Mental Health Prevention, Education, Recovery

1. Mental Health Prevention, Education, Recovery The Association for Natural Psychology For Behavioral Health Services, Mental Health Professionals and Facilities

2. Like tuning a violin… All photos in this presentation, with the exception of selected books, are courtesy of FreeDigitalPhotos.net http://www.freedigitalphotos.net . Violin Head " by nuchylee

3. The brain is a delicate instrument "Human Brain" by ddpavumba

4. 26.2% of U.S. population - approximately 1 in 4 Scope of mental health disorders in U.S. population According to the National Institute of Mental Health (NIMH), at any given year, An estimated 26.2 percent of Americans ages 18 and older — about one in four adults — suffer from a diagnosable mental disorder.1 When applied to the 2004 U.S. Census residential population estimate for ages 18 and older, this figure translates to 57.7 million people. 2 57.7 million people in U.S. The Numbers Count: Mental Disorders in America. National Institute of Mental Health (NIMH). http://www.nimh.nih.gov/health/publications/the-numbers-count-mental-disorders-in-america/index.shtml Silhouette guys walking" by sattva

5. Serious Mental Illness • 6 percent, or 1 in 17 — suffer from a serious mental illness.1 • The leading cause of disability in the U.S. and Canada.3 • Many suffer from more than one mental disorder at a given time. Nearly half (45 percent) of those with any mental disorder meet criteria for 2 or more disorders, with severity strongly related to comorbidity.1 The Numbers Count: Mental Disorders in America. National Institute of Mental Health (NIMH). http://www.nimh.nih.gov/health/publications/the-numbers-count-mental-disorders-in-america/index.shtml "Human Pyramid" by digitalartt

6. Education of the client/patient Self help Lifestyle changes Developing Coping Skills Bibliotherapy Prevention are key elements of success for long-term recovery. The first part of this presentation is to demonstrate that Section I

7. Sections I - IV • Part I Education, self help, lifestyle changes, developing coping skills, bibliotherapy, prevention – 54 slides • Part II Models of Mental Health – 11 slides • Part III Issues with Psychiatric Drugs – 19 slides • Part IV Psychiatric Facilities and Professional Approaches Towards Reduced Emphasis on Pharmaceuticals – 9 slides

8. Lifestyle adjustmentscan positively affect mental healthand that these need to be taught to the client/patient-synopsis • Section I • Education of the client/patient • Self help • Lifestyle changes • Developing Coping Skills • Bibliotherapy • Prevention

9. Developing coping skills-synopsis • is an important element to prevent relapse and to improve mental health outcomes. • Section I • Education of the client/patient • Self help • Lifestyle changes • Developing coping skills • Bibliotherapy • Prevention e.g. Journaling

10. Self Help, Education and Bibliotherapy - read a book!In the UK, British mental health professionals prescribe “Bibliotherapy” for their patients. Patients are required to read up on their mental health disorders, learn about causes, practical measures and self help.Some mental health professionals in the U.S. also prescribe bibliotherapy. “A growing number of therapists are recommending something surprising for depressed and anxious patients: Read a book.The treatment is called bibliotherapy, and it is gaining force from a spate of research showing that some self-help books can measurably improve mental health. In May alone, the journal Behaviour Research and Therapy published two studies demonstrating the effectiveness of bibliotherapy in patients with depression or other mood disorders. The national health system in Britain this year is prescribing self-help books for tens of thousands of people seeking medical attention for mood disorders.” Kevin Helliker. Bibliotherapy: Reading Your Way To Mental Health. (2007). Wall Street Journal. http://online.wsj.com/article/SB118583572352482728.html

11. Education is one of the keys to learning how to recover from mental health disorders, both serious and less serious disorders.This can lead to… • Lifestyle changes • Developing coping skills Lifestyle changes and developing coping skills are essential elements of successful recovery. Journaling Good nutrition

12. Mental Health America, a mainstream U.S. activist mental health non-profit recommends9 strategies for better mental health • Connect with others • Relax your mind • Exercise • Get enough rest 6. Keep a journal 7. Watch your negative self-talk 8. Get involved with spiritual activities 9. Write down 3 good things that happen to you each week.

