The Governor has proposed a bill that would “remove licensing requirements and impose registration requirements for the following professions: dietitians, athletic trainers, funeral directors, mental health counselors, marital and family therapists, social workers, speech pathologists, and audiologists.” The (bill) requires dietitians, funeral directors, mental health counselors, marital and family therapists, and social workers to register with the department of public health.” This bill, HSB138, has been referred to the House State Government Affairs Committee. The current licensing process is in place to assure the public that licensed professionals have completed rigorous education and testing and are monitored for compliance and ethical behavior. Please call the House switchboard (515)281-3221 and let them know your concerns.
You can also take action here:
Interestingly enough National Alcohol and Drug Addiction Recovery Month and World Suicide Prevention Day are both in September. What is the connection? Check out this article to find out more.
May is Mental Health Awareness Month. NAMI is a great resource to learn more about mental health as well as how to get help. To learn more about mental illness check out NAMI.
The DSM-V is filled with various diagnoses and criteria for each diagnosis. Some symptoms are similar in several disorders. Two of these are Bipolar Disorder and Schizo-Affective Disorder. Julie A. Fast at bphope.com wrote an article differentiating these symptoms.
What is the difference between Schizo-Affective Disorder and Bipolar Disorder? by Julie A. Fast
This is a question close to my heart as my psychosis came back for a few days last week and I was reminded of the many years I lived with psychotic symptoms that I didn’t understand. We often misunderstand psychosis, but it’s really quite simple. Psychosis is a break with reality that includes hallucinations and delusions. A hallucination involves the senses and means you see, hear, smell, taste or physically feel something that isn’t there. Seeing animal shapes run around chairs or hearing your name called in a store are examples of hallucinations.
Delusions are the big Kahuna. These are false beliefs. Paranoia is a delusion. Thinking there is a camera in the corner of a room recording your every movement is a delusion. Believing that the cops are surveilling your house and sending the information back to the president is a delusion. Delusions are hard to deal with because they feel so real! When a person has hallucinations and delusions, but doesn’t have mood changes, it’s called a psychotic disorder. Schizo refers to psychosis and affective means mood.
Bipolar disorder is strictly a mood disorder, while schizoaffective disorder is a mood disorder combined with separate psychotic symptoms that are not attached to mania or depression.
Bipolar disorder affects a person’s ability to regulate moods. Bipolar disorder is a mood disorder only and not a psychotic disorder because everything involved with bipolar disorder must be attached to a mood. To put it simply- people with bipolar disorder have psychotic symptoms at the same time as mania or depression. In pure bipolar disorder you can be ‘depressed and psychotic’ or ‘manic and psychotic.’ Psychotic dysphoric mania means you are depressed, manic and psychotic at the same time. Just lovely! There is never a situation in bipolar disorder where you are only psychotic. (Please note that although psychosis is common in bipolar disorder, not everyone has psychotic symptoms.)
If you have bipolar disorder, but you have psychosis when you are NOT manic or depressed, this is the criterion for schizo-affective disorder.
Once I looked back on my psychotic symptoms that started at age 19, I realized that I have always had schizoaffective disorder. It’s just not talked about much with a bipolar disorder two diagnosis.
I’ve had hallucinations and serious paranoia all of my adult life. I experience psychosis when I’m depressed, but I also have it when I am not depressed or manic, but I’m anxious and stressed. I have situational psychosis in crowds or high intensity situations such as a college class room. I can’t believe I lived with it for so long with no help. I thought everyone heard voices telling them what to do or saw themselves being run over by a bus- like watching a movie!
Schizo-affective disorder is bipolar disorder with psychotic symptoms. Schizo affective disorder is NOT bipolar disorder plus full symptom schizophrenia.
What is Schizophrenia?
