I keep a folder for interesting articles and tidbits that my readers might find fun to read and instructive. It has been growing fat!

Usually, I post a selection of these every couple of weeks or so, but have neglected to do so for quite some time. Though today’s post will not even begin to clear out the folder, at least it’s a good start!

Today’s topics cover a broad range of topics, as shown by the subject list:

1. Therapy by Telephone
2. Battle of the genes determine mental illnesses?
3. Seven habits that could transform your life
4. Is there a way to get rid of unwanted memories?
5. Why we overeat when we’re stressed

1. Therapy by Telephone

The attrition rate for telephone therapy is only 7.6 percent

Up to half the people that enter therapy drop out after a few sessions, and among patients who say they want psychotherapy, only 20 percent actually show up for a referral.

Part of the problem is denial and the stigma of mental illness.

But another part is that people can’t get off work, can’t fit therapy into their schedules, or have transportation problems. The elderly, the poor, and the disabled find it particularly hard to make traditional therapy appointments.

In addition, people with Anxiety Disorders or depression may simply not be capable of getting themselves to the therapist’s office on a regular basis.

A new study by David Mohr of Northwestern University suggests that a better option for some patients would be therapy by telephone. He found that the attrition rate for telephone therapy was only 7.6 percent, as opposed to nearly 50 percent for face-to-face therapy. Mohr says, “The telephone is a tool that allows the therapists to reach out to patients, rather than requiring that patients reach out to therapists.”

Read the full article, “The Benefits of Therapy by Phone.”

2. Battle of the genes determine mental illnesses?

Certain illnesses are single-gene caused: Mental Illness, too?

A topic being hotly debated among scientists is the extent to which the father’s and mother’s genes influence a developing fetus. It is already known that certain illnesses, such as Angelman syndrome and Prader-Willi syndrome spring from the same gene, and are determined by whether the father’s or the mother’s genes dominate.

Now two researchers, Bernard Crespi, a biologist at Simon Fraser University in Canada, and Christopher Badcock, a sociologist at the London School of Economics, are saying that the same single-gene mechanism works with mental illness.

They hold that an evolutionary tug of war between genes from the father and the mother can tip brain development in mental illness, as well. A strong bias toward the father pushes the developing brain toward the autistic spectrum at the expense of social development. A bias toward the mother moves the growing brain along what the researchers call the psychotic spectrum, toward hypersensitivity to mood: both their own and others’. This, according to Crespi’s and Badcock’s research, increases the risk of developing schizophrenia, and mood problems such as bipolar disorder and depression later on.

While most scientists and researchers see obvious holes in this theory, they are also intrigued by it. It is generally agreed that the research will spark new avenues of investigation into the reasons behind mental illness.

The New York Times article is “In a Novel Theory of Mental Disorders, Parents’ Genes Are in Competition.”

3. Seven habits that could transform your life

Change bad habits for good

In a departure from my usual fare for Anxiety, Panic & Health, I offer an excellent article that could have a significant impact on your life.

People are overwhelmed when it comes to starting positive life changes. Leo Babauta, the host of Zen Habits, provides a list of wise ways to change bad or undesirable habits to good ones. Even if we were to follow just one or two of these 7 habits, it would make a profound difference in our lives.

The article is “7 Little Habits That Can Change Your Life, and How to Form Them.”

4. Is there a way to get rid of unwanted memories?

Get rid of trauma, fear, even a bad song

Every one of us has memories that we wish we could get rid of; they clutter up our thoughts and impede our efforts at just getting on with our lives. The memory could be a chronic fear, a traumatic loss, or a bad habit. Or it could be as simple as the music and lyrics to a bad song that obsessively runs through your mind.

These bad memories just seem to be a part of being human, but now scientists are learning how to erase specific memories with an experimental drug. So far, the research has only been done with animals, but they say that the memory system is likely to work almost identically in people.

Imagine being able to get rid of the memories of that terrible automobile accident, or Paul Anka’s “You’re Having My Baby!”

A full explanation of the research and its implications are found in the article, “Brain Researchers Open Door to Editing Unwanted Memory.”

5. Why we overeat when we’re stressed

Reason for stress eating found

It seems that many people turn to food and overeat when they’re stressed or anxious, as pointed out in my recent article, “Surviving the Recession, Part 2: Anxiety, Harmful Behavior, and Paralysis.” This is everyday knowledge among the public, but now scientists are learning why it happens, with the possibility of developing a treatment to avoid it and other eating habits.

The “hunger hormone” ghrelin increases when a person doesn’t eat. Now scientists have discovered that it increases when a person is stressed, anxious, or depressed, too. This rise in ghrelin might be the body’s defense against the symptoms of stress-induced depression and Anxiety. So ghrelin rises, we eat more, we feel better, but we gain weight.

The work of these scientists presents the possibility of developing treatments that would dampen the urge to eat when stressed. On the flip side of the coin, they are investigating ghrelin’s role in conditions such as anorexia nervosa, with the potential to learning how to treat it more effectively.

The article, “Hunger Hormone Increases During Stress, May Have Antidepressant Effect,” is very interesting, and gives a good overview of this new research and its opening the doors to treatments for both overeaters and undereaters.

What do you think?

I’ve been a bad boy!

I promise that I will do better in regularly posting this type of miscellany — the reaction from readers in the past has been good, and it’s obvious that many of you enjoy them. My problem is that I get so caught up in the big research articles that I forget that readers want and like shorter ones!

• What memories would you get rid of if you could?
• Would you take a medication to help you not overeat when stressed?
• Do you think that therapy by telephone would work for you?
• What kinds of articles would you like to see more of?

©2009 Anxiety, Panic & Health. All rights reserved.

Related Posts:

• Saturday Summary: Anxiety Articles, Interesting Posts, Upcoming Reviews
• Anxiety’s Bad Memories Can Be Minimized, Scientists Find
• Prone to Anxiety? New Gene Research Says “Yes”
• 5 More Interesting Articles for You: Your Occasional Reader
• Obsessive-Compulsive Disorder Linked to Brain Activity

The National Alliance on Mental Illness (NAMI) has released a new report, Grading the States, assessing the nation’s public mental health care system for adults.

The average grade in 2009 for the United States was a D. This grade has not budged from the D the US received from NAMI in 2006. Fourteen states improved their grades in 2009. Twelve states fell backwards.

This national grade, an average of the state grades, reflects our country’s utter neglect of its most vulnerable citizens. The lack of improvement over time brings into sharp relief our complete failure to take charge of an ineffective system and begin to transform it.

Michael J. Fitzpatrick, NAMI’s executive director, said:

Mental health care in America is in crisis. Even states that have worked hard to build life-saving, recovery-oriented systems of care stand to see their progress wiped out.

Ironically, state budget cuts occur during a time of economic crisis when mental heath services are needed even more urgently than before. It is a vicious cycle that can lead to ruin. States need to move forward, not retreat.

Too many people living with mental illness end up hospitalized, on the street, in jail or dead. We need governors and legislators willing to make investments in change.

This post provides details of the NAMI report, makes recommendations, and analyzes the implications of this dire situation for mental health in America.

What is the National Alliance on Mental Illness?

NAMI is the largest grassroots organization for mental health

The National Alliance on Mental Illness (NAMI) is the nation’s largest grassroots organization dedicated to improving the lives of individuals and families affected by mental illness. It was founded in 1979, and has affiliates in every state in the US, and in more than 1,100 local communities across the country.

NAMI holds that the key concepts of recovery, resiliency and support are essential to improving the wellness and quality of life of all persons affected by mental illness. It states that mental illnesses should not be an obstacle to a full and meaningful life for persons who live with them. NAMI advocates at all levels to ensure that all persons affected by mental illness receive the services that they need and deserve, in a timely fashion.

For more information about NAMI’s mission and activities, visit their “About NAMI” web page. The main NAMI website can be reached by clicking the NAMI button in the right sidebar. I urge you to support NAMI in its important goals and activities.

What about the report? What are the details?

The NAMI report was undertaken in August, 2008, and had several improvements over the surveys done for the 2006 report. The survey was based upon the latest studies and research concerning mental health care in all its aspects. 

The report was limited by lack of data

The nation’s public mental health system is complex, and NAMI states that the report was limited by the lack of reliable outcome data. They found that plans and policies may exist, but they do not necessarily translate to implementation. In addition, evidence-based practices may be intended, but fall short of adherence to standards.

