Mental Health and Wellness - Western State Hospital Internship Program

August 08 2015

Managing My Illness?

How do I manage my illnesses? I go to my psychiatrist for tune-ups when I need it, and otherwise keep regular appointments with her. I go to my therapist as needed, and at one time was going weekly after my last hospitalization. The truth is…I don’t do all that I’m supposed to do all of the time. Why not? Because LIFE. I’m honest about it. I know what I’m SUPPOSED to be doing. I know what I did to get healthy. I know what I have to do to stay healthy….just sometimes, I don’t do those things, for various reasons. It shows up in my mental health.

As patients come in and out of the hospital, it may be frustrating to see the cycle. It may seem so simple to the average person. Just take your medicine. Go to your doctors. Why is it so hard? Because LIFE. I understand this. I am married to a very supportive person. He takes over the household responsibilities when I’m not doing well. If I have an exhausting day, he’s there to cook dinner for my two children, while he gives me time to rest. Not everyone has that.

I don’t always eat healthy meals, like I’m supposed to. The other day, I ate an Arby’s sausage biscuit for breakfast, a double cheeseburger from McDonald’s for lunch, and Taco Bell for supper. I’m still alive somehow. I don’t always get enough sleep, like I’m supposed to. I get too busy to make appointments with my therapist when I need to go. I try to be Super Mom to my kids, a Band Mom to 48 high school band kids, and work full time. Who has time to go to doctors, even if the therapist will see me on Saturday, which he will? That’s not an excuse, or shouldn’t be for me. It is incredibly easy to forget that I am not quite like everybody else, as much as I like to feel like I am. I can’t short-cut my health, or I might end up hospitalized again. Bipolar I is a serious mental illness, and I have it.

Medicine gets stolen (truly). Cars get flat tires and appointments are missed. Life gets overwhelming, especially when the mentally ill person has no one supporting them. It takes work to be a productive person who lives a self-directed life if one has a serious mental illness. Sometimes, despite good intentions and efforts, forces beyond the person’s control may keep the person from doing what he or she needs to do to become healthy. If you know someone with a mental illness, giving them a little support might make a world of difference.

Rebecca Coursey, KPS
Peer Support Specialist

August 08 2015

Friday Factoids: Relationship between Tobacco Use and Psychosis

Though an association between tobacco smoking and psychotic illness is well known, reasons for the association are more ambiguous. Recent research has associated smoking tobacco with an increased risk for developing psychosis (Gurillo, Jauhar, Murray, & MacCabe, 2015). The authors reviewed studies that reported rates of smoking in people with psychotic disorders compared with controls. They hypothesized that tobacco use is associated with increased risk of psychotic illness, that smoking is associated with an earlier age of onset of psychotic illness, and an earlier age of smoking is associated with increased risk of psychosis. Overall, though the association between tobacco use has been established, little attention has addressed if tobacco may actually increase the risk of psychosis.

Gurillo, Jauhar, Murray, and MacCabe’s (2015) analyzed 61 studies composed of 15,000 tobacco users and 273,000 controls. The results indicate that people who suffer from psychosis are three times more likely to smoke. Also, 57% of individuals with first episode psychosis were smokers. The risk of psychotic disorder increased modestly by daily smoking. In short, daily tobacco use was associated with increased risk of psychosis and with an earlier age of onset of psychosis.

Again, it is difficult to determine the direction of causality; rather an association between tobacco use and psychosis was supported. Also, the authors noted the possibility of publication bias might be present. Even still, the authors caution that smoking should be considered a possible risk factor for developing psychosis, and should not be construed as merely a consequence of the illness. Furthermore, consistent with the dopamine hypothesis, they suggest that nicotine exposure may increase the release of dopamine and cause psychosis to develop. Limitations include, a small number of longitudinal prospective studies and determining the exact consumption of other substances in some of the included studies. Of course the authors suggest more research is needed. Overall, they note that tobacco use may be a modifiable risk factor for psychosis, and every effort should be made to modify smoking habits in this population.

Gurillo, P., Jauhar, S., Murray, R. M., & MacCabe, J. H. (2015). Does tobacco cause psychosis? Systematic review and meta-analysis. Lancet Psychiatry, 2(8), 718-725.

Dannie S. Harris, M.A., M.A., M.A.Ed., Ed.S.
WKPIC Practicum Trainee

August 08 2015

Friday Factoids: Sleep and Brain Functioning

A Monday catch-up factoid!