Schizophrenia, a psychotic disorder is a complicated illness that is much more than psychosis. Social skill impairment, serious thought disorder symptoms, self care challenges, focus problems and other symptoms that are called the positive (talking to yourself in public for example) and negative (catatonic/frozen body for example) are not necessarily present when a person has schizo affective disorder. In fact, if a person has bipolar disorder and the traditional symptoms of schizophrenia, it’s actually two diagnoses. It’s important to note that although people with schizophrenia can have depression, they NEVER have mania. Mania is strictly a bipolar disorder (or schizo affective disorder) symptom. The chart below describes the different types of schizophrenia. Notice how the symptoms are not always about delusions and hallucinations. It’s in these symptoms outside of hallucinations and delusions that bipolar disorder and schizophrenia differ the most.
I have repeated myself a bit in this article as I too find the question a bit complicated. Here’s a simple definition you can use if someone asks you the question: What is the difference between bipolar disorder psychosis and the psychosis that leads to a schizo affective diagnosis?
Bipolar disorder is a mood disorder that includes mania and depression. People with bipolar disorder can have psychotic symptoms, but they are always attached to a mania or a depression. If people with bipolar disorder have psychosis that is separate from mania and depression, they have schizo-affective disorder.
Just like me!
Since “forever” the phrase “take a deep breath” has been given as advice for stress, anxiety, grief, etc. etc. Unfortunately, this advice doesn’t usually come with instruction. To be effective, deep breaths need to be done right. Check out this blog by Carmen R. Sonnes at BloggingBehavioral for learning the art of “Deep Breathing.”
One of the most helpful behavioral tools we can use to manage anxiety, panic, stress, anger, and fear is deep breathing exercises.
Many people with anxiety disorders and anger management issues, for example, breathe in a shallow manner, known as “upper chest breathing.” This type of shallow breathing is unintentional and largely goes unnoticed until something triggers the anxiety/fear/anger mechanism. At this point, a “tightness” in the chest might be felt. Others describe this as “pressure” or feeling as though a heavy “weight” is on their chest; classic signs that now is the time to engage in some deep breathing exercises.
Begin by lying flat on your back on a firm surface. A padded, carpeted floor is an excellent location.
You may also sit up straight in a chair, if that is more comfortable. If sitting, be sure your lower back is fully supported, your feet are flat on the floor and your knees are level or at a slight decline.
You can also practice this exercise standing upright. All sorts of choices for all sorts of situations you may find yourself in. For example, I like to do deep breathing exercises while standing in long checkout lines. Gives me something to do besides glare at the slow check writers in front of me.
Lower Abdominal Breathing:
Place your hand on your stomach area.
Breathe as you normally would and notice whether your hand and stomach rise and fall, or your chest rises and falls, as you breathe.
When you are breathing properly, your chest will stay still while your stomach will rise slightly as you inhale. When you breathe out, or exhale, your chest will continue to stay still while your stomach lowers slightly.
To learn to breathe correctly, begin by slowly inhaling through your nose on the count of six while gently allowing your stomach to lift or raise your hand.
Hold the breath for a count of four.
Slowly exhale through your mouth for a count of eight, fully exhaling until all air is gone, while gently pushing down on your stomach. Now for a round of comfortable, natural breaths. Focus on the feeling of relief you get during these natural, easy, recovery breaths.
Repeat this cycle of 6-4-8 second breaths, with recovery breaths in between, for a good five minutes.
It is quite normal to feel slightly dizzy or light-headed, especially as a beginner. If the deep breathing causes you to begin panicking, only do it for as long as you are able. Increase the length of time each day until you can do the exercise for at least five minutes twice per day. If you continue to practice breathing this way, you may begin doing it more naturally throughout the day.
An additional benefit will be that once you are familiar with the exercise, you may do it while experiencing anxiety or at the beginning of a panic attack, and you may feel relief. The more you practice the deep breathing throughout the day, the more effective you will be at heading off anxiety and panic symptoms.