13. Focus on: Nutrition • To select one area of lifestyle change – Nutrition Many who suffer from a broad arena of mental health difficulties and disorders, including sleep disorders, depression and bipolar disorder, as well as serious mental health disorders such as symptoms associated with schizophrenia, do well to give serious consideration to nutrition. Poor nutrition can precipitate Major Depression and other mental disorders, and positive lifestyle changes can make a big difference towards improvement in mental health.

14. Exercise Lifestyle change and coping skill Clinical studies indicate that exercise can be more effective than antidepressants for mild to moderate depression. (Duke University). Study: Exercise Has Long-Lasting Effects on Depression. September 22, 2000. Duke Today, (Duke University). http://today.duke.edu/2000/09/exercise922.html Other studies and observational evidence indicate that exercise can be effective for Major Depression. See Keith Johnsgard’s book (right), Conquering Depression & Anxiety Through Exercise.

15. Exercise for Depression • Harvard Mental Health Newsletter • and Mayo Clinic similarly recommend exercise for depression. "Feet Of Runner In Evening Light" by Sura Nualpradid Exercise and Depression. August 3, 2009. Harvard Mental Health Letter.https://www.health.harvard.edu/newsweek/Exercise-and-Depression-report-excerpt.htm Depression (Major Depression) - Depression and anxiety: Exercise eases symptoms. (2011, October 1). Mayo Clinic. http://www.mayoclinic.com/health/depression-and-exercise/MH00043

16. Exercise can positively affect mental health of individuals with bipolar disorder Dr. Gary Sachs, Director of the Bipolar Clinic and Research Program, Massachusetts General Hospital in Boston states that both exercise and lifestyle play a significant role in recover from bipolar disorder, though these are underutilized. How Can Exercise Or Lifestyle Help Bipolar Disorder? April 29, 2008. I ABC News. Interview with Gary Sachs, M.D., Director, http://abcnews.go.com/Health/BipolarTreatment/story?id=4360219#.UGcID5jMhOI Gary Sachs, M.D. Massachusetts General Hospital in Boston http://www.massgeneral.org/psychiatry/doctors/doctor.aspx?id=16732

17. Bipolar Disorder is proven to benefit from lifestyle changes. • Stanford University psychiatrist and professor Wes Burgess, M.D., Ph.D. notes that persons with bipolar disorder can experience up to a 30% decrease in symptoms by giving attention to… • diet • nutrition There is a high correlation between alcohol, past or present, abuse and bipolar disorder. New lifestyles need to be implemented for many. • exercise • quitting smoking • abstaining from alcohol • (from The Bipolar Handbook. Wes Burgess, M.D., Ph.D.)

18. Answer to problems of bipolar disorderGary Sachs, M.D., Director, Bipolar Clinic and Research Program, Massachusetts General Hospital • “The answer to the problems that bipolar disorder causes are not all medication-related. A healthy lifestyle, adopting an exercise program, not only helps regulate your circadian rhythms but can help you reach your life goals.” “It's extremely important to set out for yourself a purpose in life apart from managing your symptoms - to use lifestyle interventions to help regulate your sleep and wake cycles, your diet, and promote wellness by adopting a healthy lifestyle.”

19. Recovery, Remission and Self-Help for Bipolar Disorder Dr. Liz Miller is an occupational health physician in UK, with a background in neurosurgery. She developed mood mapping as a result of her own diagnosis of bipolar disorder, and her struggles to overcome it. Mood Mapping is one method of self help whereby individuals can gain insight and make needed adjustments.

20. “Cured of bipolar disorder” "I consider myself cured of bipolar, [ Bipolar 1 ] which I had for ten years, including three mental health sections and industrial quantities of psychiatric medication. I have been completely well for the last twelve years and not taken so much as an aspirin. I am certain that nothing can happen to bring it back again. I know I will never be manic or seriously depressed again. I see these conditions as nothing more than states of mind, which I have learnt to manage..." (quoted w/permission from Dr. Miller). U.K. Neurosurgeon Dr. Liz Miller

21. Bipolar Disorder I or IIare not necessarily lifetime disorders and some do fully recover to see their disorder go into permanent remission. Dr. Miller’s experience is not unique. This idea is supported by clinical psychologist and university professor of psychology, Donald J. Kiesler, PhD, as well as by mental health service providers in Quebec, Canada. Similar experiences verify that Bipolar Disorder I and II are not necessarily lifetime disorders.

