#I’m a terrible example of bipolar recovery | Explore Tumblr posts and blogs

likeabxrdinflight · 4 years ago

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More to keep you distracted! What's your opinion on the idea that Azula needs to hit rock bottom before she can recover?

Haha, went to sleep before I got this one. But thanks for indulging me ^^

There’s lot to unpack here, so this will be long.

So. It sort of depends on what is meant by “rock bottom.” If people mean she needs to suffer more, experience more punishment or trauma or mental illness, then...I think that is a dangerous notion to be telling anyone, especially those with a trauma history or mental illness. I don’t think suffering is a requirement for growth or change, nor do I think suffering somehow inherently begets growth. There are plenty of people for whom suffering and trauma only made them bitter, angry, and deeply unhappy. I think, more than anything, it is love, support, and hope that promotes change- not suffering.

I’m going to briefly use the example of my brother, who was diagnosed with bipolar disorder last year. His depression made him angry. He became a very nasty, toxic person when he was deeply depressed. He was suffering, but it didn’t make him better. It didn’t make him a nicer person and it certainly didn’t make him open to changing himself- in fact, in his lowest states, he was least open to getting help and he was at his absolute meanest because of it. He became stubborn and rigidly convinced that nothing could help him, that things would never get better, and he verbally attacked anyone who tried. I was on the receiving end of this a lot, I felt like a punching bag more than a sister some days. But he was finally diagnosed after years and years of me and my parents begging him to see a psychiatrist, who put him on a proper medication. That was when he began to improve. He has begun changing and healing because he got help, because he got the kind of medical support he needed, not from suffering through debilitating depressive episodes. I have my brother back now, I can talk to him without getting my head bitten off, he is in a much better place and finally seems hopeful for his future, and our relationship is much better than it was a year ago.

Now, there is such a thing as post-traumatic growth, because some people do find meaning in suffering and use that to facilitate their own growth and development. But in order to utilize post-traumatic growth, someone has to already be quite resilient, and these are people that typically come from healthy backgrounds who have secure attachments. Spirituality is also associated with post-traumatic growth. And that’s fine, I am hardly about to tell someone “no actually, please don’t find anything positive in a terrible thing that happened to you.” That would be pretty shitty of me. But post-traumatic growth is probably not the norm and under no circumstances should we be shaming people whose trauma does not lead them to positive change, and nor should we act like trauma and suffering are necessary for it. That’s just not the reality.

There are some things I do think are required for Azula to heal and grow, however. One of them is remorse, and maybe this is what people mean by “rock bottom.” Maybe they mean she needs to hit a certain point in terms of her world view deconstructing in order to experience true remorse. And though I wouldn’t word it that way, I wouldn’t call it “rock bottom”- I do think Azula needs to understand why the war was wrong and harmful and I do think she needs to unlearn the toxic doctrines of the Fire Nation (and her family) in order to fully heal. I don’t think this is the first step in her recovery process, but I do think it’s an important one. And it may be a difficult process, but feeling remorse for one’s actions does not have to mean consistently beating oneself up or wallowing in shame and guilt for eternity (I think sometimes people assume that’s the case...). There’s a healthy version of this in which Azula can realize the ways in which she was used by her father as a tool of war, acknowledge her role in it and her role in other peoples’ suffering, and work to make amends while also improving herself as a person and healing from her own trauma. Not necessarily in that order.

There’s a lot she needs to unpack personally too, and for her to finally, consciously acknowledge that Ozai never loved her is likely to be incredibly painful, but I think that’s an important part of the process too. That’s an illusion that a lot of abused kids cling to- that the abuser was right, that the abuser loves them, that it’s all okay, that they deserve the abuse- because they need to try to preserve that sense of attachment to their caregiver. It’s a protective process. (You see this in Zuko too, for a time). But when the illusion breaks, and it usually does (side note- don’t force this process, you risk re-traumatizing the individual), it can be devastating. It’s a huge blow to the defenses that the victim has constructed. For a child, this is especially horrible. A parent is supposed to love and protect you, and when you realize they don’t...I mean...it’s an awful pain.

There’s a child I worked with when I did a year-long training in a foster care agency that I sometimes hold in mind when I think of Azula. It’s not a direct comparison, and certainly Azula isn’t a real person and this child is, so bear that in mind, but there are some similarities. I cannot give details on this, but I can say this: he was much younger, but still very aggressive and could be violent, and he had so many emotional and behavioral problems. He also had an extensive history of abuse and abandonment. It was hard to read his file. Yet when I worked with him- and all I was doing was the psych eval, not even therapy- this child became so attached to me because I showed him empathy and support. And he said something to me I’ll never forget, which I won’t quote directly, but it was along the lines of wishing his parents cared for him like I did.

And I’d met with him twice.

So I would hope that if and when Azula has this same revelation, that her father does not and did not love her, she has some support in her life to help her through that. Perhaps that is what is meant by “rock bottom.” In which case...maybe, yes, it is necessary for her to go through this painful process in order to heal.