Slow, emptying exhales tend to be the most therapeutic for some. Really concentrate on exhaling fully. You might experiment with exhaling to the point of emptying your lungs. You want to feel a slight discomfort and then take a relaxing, relieving, natural inhale. Concentrate on the feeling of relief that you are now able to breathe in a comfortable, natural, unforced way. Alternate several natural breaths in between the deep breathing exercises.
Resist feeling frustrated with yourself or giving up if you are struggling to do this exercise correctly. It takes practice. Give yourself time. Do not give up.
Do not be afraid of the exercise causing panic. Remember: you are in control and can stop at any time. Take it as slowly as needed.
Our first fall event was the “Love Yourself ” Block Party on Friday, October second. Creative Counseling Services teamed up with the ISU chapter of Love your Melon. Love your Melon is an apparel brand run by college students across the country on a mission to give a hat to every child in America who is battling cancer.
Another highlight of the block party was special guest, Lisa Heddens. CCS awarded the Exceptional Service Award to representative, Lisa Heddens for her work in monitoring the Medicaid Modernization. Heddens is serving her 7th term in the Iowa House. She is a Ranking Member of the Health and Human Services Appropriations Subcommittee. She also serves on the Appropriations, Human Resources, Natural Resources and the Administrative Rules and Regulations committees.
Congratulations to Stephanie Vela. Stephanie completed her Stephanie graduated with her MS in Clinical Mental Health Counseling in Aug 2015. She is now a temporary Licensed Mental Health Counselor! Way to Go!
UPCOMING EVENTS… WING IT ON WEDNESDAY!! This is multi-tasking at its best. Help support the services that CCS provides to the community and savor your favorite wings at the same time. Enjoy a wonderful meal at BUFFALO WILD WINGS in Ames on Wednesday, December 9 11am – closing. Whether you dine in or carry out, present a ticket or just Just mention that you wish to support CCS and Buffalo Wild Wings will donate 10% of all pre-tax sales (less promotional discounts) to Creative Counseling Services. This includes everything on the menu- food and beverages. Treat yourself to Buffalo Wild Wings….and help others at the same time. It doesn’t get much better than that!
Feature CCS Board Member Amber Vaughn-Schaefer Amber is the Program Director at The Center at Mainstream Living. She has been with the company for eight years, and has been the program director for the past four. Amber oversees day habilitation and enclave (employment) services for adults with intellectual disabilities. She says “I have greatly enjoyed the opportunity to be able to serve so many wonderful individuals and their families in the Ames and surrounding communities. I am also currently enrolled in Leadership Ames XXIX. This has been a very rewarding experience as I’ve learned so much about the needs and opportunities in Ames.” Amber majored in Child, Adult and Family Services at Iowa State. A Amber plays the piano as well as the ukulele. She plays ukulele with six others in an all ukulele club/band – Britches and Hose. They’ve played many events ranging from weddings to farmer’s markets to Bacon Fest. Amber Vaughn-Schaefer
“Start by doing what’s necessary; then do what’s possible; and suddenly you are doing the impossible.” ~Francis of Assisi
Fundraising efforts continue to be a top priority for CCS. A majority of our clients rely on Medicaid for payment of services, and as Iowa continues through the Medicaid Modernization, we can expect to see changes in our reimbursement structure. Unanswered questions include provider reimbursement rates, provider networks, and length of time between providing a service and getting paid. If we do not have the funds to operate would be forced to close our doors. This would leave 100 people, every week, without the services they need. We ask that you make a commitment to support our services by making a cash donation. Your tax deductible gift will go directly to client services, needed overhead, services and supplies and professional development. Please help us realize our vision. Every donation, regardless of size, makes a difference.
Unless someone like you cares a whole awful lot, nothing is going to get better. It’s not. ~Dr. Seuss
Suicide is a topic that most people will talk about in abstract terms. The seriousness of suicide causes a lot of people to shy away from the subject. In our practice, we see people who are struggling with thoughts of suicide. We see the families of people who have attempted suicide, and families of people who have ended his/her life. For all these families, we see a daily struggle with feelings of guilt and fear that they could have, or should have, done something different. Our guest writer today shares a little bit of her story about what its like to survive suicide. We are so thankful for her words and the ability to share her story.