The NAMI report is divided into four categories of scores for every state. Each category has 8 to 33 different criteria with a separate grade for each criteria as well as an overall grade for the category. The categories, with their overall grade, are:

1. Health Promotion and Measurement

This category counted for 25 percent of the grade. The overall grade for all states was a D. There are 16 criteria, including: 

• Workforce development plans
• Mental health coverage for both the insured and uninsured
• Data on race/ethnicity, psychiatric beds, cause of death, ER wait-times, and treatment methods
• Wellness Promotion/Mortality Reduction Plan 

2. Financing and Care Treatment/Recovery Services

This category counted for 45 percent of the states’ grade. The average grade for all states was a C.  There are 33 criteria, including:

• The quality and numbers of care professionals, psychiatric beds, treatment, transportation, housing, employment and education
• State and Medicaid support for community treatment, case management, medications, and co-occurring disorders treatment
• Community, family and self-care education and opportunities

3. Consumer and Family Empowerment

This category counted for 15 percent of the grade. The average grade for the states was a D. There are 8 criteria, including:

• Consumer and Family monitoring teams, state committee memberships, and consumer-run programs
• State support of the education of families, peers, and providers

4. Community Integration and Social Inclusion

This category counted for 15 percent of the grade for the states. The overall grade for all states was a D. The 8 criteria include:

• Housing
• For the mentally ill, jail diversion programs, Medicaid support after incarceration, and reentry programs
• State support of police crisis intervention teams
• Mental health courts overall score and per capita availability

For more information on the overall report, with categories and criteria scores for the US, visit the “United States Scorecard” web page.

What grades did each of the states get?

The overall scores for the states were:

• A: 0 states 
• B: 6 states 
• C : 18 states
• D: 21 states
• F: 6 states

Following are the overall scores that each of the states received:

• Alabama – D
• Alaska – D
• Arizona – C
• Arkansas – F
• California – C
• Colorado – C
• Connecticut – B
• Delaware – D
• District of Columbia – C
• Florida – D
• Georgia – D
• Hawaii – C
• Idaho – D
• Illinois – D
• Indiana – D
• Iowa – D
• Kansas – D
• Kentucky – F
• Louisiana – D
• Maine – B
• Maryland – B
• Massachusetts – B
• Michigan – D
• Minnesota – C
• Mississippi – F
• Missouri – C
• Montana – D
• Nebraska – D
• Nevada – D
• New Hampshire – C
• New Jersey – C
• New Mexico – C
• New York – B
• North Carolina – D
• North Dakota – D
• Ohio – C
• Oklahoma – B
• Oregon – C
• Pennsylvania – C
• Rhode Island – D
• South Carolina – D
• South Dakota – F
• Tennessee – D
• Texas – D
• Utah – D
• Vermont – C
• Virginia – C
• Washington – C 
• West Virginia – F
• Wisconsin – C
• Wyoming – F

Complete information for each state, the methodology and the full report are available at the “Grading the States 2009” web page.

The nation’s grade was a D. What’s the problem?

The state of public mental health care in the US is not all grim. In many states, mental health agencies are building their programs and workforce on solid planning. They are moving toward evidence-based practices, and working hard to coordinate with other systems, such as physical health, criminal justice, and housing.

Improvements are not deep or wide enough to improve the report card

But these improvements are not deep enough or wide enough to improve the national report card. Too often, state mental health directors are frustrated by budget cuts, bureaucratic procedures, and outdated requirements. There are many critical components in this system, including federal agencies such as Medicaid and SAMHSA, governors, and state legislators. Without a unified commitment to change and concerted efforts at coordination, little can be accomplished.

This paralysis can be readily seen in the long list of problems that have led to our nation’s second consecutive grade of D. Among the problems faced are: 

• Too few psychiatric beds, treatment services, and community-based supports for those who need them
• People with mental illnesses are neglected until they reach the point of crisis, and are then dumped onto other systems. 
• People with mental illnesses are unnecessarily incarcerated, homeless, out of work, and unable to access needed medicines. 
• We have an extremely limited capacity to monitor and measure our own efforts — the very foundation of effective reform. 

North Carolina received a grade of D, as did 20 other states. Deby Dihoff, Executive Director of NAMI North Carolina, states that:

Years of bad policy decisions have left emergency rooms, the criminal justice system, and families to shoulder the burden of responding to people living with mental illness in crisis. Our grade reflects the chaos and disorganization in our state.”

North Carolina is not alone in the “chaos and disorganization” in their state. It’s probable that the same thing could be said about the majority of states, and for the US in general.

Is there any hope for public mental health care in the US?

Make the same commitment to mental illness as to HIV

There is hope that this shameful situation can be changed. The United States has made great strides in combating cancer, heart disease, HIV, and diabetes. We must make the same commitment to recovery for people with mental illness.

The new Obama administration has a stated goal of fully supporting mental health care on a parity with physical health care. In addition, the new budget has significant spending for health care in general, with the aim of eventually making sure that every American has the insurance to provide the health care they need. 

Along with these reforms, we need as a nation to put mental health on the same level of urgency as diabetes, cancer, and HIV. When suicides are responsible for more deaths than AIDS and homicides combined, it is obvious that mental health issues cannot be swept under the rug any longer for the general health of the nation to improve.

NAMI has many recommendations for transforming state public mental health systems, both in general and state-by-state. Rather than repeat them here, I urge you to visit the web page “Grading the States 2009: Recommendations” to learn more.

What do you think?

Georgia has had massive budget cuts

My own state, Georgia, received a grade of D, as did 20 other states. Georgia citizens have seen massive budget cuts, the closing of many community clinics, and the reduction of mental health services all over the state, particularly in less populous areas. 

The local NAMI chapter was very instrumental in the decision to not close a community clinic in 2007 that serves a 6-county area. I shudder to think of what effect that its closing would mean to the mentally ill people of this area.

In the current economic crisis, states all over America are cutting budgets for health care in general, and mental health care in particular. I urge you to be active in trying to preserve the mental health care in your area. There are more than 1100 local chapters of NAMI across the US, and there’s a good chance of their being one near you. Join with them in helping to provide better mental health care for all the citizens of the United States! As mentioned, you can access the main website of NAMI by clicking the button in the rightmost column of this page.

• What do you think the nation’s and your state’s report card grade says about the attitude toward mental health care?
• Has your area experienced any public mental health care cuts?
• What do you think can be done to solve the problem of abysmal public mental health care in America?

As always, your comments are welcome!

If you have enjoyed this post, please consider subscribing to this blog, either via RSS or email at the top of your screen. It’s free! You can also follow me on Twitter from the same place. I would also appreciate your sharing this post using your favorite social media, such as StumbleUpon or Digg. Just click the little green “ShareThis” button at the bottom of this post.

Resources used in this post:

Boyd, Leslie. (2009, March 11). NC gets a D in mental health. Retrieved March 12, 2009 from http://www.citizen-times.com/apps/pbcs.dll/article?AID=200990311035.

All other resources used are found in within the body of the post

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• Anxiety and anxiety: What’s the difference?
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• Quarter of All Hospital Stays Are for Mental Health Reasons

Every blog has posts that seem to be overlooked by readers, some deservedly, and some not. 

The posts in this list are those that I feel are important for various reasons. They run the gamut from groundbreaking new research, to reasons why we don’t see therapists, to effectively managing your medications.

According to site statistics, these posts have received very little attention from readers, and I am not sure why! Because of their subject matter or their keywords, they haven’t received much search engine traffic, either.

Rather than let these posts recede into oblivion, I’m asking you to take a second look and maybe give them a little love!

1. What Are the Stressors in Your Life?

This is an opinion piece based on my own experience with stress. It discusses how stress affects our lives, and makes the distinction between internal and external stressors clear.

2. Chronic Insomnia Can Lead to Anxiety Disorders

A large study found that chronic insomnia is a risk factor for Anxiety Disorders, but not depression. As a sufferer of both chronic insomnia and Anxiety Disorders, I find that the latter are at their worst when my insomnia is at its worst.

3. TV Portrayal of Psychologists Keeps People from Getting Treatment

A large part of the stigma of mental illness is learned from the media. TV, in particular, is guilty of perpetuating many outdated and wrong-headed notions about the mentally ill and about mental health professionals. 

4. Denial: Why People Don’t Get Treatment for Anxiety

Up to 20 percent of Americans suffer from Anxiety but only a small fraction get treatment. Denial is a primary reason, even stronger than the stigma of mental illness. There is a revealing list of reasons why denial is a common coping mechanism, with suggestions for overcoming denial to get help.