But if by “rock bottom” people mean punishing her more, throwing her in prison, making her suffer some kind of retribution, that she should have to sink further into depression or mental illness before she is allowed to heal...no. I don’t think that’s necessary at all. People in the ATLA world would want to see justice for the war, and I understand that, but inflicting punishment on a fourteen-year-old in the hope that it makes her a better person is not justice.

#abuse cw #this is a bit of a minefield of discussion topics haha so I'm trying to pull in as much of my expertise as possible for a tumblr post...#healing from abuse is a long and complicated journey #it's also an individual one #so every person who has been abused will have a different process by which they heal #atla #eshusplayground

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twistedwonderlandimagines · 5 years ago

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Big sis Sienna’s advice for learning how to happy

Not TW, but your big sis is here to give advice on how to be less sad and more happy. I’ve had to deal with Social Anxiety, High Functioning Autism, and Bipolar Disorder for almost twenty years now (that is to say my whole life), and I’ve learned a few things that I’d like to share.

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1. When you find a new group of people to socialize with, let go of someone toxic, or start towards recovery, it’s going to be scary at first. It’s going to give you anxiety at first, and it’s gonna take a while to get used to the changes. The human brain likes routine, so even good changes can feel really bad at first. When my abusive relationship ended, I felt horribly anxious and depressed for weeks, but now I’ve never felt better in my life.

2. It’s hard to stop negative self-talk. But it’s way harder to recover when you’re saying bad things about yourself. You have to force yourself to say good things about yourself and the things you make. You’re going to start seeing the good in yourself, and you won’t have to force yourself to find the good in yourself and the things you create anymore. It may take time, but you’ll get there.

Instead of saying, “my writing is garbage,” or “my art is terrible” pick out a scene or part of the drawing you really like and take a moment to compliment yourself on it. Look at the parts you didn’t like and instead of insulting them, try to find the things you did right and consider how you might make it even better the next time.

3. Do multiple activities in one day. Doing one thing for too long is depressingly boring. You may love writing, playing video games, or reading comics, but doing them nonstop without changing things up gets stale quick.

Mental stimulation can improve your mood.

4. I know you’ve heard this a million times, but remember to take care of yourself. If you’ve got medication, take it. Make sure you’re drinking water and eating well. Get at least eight hours of sleep and remember to exercise. Don’t forget about hygiene.

5. Keep a journal. Writing down your thoughts really does help.

6. There are going to be setbacks. You’re going to feel like you’re sliding back downhill, and this is normal. There is nothing wrong with you if you face a setback. Everyone does. Try to stick to the other advice on this list and push through. You’re doing great.

7. Go to therapy. Go to therapy. GO TO THERAPY.

Everyone should go to therapy at least once if they have the opportunity. Why? Because we live in a society where people don’t talk about their feelings enough. We all need to learn how to be more open. Also, there’s no shame in needing therapy and medication, no matter what anyone says otherwise.

Finding the right therapist goes a long way towards recovery. If you’re with a therapist who doesn’t feel quite right to you, then express to the psychiatrist that you need a new one. Don’t be afraid to hurt their feelings- they understand that they might not be the best fit for you.

8. Go to the people you love and trust for emotional support. If you saw them struggling, you’d want to help them, right? I guarantee that they want to help you just as much.

Don’t expect them to be able to provide the same type of professional help that a therapist would, though. Friends and family can give you a shoulder to cry on and remind you that you’re loved and wanted. Therapists understand how the human mind works and are professionally trained to help make you feel better in the long run.

9. This may seem easy, but it’s actually a hard lesson to learn for many people. Not everyone will agree with you or like you. In fact, some people may dislike you not because of something you did or said, but just because they’re having a bad day and need something or someone to take it out on. (They need to learn better coping mechanisms.)

Also, for every one person that dislikes you, there are a lot of others that love you. The people that love you are the most important, so don’t convince yourself that the people who dislike you are a big part of your life.

10. Figure out what you value, and stick to your values. It may seem odd, but sticking to a moral or philosophical belief can ground you and make you feel more proud of yourself. As an example, you may believe that people should only be judged based on how they treat others. Or you may believe that no life should ever be cut short for any reason, even as a punishment.

11. Take responsibility for your actions when you are in the wrong, but you don’t have to yield when you are right.

12. Holding a grudge only makes you feel worse about what happened. By no means am I saying you have to forgive them or let them back into your life. What I’m saying is that you shouldn’t let the past haunt you forever. You’ll still think about it sometimes (everyone does), but you should try your hardest not to dwell on it. I know that’s hard, but if you never try then you’ll never move on.

13. Sometimes it’s better to analyze a situation logically rather than emotionally. I struggle with this myself. It’s hard to look at a situation without letting too much emotional bias muddle your perceptions. And of course there are times when emotion should outweigh logic, but when your friend hasn’t replied to a text in an hour they’re probably just busy, unless you just said something terribly obscene (which you probably didn’t).

#not tw

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alifeasvivid · 6 years ago

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Recovery is literally the hardest thing you will ever do. (tw suicidal thoughts mention)

It’s also the most worthwhile.