THIS IS WHAT SURVIVING SUICIDE IS LIKE
I’ve been reading a lot about how September is Suicide Prevention Month. This is what suicide looks like. A wife mourning over losing her husband and best friend, 4 years later. In what felt like a mere nanosecond, our lives were forever changed, the day he chose to take his life. **warning this gets a little graphic**
The night before Erik committed suicide, we went to a movie together with his family. We held hands. I remember how my head felt leaning on his shoulder, his arm wrapped around my shoulder. I remember coming home, and how he lay on the floor and read Annika a bedtime story and tucked her in. I remember cuddling in bed with baby Rowan in between us. The next thing I remember is him waking up at 6:30, he was pacing the room. Anxious. He woke me up, “Babe, babe, is everything going to be ok?” I said, with a tired smile in my voice. “Of course everything is going to be ok.” He asked me over and over. I was so tired…weeks of his depression were wearing on me. I knew I should get up and sit with him, but I was feeling so irritated that I always had to save him. Who was going to save me? This sounds selfish now, but it is my reality. Because what happened next is also what I have to live with. Forever. He said, “ok, are you sure?” I said, “yes”. I don’t remember if I told him I loved him. I DON’T F*CKING REMEMBER IF MY LAST WORDS WERE I LOVE YOU!!! I said, “babe, when you go downstairs, please don’t get caught in your own head. Put on your favorite show. Read your favorite book. Anything but just sitting there.” He left and I fell back asleep. Two hours later, I found him hanging in our basement. I had woken up and couldn’t find him. Our then 6 ½ year old Annika heard the screaming. She came down, she touched his arm. She said, “daddy, please wake up.” In the middle of getting her out of there, calling 911, grabbing a f*cking knife to cut my husband down, my entire word came crashing down inside of me.
I had asked all the right questions. We had seen his psychiatrist 48 hours prior to his suicide and he had prescribed a new medicine. I did EVERYTHING on that f*cking list. But I didn’t get up that morning. I didn’t sit with him like I did every god damned morning for pretty much our entire marriage. This is what surviving suicide feels like. This is what I live with every single day.
You are probably aware that October 4-10 is Mental Health Awareness week. When I talk with people about mental health awareness, they often think of extreme mental illness and assume that our office can’t possibly see that many people. But the reality is, we see over 100 people a week in our office. Because EVERYONE has mental health. Some people struggle with more chronic and severe symptoms than others. Some people pretend they don’t have feelings at all so they don’t have to feel. But the reality is, everyone has mental health.
This week, we decided that we would highlight some stories of regular people who are impacted by others. So often we focus on the “client” but each “client” has a family, friends, coworkers, etc. that are impacted by mental health problems. The first story comes from a woman who has been managing her mother’s mental health issues for as long as she can remember.
Like many people, my home is filled with furniture that is not my own. My dining set came to live with me after years of being in storage. And it came to live in storage after a short life with my mom in a one bedroom apartment on Chicago’s north side. My mom had asked repeatedly for a dining set but my siblings and I agreed that the small size of her apartment and the number of people she entertained for dinner on a regular basis (zero) didn’t warrant the purchase of a set. Imagine our surprise when we learned of her new eight piece acquisition. It wasn’t long before my older sister stopped by the furniture store to see what could be done. And I believe, on behalf of my mother and my older sister, I owe the furniture store manager an apology. Here goes:
Dear Furniture Store Manager,
A number of years ago, a glassy eyed woman with wild hair, mismatched clothes, and a purse overflowing with years old letters and newspapers, hobbled off a city bus and walked into your fine establishment. She, having impeccable taste, selected a gorgeous cherry wood dining set complete with six chairs, an expandable table, and a lighted china cabinet. Somehow she found a sales person to help her. And somehow the powers that be found my mother to be worthy of credit. I will never understand how this happened because my mother has suffered from manic depressive episodes and delusions for almost as many years as she’s been alive; she can’t really be trusted with something as simple as a library card, let alone furniture store credit. Her poor mental state has kept her from holding down a job for the past three decades. It cost her custody of her children. It cost her relationships with her parents and siblings. It cost her everything. But none of that matters to you. What matters to you is that she passed your credit check. Strange that someone who wasn’t even responsible for paying her own rent was able to get credit, but I digress.