22. Television and Depression • Television may cause or contribute to depression in some individuals. American psychologist in Britain, Aric Sigman, links a television lifestyle with higher rates of depression. This is a reasonable conclusion, as the passive nature of television lends itself well to a depressed state.

23. ½ hour of watching television can contribute to depression for some who may be pre-disposed towards depression Life Coach, author and relationship expert Mel Robbins states that only ½ hour of television makes her feel depressed. When television is a lifestyle, then both the passivity, as well as the depressing nature of the news and some news magazine programs, can contribute to depression in individuals. For some women, soap opera or novella addiction might contribute towards depression, as they never can attain to the level of relationships developed in this fantasy world. Life Coach and media personality Mel Robbins

24. Living Without the Screen For some, perhaps many, with mental health disorders, the lifestyle advocated by sociologist Marina Kromar is more conducive to good mental health. For those with any mental health disorder, the Association for Natural Psychology recommends a completely or relatively “screen-free” lifestyle, especially during the first six months to one year of recovery.

25. Pornography and Mental Health Disorders • Pornography addiction and/or excessive masturbation might also be a factor in depression or bipolar disorder for some. The absence of emotional bonding with daily sexual stimulation can create a vacuum of loneliness which leads to depression or emotional, behavioral, or psychological instability. Real relationship might become more difficult to manage in view of solitary sexual stimulation. University of Texas study links female masturbation to depression. Sexual Functioning and Self-Reported Depressive Symptoms Among College Women. Penny Frolich, Cindy Meston, University of Texas, Austin (2003) http://homepage.psy.utexas.edu/homepage/group/MestonLAB/Publications/depress.pdf

26. Self-HelpOvercoming Pornography Addiction • Ideas for Changing Pornography Usage • Change routines and environments that lead to pornography usage. Avoid high risk situations. • Make a list of the positive and negative consequences of using versus not using pornography. • Spend less time alone. Review the status of your friendships and relationships. Are they meaningful and satisfying? If not, what would make them more fulfilling? • Learn new ways of coping with strong feelings like anxiety, loneliness, anger, depression, and boredom. • Identify activities that can help you relax, enjoy yourself, and feel refreshed. • The following self-help web resources… University of Texas at Dallas http://www.utdallas.edu/counseling/pornaddiction/ How would you know if your pornography use is harmful to you? • The use feels like it is out of your control. You make unsuccessful efforts to quit or limit your use. • Your use of pornography is incompatible with your beliefs and values. You feel guilt, shame, depression, and/or remorse after using pornography. (it/bold added)

27. Psychotherapy, Talk and Cognitive Behavioral Therapy • Various psychological therapies can also be as effective as psychiatric drugs in the short and long-term for many. Therapy" by Ambro courtesy of FreeDigitalPhotos.com http://www.freedigitalphotos.

28. Cognitive Behavioral Therapy as Self-Help • Cognitive behavioral therapy can be employed as a self-help tool and mental health strategy. Learning to recognize and correct common faulty reasoning or cognitive errors can help some out of depression, including depression associated with bipolar disorder. There are many books similar to this self-help book.

29. Coaching Coaching for mental health, with its emphasis on practicality and sticking to treatment plans and goals, is an excellent tool which some have found as effective or even “more effective” than therapy. • Life Coachingcan be helpful for many high-functioning adults experiencing mental health difficulties or disorders. • Coaching for ADHDis totally mainstream and well-developed, supported by professional organizations. • Coaching for Bipolar Disorder, is not as well- • developed, however, there are experienced • coaches who specialize in bipolar disorder, who • have helped many towards the goal of managing • bipolar disorder, and some to full recovery. http://giantstepscoaching.com/category/home/

30. Coaching for Bipolar Disorder “I see it as my job to help balance the individual and encourage him to change some of his habits. For instance if he isn’t exercising or sleeping properly, I focus on those core habits then work on fine tuning other habits. I find people with bipolar disorder inherently unbalanced. I have to teach it to them.” Bipolar disorder coach, specialist, Bradley Foster.

31. Art as a Professional Therapyand as Self Help • Professional Art Therapy can be a form of therapy that is very effective for many individuals for a wide variety of mental health disorders. It can help people to open up when they might be reticent. • Art as self help can be very effective for most psychiatric disorders. It soothes the mind, helps individuals recover from stress trauma and is a natural aid for anxiety. Creating art can contribute to feelings of self worth and self esteem, as well as to inner peace.