5. Take Charge of Your Medications!

My Mother’s death was caused by conflicting medications. This post shows you how to effectively manage your medications so that you are well-informed about their side effects and interactions. It also discusses how to talk to your doctor about the drugs that they are prescribing. It includes an offer to share the form I’ve developed to do so.

6. 95% of Diagnosed Social Phobia Sufferers Originally Go to Doctor for a Different Problem

Social Phobia has been found to coexist with other mental disorders in over 25 percent of patients receiving treatment. Yet, because it is not well-understood, it is often overlooked. In addition, almost all of the patients going to a doctor about a mental disorder do not go because of Social Phobia symptoms. 

7. Anxiety: Two General Types Found in Brain

Two general types of Anxiety were found by University of Illinois researchers: anxious apprehension and anxious arousal. This finding has great potential to influence the classification and treatment of Anxiety Disorders.

8. Anxiety Common in Elders, But Goes Undiagnosed and Untreated

Anxiety is the most common mental disorder experienced by older adults. As the Baby Boomers begin to reach retirement age, their mental health will become more and more important. It is urgent that doctors check elders for mental disorders, especially Anxiety Disorders, to maintain elders’ well-being.

9. 10 Reasons Why We Lie to Our Therapists

Therapy requires a great commitment of time, and according to your insurance coverage, money. Yet people lie or hide the truth from their therapists on a regular basis. It’s obvious that this keeps us from receiving the kind of care we need.

10. Book Review: Fear and Other Uninvited Guests by Harriet Lerner

Among all the hyped books on “curing” Anxiety is this wonderful little volume written by psychologist Harriet Lerner. An Anxiety sufferer herself, she recounts her experiences and how she overcame her own fears. It is one of my favorites.

What do you think?

Most of these posts are from the earlier days of this blog, and have become buried in the archives. I think they deserve a second look for the reasons cited. I hope you think so, too!

• Is there any post on this list that you like and had overlooked?
• Do you think that these posts deserve to sink into oblivion?

As always, your comments are welcome!

If you have enjoyed this post, please consider subscribing to this blog, either via RSS or email at the top of your screen. It’s free! You can also follow me on Twitter from the same place. I would also appreciate your sharing this post using your favorite social media, such as StumbleUpon or Digg. Just click the little green “ShareThis” button at the bottom of this post.

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Mental wholeness is the last term in the tag line for this blog, Living with Health, Wellness and Wholeness.

Wholeness is a concept that has many meanings in our culture. It is spoken of by New Age gurus, preached from the pulpit, and bandied about by pop psychologists. Yet none of these can give you a straightforward answer as to what wholeness really is. 

Mental wholeness is murkier still. It is referred to by many, again without definition. This may be because the meaning of the term is difficult to articulate, the person doesn’t really know what it means, or that they just like the mysterious way it sounds!

This post explores the meanings of wholeness and provides my definition of mental wholeness as used in this blog. It is the third in a series that defines mental health, mental wellness, and mental wholeness, three pillars of all the posts written here.

The yearning for wholeness

Wholeness: There are more questions than answers

We all have a deep yearning for wholeness, yet it is a concept that defies description. What is it to be whole? Whole in what way? Is wholeness the same for every individual? There are more questions than answers.

We all have been broken by life, fragmented by all the things that happen along the way. Mental illness, in particular, breaks us not only internally, but externally from friends, family and the world. One of the most devastating feelings we can have is that we are so broken that we cannot pick up the pieces, that we are not moving forward in life, or are even moving backward.

Mental wholeness is a process

Mental wholeness requires letting go, change and growth

It is best to think of mental wholeness not as a state, but as a process. Carl Jung, the Swiss psychiatrist, taught us that the process of healing and wholeness comes from the balancing our lives. 

None of us are entirely whole, and none of us can be entirely whole, but wholeness is a level of perfection that we should be continually striving for. The pieces can be put back together and life can move forward. 

The process requires letting go, change and growth. Jung says,

The realization of the self … leads to a fundamental conflict, to a real suspension between opposites…, and to an approximate state of wholeness that lacks perfection. … The individual may strive after perfection … but must suffer from the opposite of his intentions for the sake of his completeness.

My definition of mental wholeness

Mental wholeness: balance, integration

Mental wholeness refers to the balance in our lives wherein our physical, spiritual and mental selves are fully integrated and equal, with none dominating the other. 

Mental wholeness takes the broken parts of our lives and puts them back together — perhaps in new ways — through change and growth.

Since life is fluid, with each day presenting new challenges, mental wholeness is not completely achievable; neither, for that matter, is physical or spiritual wholeness. But wholeness is a journey, just like life, and we keep moving down its path one day at a time.

Above all, mental wholeness is a process, a lifelong process. It is not something we acquire quickly, like relief through medications, or learning to manage mental illness with therapy. It is a state that we work on daily, through life’s vicissitudes and changes. 

Will we know when we approach something like wholeness? I’m convinced that we won’t, because with wholeness grows humility; the closer we come to wholeness, the farther that we see we have to go to become balanced and fully integrated.

Conclusion to the series

Mental health, wellness, wholeness a movement along a continuum

If we think of mental health, mental wellness and mental wholeness as processes rather than being static, our lives can be filled with a sense of accomplishment and happiness with our current state of being. Remember that mental health, wellness and wholeness are not the absence of mental illness, but a movement along a continuum from having impaired functioning to successful mental functioning. We may be broken, we may have setbacks, but we are capable, every one of us, of living a happy, fulfilling life!

What do you think?

This series has been very difficult to write, even though I had covered some of the same ground in an earlier post. When it comes down to it, it’s hard to articulate my beliefs and feelings about terms I have an inner, intuitive feeling about, but no words to say that can communicate these to others. I hope that I’ve been articulate enough for you to understand these three pillars of this blog’s foundation!

• How would you define mental wholeness?
• Do you think that there is any such thing as mental wholeness?
• Do you agree that mental health, wellness and wholeness are processes rather than fixed states of mind?

As always, your comments are welcome!

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If you have enjoyed this article, please consider subscribing to this blog, either via RSS or email on the top of the right sidebar. I would also appreciate it if you shared this article with your favorite social media, such as StumbleUpon or Digg. Just click the little green “ShareThis” button at the bottom of this post.

Resources used in this post:

Bessinger, Donivan. (2000). Carl G. Jung: A Brief Introduction to His Ideas. Retrieved from Journey into Wholeness Web site: http://users.aol.com/journeywh/jwjung.htm

Myers, Jane. (2004, April 23). Wellness Models, Assessment, Research. Retrieved August 4, 2008 from University of North Carolina at Greensboro Web site: http://www.uncg.edu/~jemyers/wellness/docs/wellness.htm

Satcher, David. (1999). Mental Health: A Report of the Surgeon General 1999. Retrieved July 29, 2008 from US Department of Health and Human Services Web site: http://mentalhealth.samhsa.gov/cre/ch1_scope.asp

Further reading:

Discovery Health: What Is Mental Health? http://health.discovery.com/centers/mental/whatis/whatis.html

Mental Wellness Information Emotional Wellness Mental Fitness Health Advice, Dr. Ron Sterling  http://www.mentalwellness.ws/

Moving Towards Wholeness  http://lessonsforliving.com/moving_towards_wholeness.htm

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• What is Mental Wellness? Living with Health, Wellness and Wholeness
• Living with Health, Wellness and Wholeness
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Mental wellness is part of the tag line for this blog, “Living with Health, Wellness and Wholeness.”

Wellness is a relatively new paradigm in health care, and the subject of mental wellness is newer still. The study of characteristics that make up mental health is called Positive Psychology, which was introduced only in 1998. Mental wellness in counseling and therapy is even more recent, being introduced in 2001.

Mental wellness is more than a pop psychology term; it is a part of the future of medicine, which is moving daily toward a concept of holistic treatment. Both presidential candidates envision more holistic health care, and medical practices across the nation are taking up the idea of treating the whole person, rather than just handing out prescriptions.

This post defines mental wellness as it is understood by its originators, and as it is used in this blog. It is the second post in the series defining the terms mental health, mental wellness, and mental wholeness as it relates to this blog’s tag line, “Living with Health, Wellness and Wholeness.”

What is mental wellness?

Wellness refers to a holistic approach in which mind, body, and spirit are integrated

As mentioned, the concept of mental wellness is relatively new, introduced only in 2001. In my research for this post, I looked at well over 50 internet sites that were classified under “wellness.” Only two even mentioned mental health. Most of the rest emphasized physical wellness, and quite a few were full of gimmicks and hype for products from spa treatments to shower heads (really!). None had anything resembling spiritual wellness in their contents. Perhaps mental and spiritual wellness are ignored because they have few commercial possibilities!