When my older sister came to your fine store a few weeks later to explain the situation and to try to get the furniture returned, you refused. Maybe you were optimistic that you would indeed get paid. Or perhaps you realized my mother should never have passed the credit check in the first place, but that what was done was done and it would be illegal to repossess the furniture until there was sufficient lack of payment. Or maybe you thought my sister was a little not-right-in-the-head herself, as she probably was not the most diplomatic as your conversation with her progressed. Whatever the case, I don’t know if you were ever paid a dime for the furniture that now sits in my dining room. If it makes you feel any better, the dining set is much too large for my small dining area and is quite out of place in my home. Even so, it is a sweet reminder that my mom is brash and brave and likes pretty things. So I guess it’s worth the large footprint.
I’m sorry you were put in the position of handling my mother’s strange demeanor and requests. I’m sorry my sister probably pounded so furiously on your front counter that you nearly pressed that special red emergency button to alert the police for help. I’m sorry the credit laws in this country at the time allowed for people like my mom to sign on the dotted line for items they would never be able to pay for (let’s not get started on the gun control debate…). I’m sorry that, perhaps, your clerk was well aware that my mother should not have been extended credit, but chose to ignore this as he or she had a sales quota to meet. And I’m sorry that the medical team who had been working with my mom for years was unable to keep her stable enough to not make impulsive and irresponsible decisions while in your store.
I can assure you, this wasn’t for lack of trying. My mom had great intentions and goals. She dreamed of finally graduating from college after what seemed like a million stops and starts. She saw her social worker weekly and her psychiatrist monthly. When in her right mind, she took her medicine religiously. The thing is, my mom wasn’t always in her right mind. The medication she took didn’t always keep her on the straight and narrow. It didn’t always keep her balanced. It didn’t always quiet the voices. So I can’t fault her for being unable to keep her impulses in check. And I can’t fault her for wanting nice things from your store. I certainly can’t fault her for desperately wanting some normalcy and coveting a proper dining table.
What I know for sure is that you can probably expect much more of this as mental health services continue to be underfunded and undervalued by the movers and shakers of the world. Pre-health care reform, it was difficult for an individual to get mental health coverage at all (as someone without group benefits for the past five years, I can personally attest to this). And post-health care reform, many lawmakers now think it’s a great idea to limit the providers that those with publicly funded insurance can be treated by. Which is laughable because people who qualify for publicly funded insurance are the very people hit hardest by lack of mental health support. They need more quality options, not less. And, since none of us live on a deserted island, the ripple effect of poorly treated Americans creeps out and effects all of us. The underserved mentally ill are everywhere. They work with you and sit next to you at your daughter’s open house. They linger in grocery stores and hang out at the library. They roam the very streets that the rest of us roam. They even walk into furniture stores and make outlandish purchases they should not make.
One in five Americans suffer from a mental health issue at some point (https://www.nami.org/Learn-More/Mental-Health-By-the-Numbers). And I will never understand how lawmakers can continue to ignore the needs of one in five Americans. But I’m not a lawmaker. I’m just an average citizen, living an average life, preparing an average dinner this evening.
So, thanks for the table I’m about to eat on. And…sorry.
Someone Affected by Mental Health Legislation, Too
We see it all the time. People feel better and go off their medications. Or, an insurance company changes the formulary and a medication change is made. Or, a new provider takes over and makes medication changes. The reality is, finding a course of treatment, including therapy and medications, can be tricky. This article gives a great overview on the realities of medication in bi-polar disorder. Sticking With It