32. Art Therapy is not an alternative treatment Art therapists are board licensed, and therefore art therapy is not an alternative, but mainstream psychological treatment. Art Therapy Photo: Creative Commons license

33. Art as self help for mental health disorders or difficulties • In Brazil, a Rio De Janeiran middle aged woman went to her doctor for help with anxiety. Rather than prescribe drugs, he encouraged her to take up art. She began taking lessons, and discovered she had a hidden talent. The art helped to relieve the stress and anxiety she was experiencing, and to get through a particularly difficult period of time in her life. She was 50 years old when she took up art. These are some of her works.

34. Music, Music Therapy and Mental Health • Music can have a positive influence on mental health when the music is positive, individuals listen to music moderately. • A wide variety of music can have positive affect on mood. Stevie Wonder, as an example, is known for quite a bit of positive, catchy music. More recently, Alicia Keys has some popular positive music.

35. Music Therapy can be effective when administered in clinical settings or in outpatient settings. From: American Music Therapy Association, Inc. How Does Music Therapy Make a Difference for Persons with Mental Health Needs? Music therapy is an efficacious and valid treatment for persons who have psychosocial, affective, cognitive and communicative needs. Research results and clinical experiences attest to the viability of music therapy even in those who are resistive to other treatment approaches. Music is a form of sensory stimulation that provokes responses due to the familiarity, predictability and feelings of security associated with it. Music therapy for clients with mental health concerns uses musical interaction as a means of communication and expression. The aim of therapy is to help individuals develop relationships and address issues they may not be able to address using words alone. Music therapy sessions include the use of active music making, music listening, and discussion. http://www.musictherapy.org/assets/1/7/MT_Mental_Health_2006.pdf

36. Type of music is a factor A Netherlands study indicates that the type of music adolescents choose can affect behavior. Some behaviors are symptoms of mental health disorders. Indirectly, then, type of music can be a factor contributing to a mental health diagnosis or label. Early Adolescent Music Preferences and Minor Delinquency. (2012, October 1). Tom F.M. ter Bogt, PhD, Loes Keijsers, PhDb, Wim H.J. Meeus, PhD. Pediatrics. http://pediatrics.aappublications.org/content/early/2013/01/02/peds.2012-0708 Choices in Music

37. When music is • Too intense • Negative • Or the listener listens to immoderate amounts of music It can contribute to depression, destabilization, anger problems, symptoms associated with bipolar disorder and other mental health difficulties. Early Adolescent Music Preferences and Minor Delinquency. Tom F.M. ter Bogt, PhD, Loes Keijsers, PhD, Wim H.J. Meeus, PhD. Oct 1, 2012. Pediatrics. http://pediatrics.aappublications.org/content/early/2013/01/02/peds.2012-0708 Bizkit - Break Stuff

38. Influence of Type of Music on Mood and Behaviors Rock Heavy Metal Gothic Punk R & B Hip-Hop Electronic dance The study states: “early fans of different types of rock (eg, rock, heavy metal, gothic, punk), African American music (rhythm and blues, hip-hop), and electronic dance music (trance, techno/hardhouse) showed elevated minor delinquency concurrently and longitudinally. Preferring conventional pop (chart pop) or highbrow music (classic music, jazz), in contrast, was not related to or was negatively related to minor delinquency.” Because musical taste often follows into one’s adult years, the emotions and behaviors acquired or influenced by certain types of music, for some, can be a factor in mental health disorders as adults or young adults (18 and older).

39. Natural Prozac • Clinical psychologist Joel Robertson establishes such a connection with music and depression, where the positive and negative effects of music on the listener are highlighted.