So I’m not gonna rehash everything in my life since last December. Long story short, I hit rock bottom, attempted suicide in a more serious way than I ever have before after dealing with those thoughts for around 15 years. I got sent to inpatient treatment and that did it. I broke the cycle. I got serious about recovery and I’ve been doing really, really spectacularly well since then.

Until recently.

That’s the tricky thing about bipolar disorder. It’s cyclical.

I’ve been falling into a depression since the end of September and the suicidal thoughts I had worked so hard to get let go of are niggling at the edges of my brain. It’s so hard. It’s not the depression that really gets me, it’s the feeling great almost all year and then now crashing back into it. It’s the cycle. It’s the ups AND the downs. I don’t want to do it.

I don’t want to live my life waiting for the other shoe to drop all the time. It’s TOO HARD and I’m so tired and I hate it. I hate it so much that I would rather---

But I look back and read all the things I’ve said on here, I remember all the conversations I’ve had with people about how even though recovery is immensely difficult, it’s worth it. I said once that I never thought I’d live this long so everything from here on out is a bonus. This is a part of my life I never thought I’d see, so why not make it something beautiful to look at?

How can I say all of that stuff, how can I stand as a credible example of all this real, hard-won positivity, hard-won self-love and confidence, if I fall apart at the first test?

I don’t back down. I don’t turn away. I don’t give up. Ever. I’ll work through this. The winter months are always a big bummer for me, but it’s fine. I can do this. I’ve been through so much worse.

So with that, a quick note to gen Z or any younger millenials... I see you guys. You’re everywhere, so I see you. I love you and think you’re all just the coolest, so I want you to have the best lives you can... so if it’s alright with you, I have some advice.

Do NOT idealize mental illness. Do not regard pain, suffering, and misery as dark and edgy and cool. I know it can be part of how all humans work out their own identities as teenagers/young adults, but... don’t take it too far. Listen to angry music. Listen to sad music. Write some highly emotional poetry and keep it in a journal that you’ll be horrified to read when you find it many years later. Let that be it.

Pain and darkness don’t make you edgy. They don’t make you interesting, particularly not in a cultural climate which is already so dark. I know a lot of millenials who have fallen into this trap (including me, shocker). It is a difficult and sticky mindset to get out of and it can lead to way more terrible things than bad poetry. Indulge in darkness in fiction, but don’t construct the narrative of your own identity and your life in that same fashion. I know maybe you think, like I did, that it doesn’t matter because you won’t live to see the part where you actually suffer the consequences for this mindset, but I stand here as proof that you will almost definitely live to see it.

Take care of your future self by loving who you are now. I know it’s hard. It’s hard because if you love yourself, if you know you’re a worthwhile person, then you have to treat yourself as such, which means you have to work hard to give yourself the life you really want.

I hope you know by now that I’m not the sort of person who says you have to have it all figured out right now. You absolutely don’t have to have it all figured out, whatever the hell that means anyway. It’s never too late to start or restart your life, but I had to learn that lesson the hard way and all I’m hoping to do here is maybe help prevent you from having to do the same.

Recovery is hard. Life is hard. Please, learn from me. Don’t make all of it even harder on yourself if you can help it.

You guys give me hope every day. You guys convince me that even as the people older than us make stupid decisions, better things are coming. More compassionate, more wonderful, smarter people are already here. I can’t wait for you to grow up. I can’t wait to see all of the even more amazing things you will do. We older millenials had the same potential, but no one believed in us. To this day, no one believes in us, but I believe in you.

I think you’re worth me sticking around for... so I can see something beautiful.

I hope you can feel that way about yourselves too.

#tw suicide mention #personal #long post

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your-dietician · 3 years ago

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A child mental-health fix takes early action, more help

New Post has been published on https://tattlepress.com/health/a-child-mental-health-fix-takes-early-action-more-help/

A child mental-health fix takes early action, more help

In most ways, Symone is like any other 17-year-old looking forward to her senior year in high school and what life may bring after — college and a career in music therapy or entertainment law, she hopes.

Her teenage years have included some notable highs. She shared the national spotlight as part of the Detroit Youth Choir, which was given a key to the city for “being the Heart, Soul and Spirit of Detroit.”

DAY ONE:Mental health crisis: Children at breaking point during COVID-19 pandemic

DAY TWO:Michigan emergency rooms confront ‘tidal wave of sadness’ among young patients

And yet, Symone said, she can suddenly feel despondent. It comes “randomly,” she said: “It’s like a mind battle.”

“I can have the best day ever, then suddenly I’m sad,” she said. “Like I want to be dead. I want to be dark. I can’t feel light, and I can’t feel happy.”

Which is why she offers this simple plea: “Don’t give up on people with mental health” issues.

In this series, Bridge Michigan and Indianapolis-based Side Effects Public Media have highlighted critical gaps in mental health resources for children and teens across the Midwest — that includes a shortage of psychiatrists, therapists and inpatient beds, and the warehousing of children in hospital emergency rooms as they wait for specialized treatment. It’s a system further strained by COVID-19.

