Mental Illness is a Surmountable Obstacle

~ Guest post by Jackie Cortez

According to the World Health Organization, 1 in 4 people suffer from mental illness. And while treatment is available, it’s often underutilized.

For many people, mental illness can be something that troubles them periodically in life but never something that incapacitates them. For others, mental illness can be completely debilitating. What’s important is recognizing mental illness and treating it with the best approach for people so they may live healthy, productive lives.

Inner turmoil

While there are social stigmas attached to mental illness, it is the self-stigma that can be the most dangerous to a person’s overall well-being. A person with a mental illness may feel ostracized from his peers and turn to outward or inward destructive behaviors to cope. These may materialize as bursts of aggression, depression, or isolation or as reckless actions including sexual promiscuity and alcohol abuse and drug abuse. A mental illness makes it difficult to see past the negative aspects of today to the bright and beautiful possibilities of tomorrow. It is estimated that more than 90% of suicides are committed by persons with a diagnosable mental disorder. Approximately half of these individuals will struggle with drug or alcohol abuse before their death.

Physical self-care

If you’re struggling with a mental illness, you should take extra care to take care of yourself. Stress takes a toll on the body and can cause headaches, insomnia, muscle tension, upset stomach, and fatigue. These symptoms’ impact can be lessened through protecting your physical health. It is easier to maintain good mental health habits when your body – your foundation – is strong.

It is important to exercise daily. This may be done individually or in a group setting as exercise provides the body with natural stress relief hormones. Maintaining a balanced diet devoid of processed foods, including sugars, additionally goes a long way toward whole-person health. Sleep is essential and most adults require between seven and nine hours each night; a brief 30 minute nap in the early afternoon can also offer a person with a mental health disorder a bit of a boost. Most importantly, drugs and alcohol should be avoided completely as, despite common belief, these substances actually exacerbate stress and depression.

A mental illness will not go away overnight. However, many people find they are less affected when they practice these good mental health habits:

Avoid guilt

Negative emotions happen and it is important not to dwell on them or pass judgment. Understand that it is how you react to these emotions that matters. Recognize them but don’t get caught up in the moment.

Pay attention to the positive

Even in your deepest, darkest hour, positive things are going to happen in your day. It could be as small as a glimpse of the mountains or fresh ocean breeze. When they happen, pause and enjoy. It may help to keep a journal and write down one good thing that happens each day. You can go back and read about your happy days when you’re feeling sad or stressed to remind yourself that not everything in life is bad.

Find strength in numbers

There are virtually countless support groups in every city in every state for people struggling with mental illness. You can perform a quick online search for groups in your area. Know that you cannot solve things on your own and there are people out there who, like you, are dealing with invisible and taboo issues. Spending time with others will not only help you get things off your chest but will keep you connected to the world around you.

If you or someone you love is dealing with a mental health issue, such as depression or drug abuse, get help. Always remember there is no shame in asking for assistance from others, be they medical professionals, family, or friends. Tomorrow is a new day and a new opportunity to look at the world with a fresh set of eyes.

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~ Jackie Cortez works with The Prevention Coalition to identify and highlight resources on every aspect of substance abuse, ranging from prevention to addiction treatment. Her mission is to use her writings to help prevent drug and alcohol abuse.

Keep the Pace – A Meditation

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When it comes to mental illness, often our moods are “all or nothing.”  We are either on top of the world or in the pit of despair.  If we are not careful, our behaviors can reflect our emotions, leading to chaos in our lives and problems in our relationships with others.

When it comes to the emotional ups and downs of mental illness, we can fight the temptation to act on them by remembering the phrase “Keep the Pace.”  In other words, let’s keep doing what we do when we are stable.  Let’s keep showering and going to bed at a decent hour.  Let’s keep eating as healthy as we can and exercising moderately.  Let’s keep our social activities up, but not excessive, and our verbal and physical boundaries intact and closely moderated.  Let’s maintain an appropriate number of projects, neither dropping them all due to inertia nor starting too many.