The best definition of mental wellness that I could find was by Dr. Jane Myers of the University of North Carolina, one of the founders of the concept. She says,

Wellness refers to a holistic approach in which mind, body, and spirit are integrated. It is a way of life oriented toward optimal health and well-being in which body, mind, and spirit are integrated in a purposeful manner with a goal of living life more fully… Wellness is more than the absence of disease, [or] a state defined as “health.” [It] incorporates a concern for optimal functioning.

Being mentally well is intertwined with being physically and spiritually well

Mental wellness, physical wellness and spiritual wellness are co-equal

By its very essence, mental wellness cannot be separated from physical and spiritual wellness. The three work together to produce the very concept of wellness.

The following list was compiled by Dr. Myers as a general guide to what it is to live in wellness. These are essential areas of concern along life’s way and not an absolute checklist that measures success or failure. You may not even agree with them all. Choose the ones you want to aspire to and make them your milestones along the mental wellness continuum.

Note that most of the points below deal with mental health and wellness in some way:

Creative Self

• Thinking. Being mentally active and open-minded. The ability to be creative and experimental. Having a sense of curiosity. The ability to apply problem-solving strategies to social conflicts.
• Emotions. Being aware of or in touch with your feelings. The ability to express appropriately positive and negative feelings.
• Control.  Beliefs about your competence, confidence, and personal mastery. Beliefs that you can usually achieve the goals you set out for yourself.
• Work. Satisfaction with your work. Feeling that your skills are used appropriately. Feeling you can manage one’s workload. Feeling a sense of job security. Feeling appreciated in the work you do.
• Positive Humor. Being able to laugh at your own mistakes. The ability to use humor to accomplish even serious tasks.

Coping Self

• Leisure. Satisfaction with your time spent in leisure. Feeling that your skills are used appropriately.
• Stress Management. On-going self-assessment of your coping resources. The ability to organize and manage resources such as time, energy, and setting limits.
• Self-Worth.  Accepting who and what you are, positive qualities along with imperfections. A sense of being genuine within yourself and with others.
• Realistic Beliefs. Ability to process information and perceive reality accurately. The absence of persistent irrational beliefs and thoughts and need for perfection.

Social Self

• Friendship. Social relationships that involve a connection with others individually or in community, but which do not have a marital, sexual, or familial commitment. Having a capacity to trust others. Having empathy for others. Feeling understood by others.
• Love. The ability to be intimate, trusting, self-disclosing with another. The ability to give as well as express affection with significant others and to accept others without conditions.

Essential Self

• Spirituality. Personal beliefs and behaviors practiced as part of the recognition that we are more than the material aspects of mind and body. Belief in a higher power. Hope and optimism. Practice of worship, prayer, and/or meditation; purpose in life. Compassion for others. Moral values. Transcendence (a sense of oneness with the universe).
• Gender Identity. Satisfaction with and feeling supported in one’s gender. Ability to be androgynous.
• Cultural Identity. Satisfaction with and feeling supported in one’s cultural identity. Cultural assimilation.
• Self-Care. Taking responsibility for one’s wellness through self-care and safety habits that are preventive in nature.

 Physical Self

• Nutrition. Eating a nutritionally balanced diet. Maintaining a normal weight (within 15% of the ideal).
• Exercise. Engaging in sufficient physical activity through exercise or in your work to keep in good physical condition.

 General Feeling of Well-Being

• Perceived Wellness. The extent to which you believe you have achieved wellness in all areas, or total wellness. Your estimate of your total wellness.
• Perceived Safety. The extent to which you believe you are safe in your home, neighborhood, and community, and the extent to which you feel safe from harm by terrorists.
• Context. The extent to which your wellness is influenced, in a conscious manner, by individual, institutional, and global contexts, and the extent to which you are aware of and intentional in responding positively to changes in wellness over time.

My definition of mental wellness

Mental wellness is part of a healthy life balance

Mental wellness is thoroughly integrated with physical and spiritual wellness, and should receive the same attention as either. It is proactive, not waiting until something goes wrong to fix the problem, but actively working on mental health as our lives progress and change. Above all, it is being self-aware, self-understanding and self-forgiving, so that a healthy balance can be maintained in all areas of life. 

What do you think?

• How would you define mental wellness? Or do you even believe in the concept?
• Do you have any items that you add to or remove from the list?
• Do you think that the emphasis on spiritual wellness as equal to mental and physical wellness is appropriate?

As always, your comments are welcome!

If you have enjoyed this article, please consider subscribing to this blog, either via RSS or email on the top of the right sidebar. I would also appreciate it if you shared this article with your favorite social media, such as StumbleUpon or Digg. Just click the little green “ShareThis” button at the bottom of this post.

Related posts:

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Resources used in this post:

Bessinger, Donivan. (2000). Carl G. Jung: A Brief Introduction to His Ideas. Retrieved from Journey into Wholeness Web site: http://users.aol.com/journeywh/jwjung.htm

Myers, Jane. (2004, April 23). Wellness Models, Assessment, Research. Retrieved August 4, 2008 from University of North Carolina at Greensboro Web site: http://www.uncg.edu/~jemyers/wellness/docs/wellness.htm

Satcher, David. (1999). Mental Health: A Report of the Surgeon General 1999. Retrieved July 29, 2008 from US Department of Health and Human Services Web site: http://mentalhealth.samhsa.gov/cre/ch1_scope.asp

Further reading:

Discovery Health: What Is Mental Health? http://health.discovery.com/centers/mental/whatis/whatis.html

Mental Wellness Information Emotional Wellness Mental Fitness Health Advice, Dr. Ron Sterling  http://www.mentalwellness.ws/

Moving Towards Wholeness  http://lessonsforliving.com/moving_towards_wholeness.htm

Related Posts:

• What is Mental Wholeness? Living with Health, Wellness and Wholeness
• What is Mental Health? Living with Health, Wellness and Wholeness
• Living with Health, Wellness and Wholeness
• Saturday Summary: The How of Happiness, Website Changes, and Upcoming Articles
• Saturday Summary: 50 Ways to Calm Your Anxiety, the New Look, and Psychotherapy Going Down the Tubes

Living with Health, Wellness and Wholeness is the tag line for this blog.

But what exactly do the terms mental health, wellness and wholeness mean? When you think about it, it’s hard to pin down exact definitions for them.  

And the definitions are continually changing for every individual, because mental health, mental wellness, and mental wholeness are processes, in movement, and not static. In a way, we make our own definitions of what they mean for each of us.

To me, these are more than interesting terms or concepts. They are the very underpinnings of this blog, the ultimate goal for every post written.

This is the first of a three-part series presenting the widely-recognized definitions of the terms mental health, mental wellness, and mental wholeness, along with my own definitions and how I use the terms in this blog. Today’s post, on mental health, will be followed by post on mental wellness and mental wholeness in the days to come.

There are many definitions of mental health, but few agreements

It is easier to define mental illness than mental health

It is always easier to define mental illness than mental health. There are whole libraries filled with books about mental illnesses, but hardly any books on what being mentally healthy really means.

And among the writers on mental health, there is no general agreement as to what exactly what it is. Each writer seems to offer a competing theory of mental health, with its own requirements and emphases. Add in cultural differences, subjective assessments and value judgments and things get really confusing. 

But one agreement among the professionals is that mental health  is not the simple absence of mental illness, and that mental illness is not the simple absence of mental health.

In 1999 Surgeon General David Satcher, in his report on Mental Health, defined it as,

The successful performance of mental function, resulting in productive activities, fulfilling relationships with other people, and the ability to adapt to change and to cope with adversity.

Mental health and mental illness are not polar opposites, according to the Surgeon General’s report, but points on a continuum, where an individual’s mental health may have many different possible values. At one end of the continuum is mental health as “successful mental functioning. ” In the middle are “mental health problems,” and at the other end is mental illness, with “impaired functioning.”

Mental health can be considered to be attitudes and thoughts that lead to actions

Can there be a single definition of mental health?

Perhaps there can be no single definition of mental health due to the many differences between people. But there are signs that one is mentally healthy. Mental health, much more than physical health, can be defined by your attitudes and the thoughts that lead to actions. It’s as much what you do as what you think. 