Fortunately, nascent efforts are underway at the state and federal level to improve access to treatment. They range from placing more psychologists and social workers in schools, to encouraging more medical residents to pursue careers in child psychiatry, to deeper investment in public health, including funding for more psychiatric beds to help thousands of families with a child in despair.

Some say the timing is right for an overhaul. Federal COVID stimulus funds can fuel the effort in ways not previously possible, including more money devoted to behavioral health as students across the country prepare to return to classrooms in the fall.

Here are seven ideas or legislative plans that may ease the burden and allow more young people like Symone to thrive:

More psychiatrists, sure. But how?

Pick just about any state and there are not enough psychiatrists who specialize in child or adolescent treatment, especially in rural areas.

The American Academy of Child & Adolescent Psychiatrists recommends 47 child psychiatrists for every 100,000 children. In Michigan, there are 11 per 100,000 children; in Indiana, it’s even worse at 6 per 100,000.

While the number of child psychiatrists has risen nationally in the past decade or so, there are still precious few and they tend to practice in more affluent, better educated and metropolitan areas. A 2019 study in the journal Pediatrics found that 70% of U.S. counties had no child psychiatrists. For example, and as Bridge has reported, Michigan’s rural Upper Peninsula, more than 300 miles long, has zero child psychiatrists.

Another impediment: Child psychiatrists tend to begin careers near the East Coast and West Coast cities where they trained, said Dr. Sanya Virani, a trustee with the American Psychiatric Association.

So how might policy makers get more medical residents to choose this field? A greater focus on financial incentives such as student loan forgiveness or higher reimbursement rates might help, particularly if they are targeted to practicing in hard-to-reach regions.

Becoming a child psychiatrist typically requires five years of training beyond medical school. That means many newly-minted child psychiatrists enter the workforce with mountains of debt.

The Michigan State Loan Repayment Program offers up to $200,000 over eight years to medical professionals practicing in underserved areas. And this year, the program is prioritizing loan forgiveness for inpatient pediatric psychiatrists. MIDOCS, a collaboration among medical schools to boost training slots in Michigan, also offers loan forgiveness.

Of course, psychiatrists are only a single point on a larger spectrum of care. Loan forgiveness programs also are used to lure other critical staff, such as social workers or therapists who have racked up student debt.

More inpatient beds

As COVID-19 began to catch the world’s attention in December 2019, Beaumont Health broke ground on a $40 million, 100,000-square-foot, 144-bed behavioral health hospital in Dearborn, near Detroit.

Officials say the facility, expected to open this year, will include 24 beds for children with depression, anxiety, schizophrenia, autism, anxiety, bipolar disorder, substance abuse orders, or other mental health problems.

That will help ease a logjam of young people in emergency rooms awaiting beds, particularly in populous southeast Michigan. The hospital also will train psychiatrists — adding the first six psychiatry residents this year and ultimately training 24 at a time, though it’s unclear how many will specialize in children and adolescents.

“It’s terrible to watch these kids in crisis. We just don’t have enough resources right now for them,” said Dr. Whitney Minnock, medical director for the pediatric emergency room at Beaumont Royal Oak.

Still, 24 beds is limited help.

Even if every one of Michigan’s 334 pediatric inpatient psychiatric beds were used — and they’re not, often because of lack of support staff — Michigan’s bed capacity still falls far short of what’s needed, experts said. The regions where beds are most scarce — such as northern lower Michigan and the Upper Peninsula — are five to 10 hours from the new Dearborn hospital.

Use one-time federal stimulus funds

Michigan Gov. Gretchen Whitmer and some lawmakers have proposed using Coronavirus State Fiscal Recovery Funds to boost behavioral health services in Michigan.

A House budget proposal passed in May would set aside $220 million for sweeping infrastructure improvements, including $100 million to expand long-term pediatric psychiatric inpatient services.

That would add as many as 120 inpatient beds for youths, said Laura Appel, vice president and chief innovation officer for the Michigan Health & Hospital Association, an industry group.

The MHA and Republican state Rep. Mary Whiteford, a registered nurse who has pushed for years for better mental health services in Michigan, helped drive the plan.

Another $85 million in the plan would build a new psychiatric center for children, replacing the aging Hawthorn Center, the state-operated inpatient facility in Northville, for children and adolescents, Whiteford said.

The budget proposal also called for $15 million in renovations to hospital emergency rooms, which would, among other things, make them safer and more secure for suicidal patients as they await treatment.

So, for instance, ERs could be outfitted with rooms without door knobs or clothes hooks that patients in acute distress could use to hang or harm themselves.

Appel said people with mental illness also need an area set apart from the typical chaos of a busy ER, with soft or natural lighting to help calm agitated patients, similar to environmental features found in psychiatric facilities.

At Grand Rapids-based Pine Rest Christian Mental Health Services, the living and treatment areas have specialized furniture that is too heavy to throw. Staff consulted a botanist to ensure the indoor plants — designed to offer a soothing, outdoor feel to large spaces — are not toxic to a child who might try to eat them, a spokesman said.