40. Amount of Time Listening to Popular Music Correlated with Major Depressive Disorder Time Listening to Popular Music Correlated with Major Depression - Major Depressive Disorder (MDD) - in Adolescents - Researchers at the University of Pittsburgh concluded that there is a correlation between Major Depression and the amount of time an adolescent spends with popular music. Conversely, Major Depression is negatively, or reversely correlated with reading print media such as books. Though the study focused on adolescents, there are many adults, especially those 18 through 25, for whom this might also be true. Using Ecological Momentary Assessment to Determine Media Use by Individuals With and Without Major Depressive Disorder. April 04, 2011. Brian A. Primack, MD, EdM, MS; Jennifer S. Silk, PhD; Christian R. DeLozier, BS; William G. Shadel, PhD; Francesca R. Dillman Carpentier, PhD; Ronald E. Dahl, MD; Galen E. Switzer, PhD. JAMA Pediatrics. http://archpedi.jamanetwork.com/article.aspx?articleid=384518

41. Positive adjustments in music • Making adjustments in music habits from intense to less intense. • and listening to music in moderate amounts rather than constantly – allowing for quiet time w/o external stimulation. • And by choosing positive rather than negative, anti-social, dark or angry music. "Piano" by healingdream "Shouting Woman Listening Music" by imagerymajestic

42. As noted, the brain is a delicate instrument In the same way a little bit of sand can ruin a car’s engine, there are many external factors which can cause the brain to malfunction or not perform optimally. "Human Brain" by ddpavumba "Close Up Of Car Engine" by Stoonn“ Psychedelic Guitar" by dan

43. Decreased cognitive capability Reduction in reasoning ability Sleep disturbances, nightmares Disorientation Short attention span Decreased stress tolerance Restlessness Fatigue Increased anxiety Irritability Loss of control Sensory Overload The Manual of Nursing Diagnosis lists “sensory overload” as a real condition, where “environmental stimuli” is above normal levels. This can resulting in…

44. Mental overstimulation through excessive media channels such as • Movies • Television • Music can be adjusted to more moderate levels, or even therapeutic levels, and this can have a positive mental health affect. However, the client/patient needs to be taught new life habits or adjust their lifestyle outside the clinical setting in order to benefit from a lifestyle that is more conducive to better mental health. “Front View Of Screaming Young Woman Listening Music" by imagerymajestic "Satellite Dish" by renjith krishnan

45. Thoughts do not originate with chemistry but with electrical charges. • Thoughts are sparked through electrical, rather than chemical charges. • It is only after the fact, between the synapses of the neurons, from thoughts already originating electrically, that the gap between synapses is crossed by chemical impulses in the form of neurotransmitters. The source of the errant thinking must be considered, the brain chemistry is often an after-fact, or may have a source that is controllable or modifiable. Mental disorders then, might more appropriately be referred to in terms of electro-chemical rather than as chemical imbalances. Neuron" by renjith krishnan

46. Addressing faulty thinking and external stimuli, we come closer to the source. By addressing thought and mood at its source, the electrical charge, rather than concentrating on the chemical neurotransmitter, we come closer to the source of faulty thinking, mental health or mood disorder. Image, Synapse, courtesy of Synapse Sheelam Ohan Some professionals consider referring to mental health disorders as a “chemical imbalance,” as inaccurate.

47. Differentiating between cause and effect There are some 23 different types of neurotransmitters in the brain. Thoughts start with electrical impulses that run through the individual neuron, nerve or, in this case, brain cell. The gap between neurons is referred to as the synapse. The electrical signal is converted to a chemical signal, as it bridges the synapse. The thought is then converted back into an electrical signal as it runs through the next neuron. The process is repeated through millions of neurons, to complete the thought, and possibly action of the body. The most well-known neurotransmitters are serotonin and dopamine.. Effect Depression, chemical imbalance of neurotransmitters

48. SSRI antidepressants SSRI antidepressants block the reuptake of serotonin into the nerve cell, by “plugging up” reabsorption points or “holes,” thus leaving more serotonin in the gap between the neurons.

49. Cognitive Behavioral Therapy Is more successful in treating depression and other mental health disorders for some people, because it addresses depression at the cause, and targets faulty thinking. It is assumed that the faulty thinking causes the depression, or causes the ultimate chemical imbalance of neurotransmitters, and that the chemical imbalance is not the ultimate cause of the depression. The positive affect, then, can be more long-term, as thinking and associated behaviors are corrected or adjusted. Effect Depression, chemical imbalance of neurotransmitters Cause Faulty thinking

50. Pharmaceutical drugs address symptoms rather than causes of mental health disorders • To illustrate: You can provide medicine to individuals with malaria, and they will experience relief. • However, the cause of the malaria is not a blood or organ imbalance, but a parasite. • The parasite is transmitted by a mosquito. By killing the mosquitoes, you are closer to the source of the problem. Mosquito In Nature" by SweetCrisis