When I feel myself slipping into either an elevated or a depressed mood state, I will remind myself to “keep the pace” and not feed into the insanity of my disorder by changing my behaviors too drastically.  Just like a marathon runner, who neither sprints nor ceases to run at all, I must pace myself to participate fully in the race, and then I will know peace.

Neuroimaging Shows Increased Activity in Bipolar Mania

In a recent study looking at the difference in neural activity between persons with bipolar I disorder who were experiencing mania, those with bipolar I disorder who were experiencing euthymia or a normal, non-depressed mood, and persons who did not have any psychiatric disorders and were considered “healthy controls,” researchers found some significant differences in two brain networks.

The first was in the Dorsal Attention Network (DAN), which is a group of regions in the brain that plays a large role in our internally motivated goals using our visual attention and short-term memory processes. In other studies, increased activity is evident in the DAN after the presentation of cues indicating where, when, or to what participants should direct their attention.

In this study, those individuals who were manic had significantly higher levels of activity in their DAN compared to the euthymic group and the healthy control group, possibly explaining the often apparent hyperattention, arousal and emotional response of those experiencing mania to external stimuli.

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This figure shows the increase of connectivity in mania (A) versus euthymia (B)

The second brain area assessed was the Default Mode Network (DMN), which is a group of brain regions that shows a lower level of activity when we are working on a particular mental task like paying attention, but higher levels of activity when we are doing more generic thinking tasks such as daydreaming, recalling memories, guessing about the future, monitoring the environment, speculating on the intentions of others – just thinking without any task-oriented goal in mind. Recent research has begun to find connections between the DMN and mental illnesses like anxiety and depression. Also, meditation is thought to be related to the DMN, which may be why its influence in well-being is significant.

Of particular note in this study, was the fact that those with bipolar disorder in a euthymic state showed hypo-connectivity in the dorsal nodes of their DMN compared to the mania group and healthy control group. The mania and healthy control groups showed the same connectivity.

Does this mean that the euthymic group was more relaxed, less worried about the past and future, less concerned about their surroundings and the behaviors of others than the other groups? Even the “healthy” group? I don’t know. The researchers didn’t comment on what this particular finding suggested other than the fact that this dorsal node is the exact location that corresponds to the target for transcranial magnetic stimulation (TMS) for the treatment of depression, even though they made sure to reiterate the fact that the euthymic group was not depressed.

The researchers pointed out the fact that their study’s results contribute to a body of growing evidence that points to bipolar mania as a behavioral pathology due not to circuit disruption but rather increased coherence (connectivity).

As far as the hypo-connectivity of the dorsal nodes of the DMN in the euthymic group goes, the researchers were not sure if this was due to a compensatory mechanism of the disorder trying to right itself or if it was in fact still part of the diseased state.

Of note:
– Diagnosis was determined using the Structured Clinical Interview for the DSM-IV (SCID)
– Limitations of the study included a small sample size of 23 manic, 24 euthymic, and 23 healthy controls.
– There were no significant differences in participant age, sex, and medications

Resources:

Differential brain network activity across mood states in bipolar disorder
Dorsal Attention Network
Dorsal and Ventral Attention Systems
Know Your Brain: Default mode network

Bipolar Brains Are Different

In the largest MRI study on people with bipolar disorder, researchers determined that the areas in the brain that control inhibition and emotion – the frontal and temporal regions – are significantly different than those of people without the disorder.

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Bipolar patients tend to have gray matter reductions in frontal brain regions involved in self-control (orange colors), while sensory and visual regions are normal (gray colors). Credit: Image courtesy of the ENIGMA Bipolar Consortium/Derrek Hibar et al

 

The study was led by the University of Southern California Stevens Neuroimaging and Informatics Institute at the Keck School of Medicine of USC: ENIGMA (Enhancing Neuro Imaging Genetics Through Meta Analysis). It involved 76 centers and included 26 different research groups around the world.

The researchers measured the MRI scans of 2,447 adults with bipolar disorder and 4,056 healthy controls. They also looked at the effects of commonly used prescription medications, age of illness onset, history of psychosis, mood state, age and sex differences on cortical regions.

Some findings suggest those with a history of psychosis have greater deficits in the affected regions and there are “different brain signatures in patients who took lithium, anti-psychotics and anti-epileptic treatments.”