The Michigan Legislature left for summer break this week without finishing the state budget. But lawmakers did finish work Wednesday on a school spending bill, setting aside $240 million to place more psychologists, school social workers, school counselors and nurses in schools.

These positions are “essential” and schools are “uniquely suited to assist youths with mental health concerns,” noted the nonpartisan Citizens Research Council of Michigan, a public affairs research group. The CRC released its own findings this week on child mental health care services, noting the lack of school staff available to assist students in crisis. Other researchers have expanded that idea to include integrating behavioral health into primary-care pediatric settings as well.

In May, the federal Substance Abuse and Mental Health Services Administration (SAMHSA) announced $3 billion in American Rescue Plan funding to support mental health and substance use grant programs across the U.S. That included nearly $42 million of new funding for community mental health centers in Michigan and more than $25 million in Indiana.

That followed $2.5 billion in SAMHSA payouts to states in March.

Intervene early

Mental health advocates say it’s critical to intervene early with those most in need.

Boosting school- and home-based programs helps identify and treat mental illness sooner, before a young patient falls into crisis, Dr. Michelle Morgan, a retired psychiatrist in the U.P., recently told residents at a community meeting in Eagle River.

Early action also helps law enforcement, especially in rural areas that operate with just a handful of officers each day.

Sheriff Joe Brogan of Baraga County in the U.P. told residents at the same meeting that when officers respond to a person in mental distress other emergencies get missed. “We don’t have anybody answering calls for service,” he said.

Michigan is one of several states working to provide police with training to better identify mental illness in people they encounter and get them into treatment centers for evaluation and help rather than sending them to jail.

Indiana has turned to a program called “high-fidelity wraparound” as a way to address complex behavioral issues in young people so they don’t get to the point of needing inpatient care.

Under the wraparound model, a case manager is assigned to coordinate a child’s care, which might involve therapists or other medical professionals as well as social workers, teachers and parents. Indiana’s Medicaid program offers this service to qualified families.

Wraparound services are useful when traditional methods of supporting a child’s mental health needs are unsuccessful. The goal is to deescalate a problem before it reaches crisis stage, said Ebony Reynolds, clinical officer of Detroit Wayne Integrated Mental Health, which manages providers for families in Wayne County.

Families “deserve a system that’s responsive to their needs, rather than just getting thrown whatever it is this system has to offer,” said Kimberly Estep of the National Wraparound Implementation Center.

Another key to early intervention is round-the-clock access to mental health support, said Whiteford, the state representative. She sponsored legislation that led to a 24-hour Michigan Crisis and Access Line that opened in April in Oakland County and the Upper Peninsula.

The crisis line, which also takes calls from those who who dial the National Suicide Prevention Lifeline, will be accessible across the state by fall 2022.

“It folds all these hotlines into a one-stop shop for anybody who needs help — from a police officer to a nurse in an emergency room to a mom worried about her child,” Whiteford said.

The line will also have access to Michigan’s Inpatient Psychiatric Bed Registry, allowing callers — from ER staff to parents — to learn sooner if there is an available psychiatric bed or service in their area.

U.S. Sens. Debbie Stabenow, a Michigan Democrat, and Roy Blunt, a Missouri Republican, helped lead an effort this spring to earmark $489 million in federal funds to expand Certified Community Behavioral Health Centers, part of a federal network that can immediately screen people in crisis, regardless of their ability to pay, and get them help. Of the amount, nearly $20 million is headed for Michigan to support efforts at five Detroit centers.

Early intervention part two: school screenings

In 2018, the Lansing-based advocacy nonprofit Disability Rights Michigan filed a class-action suit, K.B. v. Lyon, accusing the state of Michigan of “staggering failures to provide needed mental health services to thousands of children and their families.”

Kyle Williams, director of legal advocacy for the advocacy group, said one crucial step in addressing systemic failures is a universal screening tool that would identify children in need, trigger a full assessment, and connect them to services before they spiral into crisis. It could be used by school counselors for a child acting out in class or staff at a juvenile justice facility after a child has been picked up by police, he said.

A child in crisis “doesn’t have the time to wait three years for an intensive service array,” Williams said.

“If you don’t pair home- and community-based services (with inpatient care), you’re looking at a cycle in which kids end up in an ER bed, return to the community, and keep destabilizing, then return to the ER again,” Williams said.

Details are still being hammered out in a settlement agreement in the lawsuit after several extensions — the latest extension is to Sept. 1.

Ease bureaucracy

Parents have enough worry when a child is in crisis. But many are forced to change jobs or quit to become full-time advocates for their children as they work through layers of bureaucracy, said Jane Shank, executive director of the Lansing-based Association for Children’s Mental Health.

“Parents get beaten down a little,” she said.

As it stands now, Medicaid funds flow through Michigan’s mental health managed care system which is made up of 10 Prepaid Inpatient Health Plans, or PIHPs, throughout the state.

They pay for treatment and services at local Community Mental Health Agencies, which, in turn, may contract with other providers. With each layer, accountability disappears, according to critics.