Despite the many competing theories of mental health, there are a few generally agreed-upon signs that a person is mentally healthy. Briefly, the mentally healthy person:

• Is able to use their cognitive and emotional capabilities
• Has a feeling of being capable and competent
• Is able to work productively
• Is able to handle normal levels of stress
• Has the resilience and flexibility to recover, or “bounce back,” from difficult situations
• Is able to function in society 
• Is able to contribute to community life
• Is able to maintain satisfying relations
• Is able to lead an independent life 
• Meets the ordinary demands of everyday life
• Has a subjective feeling of well-being
• Has the ability to enjoy life

Do you need to meet all these criteria to be mentally healthy?

You do not need all these signs to be mentally healthy

Not all these signs need to be present for you to be considered mentally healthy. Indeed, it would be hard to find a mentally healthy person that exhibits all these signs, and a mentally ill person who did not exhibit some of them. Remember that mental health is a continuum, and these signs are milestones along that continuum. 

Each of us is different, and each of us makes our own definition of what mental health is. The definition will vary according to where you are in your life, and whether you are stable, moving toward mental illness, or moving away from it. The definition changes as you age, as your priorities and aspirations shift, and as you cope with life’s challenges.

Life does not stop for the person with a mental illness: They will grow older, they will encounter life challenges in addition to their mental challenges, their perspective of the world will change. The definition of mental health that might have fit before the person had a mental illness may not be the one that’s appropriate as they recover. This is a mistake many people make as they recover from a mental illness: They want to be “like they used to be,” which is impossible. We all change as we move along life’s journey, and no one, mentally ill or not, can return to the way they used to be.

My definition of mental health

Daily functionality, personal relationships, and life satisfaction

I put a great emphasis on daily functionality, personal relationships, and life satisfaction in my working definition of mental health. For people recovering from a mental illness, these three seem to be the most important factors in the depredations of their mental illness, and the most important factors indicating success in their climb toward recovery. 

You can have a good life without meeting all the criteria for mental health

I think that one can have a fulfilling, productive life without meeting all the criteria for mental health listed above. Keep in mind that mental health is not the complete absence of mental illness, nor is mental illness the complete absence of mental health.

There is more to a good life than a list of criteria

We too often forget that there are other factors besides the ones on the list above that go into making a good life. A person’s feeling of contentment, fulfillment and achievement will go far toward making them feel mentally healthy. 

Mental health is relative

And finally, I believe that mental health is a relative state, especially when we speak of it in contrast to mental illness. No one is completely mentally healthy, and no one is completely mentally ill. A person recovering from Agoraphobia may have a daily functionality, personal relationships and life satisfaction that leads to a fulfilling life, yet cannot claim a number of the factors in the list above. They are mentally healthy relative to their former state, and will pick up more of the list items as they recover more fully, but the mental health emphasis should rest on the fulfillment the person is getting from life.

What do you think?

In this first post of the series on “Living with Health, Wellness and Wholeness,” I have tried to give an overview of what professionals think mental health is, and how I define and use the term in this blog. As you can tell, my approach is somewhat different from the mainstream, emphasizing the individual’s assessment of their mental health, the relativity of mental health, and the recovery from mental illness.

• How would you define mental health?
• Do you have items that you would add to the list of mental health criteria?
• Do you agree that mental health is as much what you do as what you think?

As always, your comments are welcome!

If you have enjoyed this post, please consider subscribing to this blog, either via RSS or email on the top of the right sidebar. I would also appreciate it if you shared this article with your favorite social media, such as StumbleUpon or Digg. Just click the little green “ShareThis” button at the bottom of this post.

Related posts:

%RELATEDPOSTS%

Resources used in this post:

Bessinger, Donivan. (2000). Carl G. Jung: A Brief Introduction to His Ideas. Retrieved from Journey into Wholeness Web site: http://users.aol.com/journeywh/jwjung.htm

Myers, Jane. (2004, April 23). Wellness Models, Assessment, Research. Retrieved August 4, 2008 from University of North Carolina at Greensboro Web site: http://www.uncg.edu/~jemyers/wellness/docs/wellness.htm

Satcher, David. (1999). Mental Health: A Report of the Surgeon General 1999. Retrieved July 29, 2008 from US Department of Health and Human Services Web site: http://mentalhealth.samhsa.gov/cre/ch1_scope.asp

Further reading:

Discovery Health: What Is Mental Health? http://health.discovery.com/centers/mental/whatis/whatis.html

Mental Wellness Information Emotional Wellness Mental Fitness Health Advice, Dr. Ron Sterling  http://www.mentalwellness.ws/

Moving Towards Wholeness  http://lessonsforliving.com/moving_towards_wholeness.htm

Related Posts:

• What is Mental Wholeness? Living with Health, Wellness and Wholeness
• What is Mental Wellness? Living with Health, Wellness and Wholeness
• Living with Health, Wellness and Wholeness
• Mental Illness Awareness Week: A Cause We Can All Support!
• Stigma of Mental Illness: Shocking Survey from Canada — US Likely the Same!

One of our nation’s greatest shames is the number of homeless people adrift in the streets and parks of our cities.

And of the estimated 744,000 people who are homeless on any given night, 40 to 45 percent of them have a serious mental illness. Most of these mentally ill people go untreated, and unable to work, live a hand-to-mouth existence out on the streets.

Senator Pete Domenici says,

No vision haunts America’s conscience more than the sight of the street people… The irrationality and anguish that grip so many of these individuals leap out during any encounter, whether in Washington or Albuquerque.”

This post, in response to Blog Action Day’s call to write about poverty on October 15th, gives an overview of the crisis of the homeless mentally ill. This post covers the following topics:

• How many homeless Americans are there?
• How many of the homeless are mentally ill?
• Why are there so many mentally ill homeless people?
• Most mentally ill homeless people are not being treated
• What’s to be done?

How many homeless Americans are there?

3.5 million are homeless in a year

The number of homeless Americans is hard to pin down, since homelessness is often a transient state, and due to the conflicting definitions of “homeless.” The best approximation is from a study done by the National Law Center on Homelessness and Poverty in 2007, which states that approximately 3.5 million people, 1.35 million of them children, are likely to experience homelessness in a given year. This translates to approximately one percent of the U.S. population experiencing homelessness each year, almost 40 percent of them being children, according to the Urban Institute.

In early 2007, the National Alliance to End Homelessness reported a point-in-time estimate of 744,313 people experiencing homelessness in January 2005. This is the figure most often quoted in homelessness studies.

How many of the homeless are mentally ill?

Homeless people suffer from high rates of mental health problems exacerbated by living on the streets and in shelters. 

40 to 50 percent of the homeless are mentally ill

An estimated 40 to 45 percent of homeless persons suffer from Axis I mental disorders in a given year, which include Anxiety Disorders, bipolar disorder, clinical depression, and schizophrenia, schizoaffective disorders, and severe personality disorders. Between 150,000 and 200,000 of the homeless have schizophrenia or bipolar disorder. This is the equivalent to the population of any of these cities:

• Dayton, Ohio
• Des Moines, Iowa
• Fort Lauderdale, Florida
• Grand Rapids, Michigan
• Providence, Rhode Island
• Richmond, Virginia
• Salt Lake City, Utah

At any given time, there are many more people with untreated severe psychiatric illnesses living on America’s streets than are receiving care in hospitals. Approximately 90,000 individuals with schizophrenia or manic-depressive illness are in all hospitals receiving treatment for their disease.

Substance use is also prevalent among homeless populations. In a 1996 survey, 46 percent of the homeless respondents had an alcohol use problem during the past year, and 62 percent had an alcohol use problem at some point in their lifetime. Thirty-eight percent had a problem with drug use during the past year, and 58 percent had a drug use problem during their lifetime.

Why are there so many mentally ill homeless people?

The plan to transition from mental institution to outpatient care failed

There was a movement in the 1960′s and 1970′s to deinstitutionalize many of those being held in state and other mental institutions. The plan was to create community health centers where the mentally ill could receive outpatient treatment, along with residential facilities for those unable to make it on their own. Needless to say, the plan failed miserably.

Since the early 1970′s there have been harbingers of an impending crisis for people with untreated mental illnesses. Large numbers of mentally ill people began forming “psychiatric ghettos” around mental health facilities in cities across America. Following on this:

• As large, often run-down, boarding homes filled with discharged psychiatric patients from the nearby hospitals, the intended policy of deinstitutionalization increasingly looked rather like trans-institutionalization — the exchange of one impersonal institution for another. 
• At the same time, the availability of single-room occupancy hotels and other low-rent housing was declining precipitously in urban areas as redevelopment and gentrification shifted into high gear.

