The law is what it is and despite its cruelty and hurtfulness we have no choice but to do our best to live with it. A law that supports the break up of thousands of marriages seems so evil, but I dont right now see how I can affect it.
I am asking for your help though. Maybe I dont have the right but I have no where else to turn. I know you deeply love and care for your wife. What would you say to me if our situations were reversed??
Please act. Whatever the resolution please act. My wife will keep her TennCare. I will never do anything to put that in jeopardy. Without your help though my marriage will not survive and for Linda and I that is a death of a different sort.
S.L. Brannon D.Div..