Rep. Whiteford said she would replace the state’s 10 managed care organizations with a single oversight body — moving the state closer to a fee-for-service health system and making the state accountable rather than diffusing accountability through layers of managed care bureaucracy.

It also would lead to “significant reduction in administrative costs,” according to the nonpartisan Michigan House Fiscal Agency. Michigan Senate Majority Leader Mike Shirkey, whose overhaul plan includes privatizing much of mental health care, and who also wants to downsize or eliminate the PIHP managed care system.

Critics argue, however, that such plans replace one layer of a bureaucracy with another and that projected cost savings are exaggerated.

“It’s a different terrain across the state — the availability of services, the availability of staff,” said Kevin Fischer, of the Michigan chapter of the National Alliance on Mental Illness.

He said the Whiteford and Shirkey plans include good ideas, but he worries about moving to a single managed care system or oversight agency.

Locally run managed care matches local needs to the best local resources, he said, saving money and providing better care.

“The people in Houghton or Marquette (in the Upper Peninsula) know what they need better than the people in Detroit do,” he said.

More telemed to reach distant children

The field of telemedicine dramatically expanded during the pandemic, in part due to relaxation of regulations by the federal government and private insurers amid COVID-19.

A Centers for Disease Control and Prevention study noted a 154% increase in telemedicine usage in March 2020, as the pandemic first hit, compared with the previous year. Telemedicine can be useful for people without reliable transportation or from rural areas without a nearby provider. It can also help parents avoid taking time from work to transport children to therapist appointments.

With so many regions in Michigan and Indiana lacking in mental health providers, strengthening telehealth can help improve access to care.

But barriers remain. Indiana-based research shows Black and rural populations are less likely to have reliable internet or a home computer. And despite a year of remote learning, children may have more trouble engaging with mental health professionals on the computer.

It remains unclear whether private insurers will continue to pay for telehealth visits once the pandemic fades. Policies can differ by insurer, state or particular plan. Many states, including Michigan, have enacted parity laws that require insurers to equitably cover in-person and telemedicine visits.

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babyconnectingworld · 4 years ago

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Can weaning your baby cause maternal depression?

A year into nursing my third son, I went to feed him for the millionth time and the strangest thing happened: I was overcome with the almost nauseatingly strong urge to not. I knew it was time to begin the weaning process, just as I’d done before with my other two babies. It took a few weeks to fully wean him, using the same gradual approach I’d taken with his big brothers, all around the 14-month mark. I expected a smooth transition into toddlerhood and looked forward to a life without another human attached to me. But the onslaught of physical and emotional changes that soon followed was overwhelming and all-consuming. I developed seemingly random symptoms I’d never experienced before: debilitating headaches, mood swings, sadness, anxiety and lethargy—it felt like PMS with a side of the flu. It was more intense than the first months of pregnancy had been. After some passive attempts to google my symptoms and find someone who could relate online, I realized I was dealing with one of the least discussed but more difficult parts of postpartum life: an intense reaction to weaning. I can describe it only as the “weaning fog.” My always reliable social media mom groups, and even some deeper research, produced little advice and very few articles on the weaning fog. Of course, I found information on the basics of weaning: preventing engorgement and finding alternative ways to continue bonding with the baby. But this wasn’t what I was experiencing. I took pregnancy tests (negative), visited my doctor (“It’s a phase”) and talked to other moms (huge variety of experiences). I was frustrated and I needed to know why I was feeling like garbage. My husband and I now refer to what happened to me as the “dark side” of weaning. Let’s start with the facts: Research does not, technically, show that postpartum depression or anxiety surges at this time. But that’s because mothers aren’t specifically screened for depression during weaning, as it’s usually a temporary phase and everyone weans at different times—it could be three months postpartum or three years postpartum. High-quality research simply does not exist yet. However, plenty of women report feeling the effects of the hormonal changes that occur during weaning. Reproductive psychiatrist Alexandra Sacks, author of What No One Tells You: A Guide to Your Emotions from Pregnancy to Motherhood and the host of the Motherhood Sessions podcast, explains it this way: “Some women are more sensitive to hormonal shifts than others; some have more dramatic mood changes around periods, during pregnancy, postpartum and around weaning, but these are individual sensitivities—so some people feel better, and some feel worse.” Others don’t notice any mood changes at all. A decline in oxytocin, the bonding hormone stimulated by breastfeeding, may lead to some women feeling low, says Sacks. She also explains that some women feel better after weaning if they had found breastfeeding to be stressful or disruptive to their own sleep (which may increase stress hormones). When you stop breastfeeding, prolactin (the milk-production hormone) drops off, estrogen shoots back up, and all of it sent me into a PMSing, semi-permanent state of terribleness. Verinder Sharma, a professor of psychiatry with a cross appointment to the Department of Obstetrics and Gynecology at the University of Western Ontario, confirms that the prolactin decrease is the issue, but it’s not the whole story: What matters is how the prolactin affects other changes in the brain and results in depression—or even mania. Sharma says to look for a “clustering of symptoms.” Some women may experience comparatively simple hormone changes with weaning, while others might be plunged into a full-blown postpartum depression. I sure had a cluster of symptoms, but I didn’t feel they were depression-like. It felt more physical for me. “We make a distinction between symptoms and syndromes,” says Sharma. For women, all “reproductive events” related to hormonal changes—this can include pregnancy and postpartum, as well as monthly PMS, menopause, and when you’re getting your period for the very first time—increase the risk of psychiatric problems, he says. For example, bipolar disorder mania is extremely affected by hormonal changes—one in three women with bipolar disorder will experience an onset within a year of starting puberty or getting their first period. It’s also the mental disorder most exacerbated by childbirth, according to Sharma.