• As early as 1972, a study commissioned by the National Institute of Mental Health reported, “Relationships between community mental health centers and public mental hospitals serving the same catchment area exist only at a relatively minimal level between the majority of the two types of organizations.”

• By 1979, the Inspector General of the U.S. Department of Health, Education and Welfare was more blunt, saying, “The relationship between the CMHCs [community mental health centers] and public psychiatric hospital is difficult at best, adversarial at worst.”

• By the early 1980s some unintended consequences of deinstitutionalization were becoming manifest. More and more very sick people were living on the streets and in public shelters.

Living on the streets and in shelters is bound to trigger mental illnesses in those susceptible to them. However, the core of the mentally ill homeless are those whose mental state makes them unable to hold jobs, and for whom the social safety net of residential facilities and community health centers has failed.

Most mentally ill homeless people are not being treated

Community mental health centers are inadequate

Community mental health centers, where the homeless might receive help, are chronically underfunded, and are often on the budget-cutting chopping block. Mentally ill homeless people present special problems for health care workers. 

• They may not be as cooperative and motivated as other patients. 
• Because of their limited resources, they may have difficulty getting transportation to treatment centers. 
• They frequently forget to show up for appointments or take medications. 
• The addition of drug or alcohol abuse can make them unruly or unresponsive. 
• Among people with severe mental disorders, those at greatest risk of homelessness are both the most severely ill and the most difficult to help.

Many of the homeless mentally ill have anosognosia, and neither realize they are sick nor how dependent they are on regular treatment. Others have given up, no longer believing the system can or will help them. 

When researchers asked homeless people what their greatest needs were, respondents listed affordable housing, safety, education, transportation, medical/dental treatment, and job training/placement. Formal mental health and substance abuse services were rated as unimportant by comparison, not very easy to obtain, and not very satisfactory to people who had used them.

What’s to be done?

We must solve the problem of homelessness first

Solving the problem of the mentally ill homeless cannot be done without solving the entire problem of homelessness. State institutions for the mentally ill are no longer available by law to accommodate them. When the basic needs of life — food and shelter — are weighed against mental health needs, both the homeless and those trying to care for them choose those basic needs.

Many cities have responded to the homeless crisis by trying to shoo them away or by criminalizing homelessness, which only shunts the problem off onto the country’s over-filled jails. Religious and private concerns try to provide shelter and food, but that is only a stop-gap measure.

Without an all-out national effort to eliminate homelessness, I can see the problem only getting worse, particularly in these precarious economic times. The least able to fend for themselves, the mentally ill homeless, have no place to go, no way to provide for themselves and have little hope in the present situation.

What can you and I do? At the moment, the most effective work is being done locally through religious and private entities providing services for the homeless. Volunteering your time or donating to these efforts seems the best that can be done until the nation turns its eye on the least fortunate among us.

There are a number of associations advocating for the homeless. Among the best of them is the National Alliance to End Homelessness. 

What do you think?

• Have you ever been homeless? What was your experience?
• What is your attitude toward the mentally ill homeless?
• Do you have any experience with helping the homeless?

Related Posts:
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©2008 Anxiety, Panic & Health. All rights reserved.

Resources used in this post:

LibraryIndex.com. (2008). The Mental Health of Homeless People. Retrieved October 14, 2008 from LibraryIndex.com Web site: http://www.libraryindex.com/pages/2321/Health-Homeless-MENTAL-HEALTH-HOMELESS-PEOPLE.html

Meharry Medical College. (2005) Homeless Mentally Ill. Retrieved October 14, 2008 from Meharry Medical College Web site: http://www.mmc.edu/www.meharry.org/Fl/Mental_Health/Homeless_Mentally_Ill.html

National Alliance to End Homelessness. (2008). Mental Health and Physical Health. Retrieved October 14, 2008 from National Alliance to End Homelessness Web site: http://www.endhomelessness.org/section/policy/focusareas/health

National Coalition for the Homeless. (2008). How Many People Experience Homelessness? Retrieved October 15, 2008 from National Coalition for the Homeless Web site (PDF): http://www.nationalhomeless.org/publications/facts/How_Many.pdf 

Treatment Advocacy Center. (2007). Fact Sheet: Homelessness, Tragic side effect of non-treatment. Retrieved October 14, 2008 from Treatment Advocacy Center Web site: http://www.psychlaws.org/GeneralResources/fact11.htm

Related Posts:

• Mental Illness Awareness Week: A Cause We Can All Support!
• Scapegoating and the Stigma of Mental Illness, Part 1
• Shameful Report Card: US Gets a “D” in Mental Health
• Stigma of Mental Illness: Shocking Survey from Canada — US Likely the Same!
• Quarter of All Hospital Stays Are for Mental Health Reasons

Over and over I see the same things in the comments on the blogs and forums I visit.

People say that they want to reduce or eliminate their dependence on psychiatric drugs. Yet they are not doing anything to do so. 

They complain that they are being enslaved by their reliance on the drugs to keep symptoms under control. But they do not take advantage of the single most effective, proven help that could liberate them.

Americans have been trained for over a century to rely on drugs to cure their ills, from the first marketing of aspirin in 1899 to the latest wonder-drug touted on tv. Have a headache? Take an Advil and it will go away. Depressed? You need Prozac. Bipolar disorder? Abilify for you. 

Madison Avenue has helped the pharmaceutical companies imply instant and permanent relief from your problems just by popping a pill. And we have swallowed this advertising hype whole! It has made us the most drug-taking nation in the world today. 

Pills have become a silver bullet for Americans seeking relief from their woes.  They expect drugs to solve their problems quickly and easily, without any extra effort on their part. 

No wonder there are so many bitter and disappointed people who feel enslaved by their psychiatric drugs!

No medication is a silver bullet

Silver bullets are a myth

The unfortunate truth is that no psychiatric drug is a silver bullet. No medication is perfect. And no medication works the same way for everybody.

A drug might eliminate or reduce your symptoms for the time being, but one of the main purposes of psychiatric medications (at least originally) is to give you some relief while you seek a more long-lasting means to cope with and manage your mental illness. 

Long-term use of drugs leads to more and stronger drugs

Long-term reliance on drugs alone leads to many medication changes to keep up with increases in the body’s tolerance and its requirements as it ages. Psychiatric drugs often have severe side effects that cause a sufferer of mental illness to suffer even more. Treated with drugs alone, many mental illnesses progress rather than maintain equilibrium, requiring even more drugs to control the new symptoms. All this leads to massive frustration, disappointment and needless pain.

But there is a tried, tested and proven effective means is readily available to help people gain long-term relief from the pain of mental illness, very often without drugs at all. What is it? Simple. Talk therapy.

Talk therapy is a proven alternative to drugs

Therapy reduces or eliminates the need for drugs

Talk therapy with a qualified mental health professional has been proven over and over to be effective in treating many mental illnesses without drugs. And if you do need relief for your symptoms and are using drugs, therapy can reduce the number and strength of the drugs being prescribed. Many people have been able to discontinue medications entirely after a successful course of therapy.

Therapy’s aim is long-term relief from the symptoms of mental illness. Therapy teaches you coping strategies, lifestyle changes and habits of mind that will help you control and manage your mental illness over a lifetime. You work with your therapist to discard old distorted ways of thinking for new, more realistic modes of thought. Your therapist can give you tips for controlling your Anxiety symptoms before they get started, and this advice works the first day and for the rest of your life!

And most therapy doesn’t take a long time. Although some mental illnesses are severe enough to require more treatment, the majority of people can be taught effective control of their disorders in a few months at most. It is common for therapy to last less than six months. 

Face it, talk therapy is not as easy as popping a pill

Therapy can be hard work

Frankly, therapy can be hard work. The effectiveness of therapy is directly related to the patient’s willingness to work with the therapist to do the assigned homework and exercises, and to put what is learned in the therapy session into use in daily life. 

To change your long-standing habits of mind takes a dedication to getting well and an openness to trying new things that many Americans do not want to undertake. They would rather take a pill and make it go away.

A large part of the success of any therapy lies in the “chemistry” between the therapist and patient. It sometimes takes two or three tries to get a therapist that both suits your needs and personality. Therapists recognize this, and are not offended if you ask for a referral. Even the American Psychological Association states this in their literature. 

However, many people give up on therapy if the first choice of therapist does not turn out well. Again, getting the right help takes a dedication to finding relief that many people simply do not have.

Therapy has been devalued by the drug and insurance companies

Insurance companies prefer drugs to therapy

Unfortunately, talk therapy has been devalued by the insurance industry in favor of psychiatric drugs. As a result, therapy reimbursements are not on a parity with treatments for physical health problems in many insurance plans. 