We all recognize the importance of sleep, but there is emerging evidence that describes a causal relationship between sleep and emotional brain function (Goldstein & Walker, 2014). The literature indicates that sleep abnormalities are involved in nearly all mood and anxiety disorders. For example, as in Posttraumatic Stress Disorder (PTSD), Rapid Eye Movement (REM) sleep is diminished and disrupted. Goldstein and Walker (2014) propose that after a traumatic experience, REM sleep helps to decouple emotion from memory, and if this is not achieved, the process will be repeated in subsequent nights. What is experienced is a hallmark symptom of PTSD, nightmares.

Further, Major Depression is associated with exaggerated REM sleep, which includes faster entrance into REM sleep, increased intensity of REM, and longer duration of REM sleep (Goldstein & Walker, 2014). With this underlying disruption of REM sleep, individuals with Major Depression are noted to experience next-day blunting due to excess amounts of REM sleep, which alters PFC-amygdala sensitivity and specificity to emotional stimuli (Goldstein & Walker, 2014).

Overall, without sleep, the regulation and expression of emotions is compromised (Goldstein & Walker, 2014). Goldstein and Walker (2014) argue that REM sleep provides a restoration of “appropriate next-day emotional reactivity and salience discrimination” (p. 702). Consequently, emotional responsiveness, sleep, and consistent REM sleep promote the processing of emotional memories. REM sleep provides not only a therapeutic depotentiation of emotion from affective experiences, but also provides a re-calibration that restores emotional sensitivity and specificity. Thus, rather than being a symptom of a psychiatric disorders, the relationship between sleep and psychiatric disorders is now considered to be more causal and bidirectional (Krystal, 2012). In short, given this intimate and causal relationship highlights the importance of assessing for sleep disturbance, as well as informing intervention.

Goldstein, A. N., & Walker, M. P. (2014). The role of sleep in emotional brain function. Annual Review of Clinical Psychology, 10, 679-708.

Krystal, A. D. (2012). Psychiatric disorders and sleep. Neurologic Clinics, 30(4), 1389-1413.

Dannie S. Harris, M.A., M.A., M.A.Ed., Ed.S.
Psychology Practicum Student

July 07 2015

Peer Support and Holistic Recovery

Peer Support not only involves asking open, honest questions and listening, but it also involves modeling recovery. The certification gained through training does not guarantee that the Peer Support Specialist will be able to effectively model recovery to an individual. There are a few things that go into modeling recovery that a Peer Specialist may not think about, but are important.

An holistic approach to recovery by definition means that it involves the entire life of a person. Community, family, body, spirit, and mind are interconnected in recovery, and in order to recover from a mental illness and/or substance abuse disorder, all must be considered important. This is difficult to model and is a delicate balance to maintain. The Peer Specialist must do so to prove recovery is possible.

How can a Peer Specialist maintain this challenge? He or she can participate in community-based support groups or volunteer. He or she can do yoga or meditation to balance the stress of the mind and body. A hobby is also a great way to deal with stress. If spiritual, attending church, or maybe just regularly praying, is an idea. Eating a healthy diet and exercising is also a great way to model recovery.

All of the things listed above can be described to someone with whom the Peer Specialist is working. Recovery isn’t just about leaving behind a drug or alcohol addiction; it encompasses the entire being and moves past the label of “mentally ill.” We must take care of our mind, body, and spirit to move on to brighter days. A Peer Specialist must try to model this to others

Rebecca Coursey, KPS
Peer Support Specialist

July 07 2015

Friday Factoids: Optimal Rest for Children after Concussion

Standard care for children who have suffered from a concussion consists of rest. An environment where stimulation is minimized (no school, no physical activities, no strenuous cognitive activity, minimal social interactions, etc.) has been the standard recommendation for many years.

A recent study conducted by Danny Thomas and his colleagues yielded surprising findings regarding optimal length of rest for children and adolescents following a concussion. The study consisted of 88 participants between the ages of 11-22 who had been diagnosed with a concussion and discharged from the ER. One group was instructed to rest at home for one to two days, and the other for four to five days. Surprisingly, follow-up neurocognitive and balance assessments showed no differences between groups after 10 days, and the group that rested longer complained of more physical symptoms (e.g., headache, nausea) after one to two days, and more emotional symptoms (e.g., irritability, sadness) over the duration of the study.

The researchers hypothesized that resting at home for a longer period of time lead the participants to experience their symptoms as more severe and potentially life altering. With more research, there may be a shift toward recommendations for shorter rest in children who have suffered from a mild concussion.

Reference
http://pediatrics.aappublications.org/content/early/2015/01/01/peds.2014-0966.abstract

Graham Martin, MA
WKPIC Doctoral Intern

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Category Archives: Mental Health and Wellness

Managing My Illness?

Friday Factoids: Relationship between Tobacco Use and Psychosis

Friday Factoids: Sleep and Brain Functioning

Peer Support and Holistic Recovery

Friday Factoids: Optimal Rest for Children after Concussion

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