How to stop breastfeedingIn the 18th century, doctors and psychiatrists did, in fact, distinguish between postpartum disorders and the “lactational period,” but in contemporary studies, they haven’t done this. Sharma says we are still evaluating men and women too similarly and that a paradigm shift needs to take place for us to more holistically consider a woman’s hormones in relation to her mental health. “That change should reflect the heightened risk around the time of reproductive events,” including during weaning, says Sharma. Due to the lack of research in this area, Sharma says there are no concrete numbers on how many women experience depression or other mental disorders during weaning. He thinks screenings for mood disorders during weaning should be as commonplace as mental health assessments during the early postpartum period. Ideally, doctors should be considering and connecting potential changes at each major hormonal shift in a woman’s life. While my so-called weaning fog was nothing like bipolar mania, I’m certain it was affected by the soup of hormones flowing from my pituitary gland and swirling throughout my body. In addition to this hormonal chaos—or maybe because of it—I was also feeling a little sad that breastfeeding was over, while simultaneously feeling glad that we had stopped. After nursing three babies, I felt a sense of nostalgia and freedom at the same time. It’s that classic push-pull feeling of parenthood: Looking forward yet yearning for the past, too. Mourning the breastfeeding period and feeling a sense of grief or loss is common. Catie Agave*, a 36-year-old mom in Toronto, felt it intensely, since she knew she was most likely going to have only one child. “The journey was ending for us, so that brought on sadness as well,” she says. While she weaned her three-year-old gradually, she started to feel foggy within two weeks of completely weaning. “I wasn’t prepared for the change,” she says. “I didn’t feel like myself. I was more exhausted even though he was finally sleeping more. By week three or four, I had a lack of interest in daily activities, which is difficult when you have a child of that age.” She kept her feelings to herself at first, and then did some googling, but she found very few research-based articles and a lack of support, even in her usual go-tos: her Facebook mom groups and breastfeeding forums. “Nobody talks about it.” “There are a lot of people talking about postpartum depression,” she says. “And reading their symptoms, I thought, yeah, this is what I have—this is depression. But nobody ever said you can have postpartum depression from weaning, too. I was very sad, and it lasted for a long time. I couldn’t find anyone else going through that,” she says. “It was a scary experience.” Agave says she was hesitant to talk to her doctor because she assumed postpartum depression (PPD) was for moms of infants, not moms of toddlers or preschoolers, and she worried she’d be judged for her choice to practise extended breastfeeding. She credits her sister with encouraging her to see a doctor, in spite of her fears. “The doctor was supportive and mentioned postpartum depression can happen up until three years,” she says. Sacks is working to popularize the term “matrescence,” originally coined by an anthropologist in the 1970s, as a better way to describe and fully capture the ongoing transitions of motherhood over time, even if your baby is now growing into a toddler. “It’s a helpful framing of new motherhood as a developmental phase, like ‘adolescence’—it’s not a coincidence that the words sound similar,” she says. “Both matrescence and adolescence describe shifts that are challenging because they involve changes in so many parts of life, ranging from the physical, hormonal, social, emotional and all the rest.” Adolescence is a gradual process—it isn’t instant in the way motherhood can be divided into pre-baby and post-baby life. But we need to be forgiving of ourselves, and to acknowledge that it might take time to adjust to all the shifts and challenges happening at once. Your body, your brain chemistry and your identity are all changing. Whether it’s a few months after birth or three years later, women shouldn’t feel ashamed if they experience the weaning fog, like me, or true depression symptoms, like Agave. We all have our own recovery period. Sacks encourages moms to remember that the end of breastfeeding doesn’t mean your baby needs you any less. Agave, who had struggled with anxiety in the past—but never depression—was ultimately referred to a treatment program where she improved through cognitive behavioural therapy (CBT). She was relieved to know CBT was an option, in addition to taking prescription medications, such as antidepressants. (She was prescribed an SNRI but chose to focus on CBT treatment instead.) “Eventually, my hormones regulated and the feeling of depression significantly decreased, but to this day, the anxiety piece is still there. I think a lot of it is the stress of being a mom.” Around the time I was preparing to pursue professional help, my own symptoms eased up, around two months after they began. I found myself reflecting back on the previous two months, asking, “What just happened?” It had felt like the flu, mixed with mild depression, combined with all those yo-yo-ing feelings about my relationship with my baby. I felt so thankful to feel “normal,” or like myself, again. Batya Grundland, a family physician with an emphasis in obstetrics and women’s health in Toronto, and the former head of maternal care at Women’s College Hospital Family Practice, says gradual versus cold-turkey weaning can play a part in the intensity of hormonal changes. She believes weaning is unlikely to be the sole cause; rather, it’s a complex puzzle with multiple additional factors happening all at once. “The tricky thing is that it would be hard to associate symptoms only with weaning,” she says. For many mothers, reductions to the nursing schedule often coincide with a return to full-time or part-time work. Some women will also experience the return of their period, with ovulation and menstrual cycles beginning to regulate again during the same time frame. “It could make sense that describe feeling pregnant. With the prolactin and estrogen changes, you could feel a whole bunch of things,” says Grundland. Not only are hormones changing drastically during this phase, but women may also be spending long days away from their babies, weaning by necessity (or attempting to pump at work), juggling full-time employment, adjusting to the work/daycare dash, not sleeping enough at night and forgetting to take care of themselves in all of this. “Moms are so busy—they need to be reminded that self-care is important, and we need to figure out ways to better support mothers,” says Sacks. She nudges parents to ask themselves how much they’ve slept and when they ate their last real meal. Do you have time to simply go to the bathroom and brush your teeth alone? Have you had time to yourself not engaged in childcare? Sacks says moms need to reconnect to who they are outside of parenting—like seeing friends, spending time with a romantic partner or pursuing non-child-related interests. “If you cut out the majority of activities that were essential to your routine before having a baby, you may feel disconnected from your identity.” Both Sacks and Grundland also recommend seeking help if temporary feelings of sadness become long-term or interfere with daily activities, but they agree that some sadness can be normal for some individuals. Most women can expect to feel physical and emotional changes for about four to six weeks, says Grundland. My journey through the weaning fog, and my version of self-care during the recovery period, meant seeking out meals with multiple food groups, a simple thing that had fallen off the priority list when I was caring for a colicky baby and keeping my other two toddlers alive and happy. I distinctly recall a three-course lunch I bought for myself, including a rack of ribs, that reminded me how to enjoy other things again, as a separate human from my baby. I had forgotten that I needed to eat real food, too. The end of breastfeeding doesn’t mean your baby needs you any less, emotionally, says Sacks. It’s like every other bittersweet aspect of parenting: “You feel a sense of longing when you see clothes your child no longer fits into, but you’re happy they’re growing. A baby is able to eat foods, but the ‘baby phase’ is now behind you. You can want two things at once.” I wanted to be the selfless, amazing super mom, but to also feel zero guilt treating myself to that rack of ribs—alone—instead of nursing a baby for the fourth time that day. I wanted to feel even-keeled and clear-headed again, yet still bond with my baby in the ways breastfeeding had magically provided. In the end, the months-long weaning fog was just another example of the bizarre and unexpected, yet temporary, phases in my first few years of motherhood. Read the full article