Some people, including Medicare patients, find that their copays are higher than for medical visits. This is just another thing that discourages people from seeking therapy!

Many people in the medical health profession are very concerned by the trend to rely on psychiatric drugs for coping with mental illness, rather than the somewhat more expensive, but equally effective, use of therapy. The drug companies have spent billions pushing the use of pills to both doctors and consumers. And insurance companies have encouraged this trend because psychiatric medications are less expensive in the short term than talk therapies.

These concerns are detailed in an article I posted just a couple of weeks ago entitled “Medication Rapidly Replacing Psychotherapy Due to Insurance Reimbursement.”

In summary

Combination of therapy and drugs the most effective

The most effective treatment for the majority mental illnesses is a combination of therapy and, if needed, psychiatric medications. 

Feeling better, getting better, staying better

Over the years, it has been proven that the people that feel better, get better, and stay better have used therapy as a front-line defense in their battle against mental illness. It teaches people effective lifestyle changes, coping strategies, attitude adjustments, and other long-term solutions rather than a simple reliance on psychiatric medication. 

If drugs are enslaving you, then therapy can set you free!

What do you think?

Personally, talk therapy has enabled me to reduce the strength of the drugs I take, and virtually eliminate another. For example, I have Panic Disorder and Agoraphobia, and have had a prescription for Alprazolam (generic Xanax) for many years. It is prescribed to be taken as needed for Anxiety symptoms as I learn to get out in the world. Through therapy, I’m proud to say that I have not taken an Alprazolam in almost a year — I’ve not needed it!

Another example: I used to take massive dosages of heavy-duty psychiatric drugs to control my bipolar disorder. As the result of therapy, those dosages have been reduced considerably, and several changes have been made in my medication to less powerful drugs.

All this has come about due to good therapy. But it took me several tries to find a therapist I felt comfortable with, and who I believed could help me. If I had given up after the first three unsuccessful attempts at therapy, I would not have the enjoyment of a vastly improved quality of life that I have today!

• What is your experience with therapy?
• Have you tried therapy to reduce or eliminate the drugs you are taking?
• What has been your experience with finding a therapist that is right for you?

As always, your comments are welcome!

If you have enjoyed this article, please consider subscribing to this blog, either via RSS or email at the top of your screen. It’s free! I would also appreciate your sharing it using your favorite social media, such as StumbleUpon or Digg. Just click the little green “ShareThis” button at the bottom of this post.

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• Generic Drugs: Are They Safe and Effective? Part Two

Worry is a wonderful thing. 

It prepares us for anything that fate and the uncertainty of this world may throw us. It helps us keep tabs on the past and the future, and keeps the present in control. Worry is the mark of a thoughtful person, one who is engaged with the world.

Scoffers might call this “The 22 Habits of Highly Ineffective People,” but you and I know better. People who don’t worry are at best suspect, and in reality, irresponsible. Like Aesop’s fable of the Grasshopper and the Ant, they are fiddling away the time, willfully ignorant of the impending doom of winter’s withering blasts!

As a service to those whose worrying habits are not up to snuff, I have put together this little list of all the characteristics of world-class worriers. I’m worried that I forgot or missed a few, but I waited until the deadline and didn’t have any more time.

Following are 22 tips to make you a world-class worrier, too!

1. If you can imagine something bad happening, it’s your duty to worry about it!

You should think that every disturbing thought that pops into your head means that you have to dwell on it, no matter how ridiculous! Whatever the source — news stories, gossip, a conspiratorial blog — you must imagine the worst and add it to your growing pile of worries. Your mantra: “I know the chances are a one in a million, but what if I’m that one?”

2. Avoid uncertainty — you need to know for sure!

You must seek constant reassurance of your status with others to validate your fears, and you must second-guess any response you get so you can ask them again! You have to keep searching for information, and keep “testing” people to make sure. Since you can never gain certainty, you must worry some more. Of course, you are worried that your husband might not find you attractive, so ask him again. And again. He can’t really mean it! Ask again. Are you worried about your job? Ask, ask again and again. It might annoy your boss to the point of firing you, but that will just confirm your fears.

3. All your negative thoughts are really true!

Despite what everybody else says, your negative thoughts have the ring of truth. Your negative thoughts must be treated as a sure sign of something bad about to happen. Your thoughts should be equated with outcomes: “I think I might lose my job” needs to become “I will lose my job!” If you have the thought, “I’ll fail the exam,” you must immediately conclude that this is very likely to come to pass. 

4. Anything bad that could happen is a reflection of you as a person!

When bad things might happen to you, you believe that they absolutely reflect on who you are. “This test is hard, I might fail it,” should become, “I’m a failure.” If there are difficulties at work, then it means that you are totally incompetent. And if that thing you’re worrying does happen, you simply didn’t act on your worry, and it’s your fault! You are a bad person, and an inefficient and under-trained worrier. Read on.

5. Failure is unacceptable!

You simply cannot make mistakes, so worrying about them is not only prudent: It’s essential. Even if it means that you procrastinate, worrying about every detail is the mark of someone who is truly concerned about complete success. Did that report you just handed in have any punctuation mistakes. If so, you are a failure. Did your kid just make a “B” on a test? You are a failure as a parent.

6. Negative feelings must be controlled! Get rid of them immediately!

You must have very negative beliefs about your negative feelings. Negative feelings need to be controlled or better still, eliminated. You should say, “If I don’t stop feeling bad it’ll last all day, ruin my life, and drive me crazy!” You must try to put negative thoughts out of your head right away. This way they will keep coming back. Not thinking about something will reinforce your fear, and cause you to worry more. Fear is good!

7. Treat everything like an emergency!

You must make yourself put off uncertainty. You must know immediately. No matter that you can’t do anything about it, it is an emergency that must be handled right now. If you wake up at 3 am, asking yourself “Will I ever find the true love in my life?” you must get up, make yourself a cup of coffee, and worry about it the rest of the night. If you just checked the air in your tires, you must immediately worry that one is getting low. Stop the car! Check right now!

8. If you don’t stop worrying right now, you’ll drive yourself crazy

You must worry that your worries might be driving you crazy. You think that you have to control your worries, so you get angry at yourself for worrying, but this only makes you more anxious and angry. You may tell yourself “Stop this nonsense,” but you must worry that it won’t work. You may try to do other things to control your thoughts, like repeating positive things, such as, “I’m really a good person,” or, “I believe in myself.” but you will know these affirmations only work for a few minutes. If you feel more demoralized, it is a good thing.

9. If others don’t worry for themselves, it’s your duty to worry for them!

Some people just don’t get it. It’s an uncertain world fraught with danger, and they don’t seem worried at all! Your children blithely walk to the bus stop every morning, not a care in the world. Worry for them! Your coworkers know that your company’s stock fell yesterday, yet go on as if nothing happened. Worry for them! Your wife doesn’t seem to be concerned about all those stories about catastrophic medical bills. Worry for her!

10. People who don’t worry are just not concerned!

They are bad people, and you should be suspicious of them. You must equate certainty with irresponsibility. Your coworkers may be working hard toward your company’s goals, but if they are not worried, well, they are unreliable and incompetent. You must worry for them, and about them, too. Is your sister seemingly unconcerned that your parents may not have enough money for a nursing home after they retire? She is dodging her duty, and should be reminded of it!

 11. “Should,” “must,” “ought to,” “need to,” and “What if…” are essential in your vocabulary.

If they’re not, you are not world-class. Every statement must be laced with one of these or something similar. You are running out of milk. Instead of making a note of it for your next shopping trip, you are obliged to say, “I must get some milk!” If you have a few minutes with nothing to do, world-class worriers will say, “I should be doing something productive!” And if you see a news report about a famine in some foreign country, “What if…” should be your first thought.

12. If you’re worried about something, you should do something about it right now!

If you can imagine something bad happening, you must take action. You should not only pay attention to negative thoughts, you must to obey them immediately! Your every negative thought becomes a commandment. If something is necessary, you must do something about it right now.

13. You must worry about and regret your past actions

Things in the past are fruitful fields for the world-class worrier. There is no such thing as forgetfulness and forgiveness. If you think that you slighted a co-worker six months ago, they may have not forgotten it, and you must worry about it. If you and your spouse had a big argument last year, you must worry about it, even though you haven’t had one since. If your child didn’t do so well in third grade and they are now applying for college, you must, you should, you need to worry about it!