Further studies will look at how these medications affect brain measures and subsequently, modify symptoms and outcomes for patients. “This new map of the bipolar brain gives us a roadmap of where to look for treatment effects,” said Thompson, an associate director of the USC Stevens Neuroimaging and Informatics Institute at the Keck School of Medicine.

I think it is awesome that they are finding physical proof of the nature of bipolar disorder; that it is not some myth or personality flaw or weakness or moral shortcoming. These findings can give people like me the validation they need to know that they are not “crazy,” but ill.

Having a brain that doesn’t function normally is no different than having a pancreas that doesn’t function normally (diabetes.) Granted the symptoms of bipolar disorder may affect those around the individual more severely than the symptoms of diabetes, but the general analogy is still the same.

Article source

Is a Daily Routine or An Unstructured Lifestyle Better for Our Mental Health?

When I was first diagnosed with Bipolar Disorder my life was in complete chaos. I had a job that didn’t have set hours, with responsibilities and a caseload that changed on a daily basis. Plus, I had three small children with a husband who worked varying hours, including nights and weekends. My days were anything but routine.

Fast forward five years later, and I am a stay-at-home mom with a set routine of getting up at the same time every morning to get the kids off to school, work on house chores during the day as my illness allows me, rest in the afternoon, be there for the kids when they get home from school and in the evening for school and sport events. I also take my medications on a routine schedule and go to bed around the same time every night.

Researchers have demonstrated that routines can help those with bipolar disorder by balancing their sleep/wake cycles. Routines can also help those with anxiety by making daily activities more manageable and predictable. Routines help us get more stuff done by keeping us on task, thus providing more time for rest and relaxation, which is also good for mental health. And routines give us a sense of control over our lives since we get to choose what we include in them.

I do find that as my illness symptoms creep back into my life, there is sometimes the need for flexibility in my routine. For example, when I am fatigued from depression, I may spend more time in bed and less time on chores.

However, after a few days or a week, my routine usually kicks back in and I am at least doing a little bit each day. While I might not feel motivated to engage in my routine, my routine motivates me to get things done, because it is what I am used to doing. It doesn’t feel right to not do it.

What about you?  Are routines good for your mental health or do you prefer an unstructured lifestyle?

Education is Key – A Meditation

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When we have a mental illness, it’s imperative to learn all we can about it in order to understand it, because understanding leads to the best collaboration with healthcare professionals when making decisions for our care and medication and treatment choices. Understanding leads to the best advocacy for ourselves when dealing with employers, family, and friends who may or may not get how mental illness affects our performance and behaviors. Understanding leads to self-compassion and patience during times when we are feeling low and can’t do what we want. Knowing it is part of the disease and not part of our character can help save our self-esteem and self-worth.

Today, I will ask my healthcare professional for, or research on my own, two sources to learn something I didn’t already know about my mental illness.

To the Worrier – A Meditation

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Worrying is a natural part of life. There isn’t one adult person who hasn’t worried about something at some point in his or her life. It is when the worry starts affecting your mental health by way of anxiety and depression, and your physical health (your sleeping, your eating, ulcers, etc.) that it becomes a problem.

We live in a time-based reality. Past, present, and future. Worrying is a past and future minded activity. We are either thinking about something in the past that has already happened, or thinking about something in the future that hasn’t happened yet (and sometimes about something in the future that may or may not even happen.)

This leaves the present time as the only place for us to escape our incessant worrying. We do this by engaging in activities that distract us and keeping our focus on the task at hand; by paying close attention to our surroundings at all times – really listen to the birds tweet, fully take in the grass’ green and the sky’s blue; listen to each word of the song on the radio, each note that is played instead of daydreaming about your worries while driving in the car.

This is called being “mindful”, and it keeps us out of past and future time and out of worrying. The mind doesn’t like it and will try to pull you back into past and future, but you can fight it by consciously choosing to stay in the present moment by never doing anything on “auto-pilot” again. Feel whatever you do with all of your senses and you will be in mindfulness.

Today, I will practice mindfulness or present-time living, and I will know freedom from worry and anxiety, even if only for brief moments.