14. If something you worry about doesn’t become true…

Your worrying about it kept it from happening. The moles on your arm that you saw two dermatologists about do not become cancerous because you worry about them. Or just maybe, you didn’t worry about the right thing. Maybe you have a mole where you can’t see it and it is cancerous!

15. Gather information to confirm your worst fears

It’s called confirmation bias: you want to gather as much information as possible so you can confirm your fears. Taking a flight? Google about plane crashes, not safe landings. Heard on the news that there was a case of West Nile virus on the other side of the country? Find out as much as you can about West Nile virus so you can be prepared! Remember those trials ten years ago about nefarious day care workers? Could the day care workers in your child’s day care center be pedophiles? Look them up to see if they have criminal records!

16. Put things off

Procrastination is just a fancy form of worry. Prolonging taking a look at important issues makes anxiety worse and makes it last longer, so delay things until the last minute. But you must remind yourself every minute that these things are undone, else procrastination will do you no good. Taxes due in two weeks and you haven’t done a lick? Worry about being late with them, how much you are afraid you’ll owe. Got a project at work? Delay it, but worry that it won’t be done well, or that you’ll have to stay up all night three days running, or you’ll be fired. 

17. Practice, practice, practice

If you have a speech to give, practice it 10 hours, when 2 or 3 would do most non-worriers. Rewrite it for the fourth or fifth time. Practice it some more. Then after you give it, have second thoughts about your delivery, no matter how many compliments you get. Determine to work harder next time. You can never be too prepared!

18. You must ruminate and think about the same things over and over

If you don’t know something or it doesn’t make sense, then worry about it over and over until it does! So what if others think we live in an uncertain world? They are just the grasshopper and you are the ant! If there is something in reality you just can’t swallow, you need to get control of it. The solution? Worry!

19. Complain and speak your worries to everyone who will listen, and those that won’t

Keeping your worries to yourself is uncharitable at best, and unforgivably dangerous at worst. You must inform others of what you are worrying about so they can be prepared, too! Worried about the state of your company? Rumor and gossip are your friends. Have fears about whether the newest flu vaccine will be effective for older people? Your mother must know! So what if your friends start screening their calls? You are carrying out your responsibility to yourself and the world. 

20. Check and recheck

If you “kind of remember” that you’ve done something, it’s your responsibility to recheck it now! Even though your energy is sapped by constantly rechecking things, you have your duties, and they must be taken care of! Driving across town to an unfamiliar place? You’ve printed out the directions, but it wouldn’t hurt to look them up and print them out again. Sent an important email? Check and recheck your “sent” box to make sure you did it, and worry that it didn’t get there. Call your babysitter every 30 minutes to make sure the kids are ok and she’s not having a wild party. Continually tell your children not to talk to strangers in case they forget.

21. Live in the future

Your worries and negative thoughts today will make you prepared! And tomorrow will bring its own new emergencies. You can’t relax for a minute, because the uncertainties of the future must always be in your mind! It’s the ant and the grasshopper all over again.

22, Doubt is good

There are no certainties, whether in the past, in the present or in the future. Doubt must be your constant companion, however much it unsettles you. Who knows when that error you might have made in the company’s books five years ago will rise up and bite you! That old girlfriend your husband was so crazy about when he was in high school… who knows when she might call him up and make him forget his wedding vows? And vacations? There is no vacation from doubt! Though you rechecked the front door five times, did you turn the stove off?

What do you think?

I hope you know I’m not trying to make fun of your Anxiety Disorder … that should be apparent not only because of the very subject of this blog, but by the many articles I’ve written. 

But sometimes humor is the best teacher, and this list is trying to reach all you worriers out there with a laugh or two. 

Maybe this article will help you see that there is some sort of internal logic and consistency in the way you think. These 22 tips fit together like a puzzle into a single whole. Worriers use worry to solve problems that don’t exist. They use worry to get rid of uncertainty in an uncertain world. And they use worry to assure themselves that they will never feel bad or fail. These are impossible goals.

I intend to come back to the subject of worrying in the near future — don’t worry, not as humor! In the meantime, I’d like to know what you think.

• Can you add any more tips to this list?
• What do you think is the single most characteristic trait of a worrier?
• Were you offended by this article?

As always, your comments are welcome!

If you have enjoyed this article, please consider subscribing to this blog, either via RSS or email at the top of your screen. It’s free! I would also appreciate your sharing it using your favorite social media, such as StumbleUpon or Digg. Just click the little green “ShareThis” button at the bottom of this post.

Resources used in this post:

Leahy, Robert L. (2008, May 1). How Does Your Worry Make Sense? Retrieved June 27, 2008 from Psychology Today Web site: http://blogs.psychologytoday.com/blog/anxiety-free/200805/how-does-your-worry-make-sense

Lyons, Molly. (2008). The 7 Worst Ways to Worry — and How to Stop Today. Retrieved September 3, 2008 from Redbook Web site: http://www.redbookmag.com/681118

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I don’t make it a practice of reposting articles, but I’m doing it this time.

There is a post from July 3, 2008 entitled “8 Tips to Survive Gatherings on the Fourth” that is relevant to gatherings on Labor Day, or Thanksgiving, or Christmas, or any day that you have to go to a gathering or a party. I have updated it and present it here, hoping it will help someone.

It will be especially helpful for people with Social Phobia, Panic Disorder, and those that suffer from panic attacks.

I have to go to a wedding party soon, and you can bet that I will be using those tips myself!

Here are some suggestions for things that have helped me:

1. Don’t try to go to too many gatherings — Set boundaries

You may be invited to more than one gathering, such as one at Mom’s and one at your best friend’s. You don’t need to attend all the parties you are invited to. Have an excuse to say “no” without stretching the truth too far. If you have to turn down an invitation, be kind but firm. When you put yourself first, you will have more to give everyone else.

2. Try to find out how many people will be there

It is very upsetting to me to find a house full of people when I just expected a friend and his family. Try to find out who will be there, and how many. This may not always be possible, but it’s worth a try to ask tactfully. If the circumstances are not right — too many unfamiliar people, or just too many people in a small space — you can take a rain check on the invitation. Do not sacrifice yourself to do what you think others expect.

3. If you go, set time limits

You don’t have to be the first to arrive and the last to leave. I always try to arrive not too long after a party starts to avoid making “grand entrance” in front of a lot of people. Always decide in advance when you are going to leave, whether it’s a set time or a set of circumstances, such as a decent interval after the meal is finished. Agree on this time with any persons going with you, so no one is disappointed or angry. And remember that if you need to leave before your agreed upon time, it’s ok.

4. Have a safe place you can retreat to

You need to have a safe place to go when you need to if your Anxiety is severe, particularly if you have Panic Disorder and Social Phobia. If your host understands, your safe place might be a bedroom or home office. Failing that, you might retreat to a bathroom or even your car. Do not be embarrassed to get away from the party to pull yourself together! Knowing that you have a safe place might mean that you never have to use it.

5. Bring someone along who understands

If at all possible, bring a friend or family member who understands your situation. For people with Agoraphobia, taking another person along may be the only way that you can go. This person should understand that you need to leave when you say so, and should know about your safe place and why you may need to use it. You don’t want to hang onto or hide behind this person, but having a “safe” person along will help you enjoy yourself more.

6. Help yourself remember your coping skills

If you have severe Anxiety Disorders and are recovered enough to go to parties, you will already have a set of coping skills to use, such as deep breathing and relaxation. Go over these skills before you leave home. Under pressure it’s easy to get flustered and forget the skills you have fought so hard to learn. There’s nothing wrong with writing them down on a slip of paper to remind yourself.

7. Remember why you are celebrating

Though it’s great to celebrate a wedding, a holiday, or a birthday, the main reason you are going is to be with people you care about and to meet new ones. It’s a time of enjoyment, sharing friendship and happiness. Think about how much you will enjoy yourself. If you think you will have to violate yourself to fit in, it may be better to stay at home.

8. If you can’t go, you can’t go. If you can’t stay, you can’t stay

You can say “no” at any time. It’s ok if you can’t go or you can’t stay. You can make it up to the people at another time, if you think they may be offended. Don’t make yourself sick when you realize you’re too anxious to go or stay, even if you have to cancel at the last minute. But if you can’t go or stay, make real goals to work on in the future.

What do you think?

• Do you have any further suggestions?
• What has worked for you?

As always, your comments are welcome!

If you have enjoyed this article, please consider subscribing to this blog, either via RSS or email at the top of your screen. It’s free! I would also appreciate your sharing it using your favorite social media, such as StumbleUpon or Digg. Just click the little green “ShareThis” button at the bottom of this post.

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