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pokerbrookie · 7 years ago

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My "coming out" post about my mental illness

I am writing this with much reluctance since I've only hinted at my life with mental illnesses in shared posts and quotes etc. Until right now I've never “come out” and declared my battle throughout my life fighting mental illnesses. I'm sorry to those of you I may embarrass by sharing my story but it's time…. It time for me to share my story, it's time to let the world know, it's time for me to fight the stigma I so hate but have felt my entire life. As I'm sure many have deduced I fight with anxiety, but not just any anxiety. Crippling life stopping anxiety. I am diagnosed using the DSM-V as bipolar type 2, agoraphobic, and OCD (NO THIS IS NOT BECAUSE I LIKE THINGS NEAT FFS). My secondary diagnoses are social anxiety (yes even people who seem extroverted can have social anxiety) and a few others. I was first in therapy at 11 years old and I was hospitalized in 1993 at the age of 13 for the first time. So yea this has been life long battle and years of different diagnoses, different programs, hospitals, shirks, therapists, medications, self medicating and on and on. I won't bore you all with my life story but I will tell you my most recent experience (If anyone is so inclined I will happily share the whole story). My most recent attempt at mental wellness started in 2014ish it was 2 years after my grandma died and those 2 years were my most sickest in my life. I was in a dark place, I wouldn't leave the house and barely the bed, I let people take advantage of me and sadly in turn take advantage of my mother. I was legit crazy nuts, I'm talking down the rabbit hole with no light at the bottom. I was one of the people you see in movies all paranoid and such. You know the ones I'm talking about, the people you feel for but don't think you know anyone that severe. Well guess what you do, at least one (if not more closet cases), you know me. I AM A ONE OF THOSE PEOPLE YOU KINDA FEEL FOR BUT MAKE UNCOMFORTABLE WHEN YOU SEE THEM IN ENTERTAINMENT OR IN YOUR DAILY LIFE. I just hide it by isolating and acting all extroverted and funny when I'm around people. But when I'm sick inside I'm dying, all I want to do is go home and my mind races with a million thoughts, one being “I want to go home” over and over” I'm more than happy to elaborate on how my mind works if you are interested. But for now I'll stick to my work these last 3.5 years. I was put into a “partial care program” also known as partial hospitalization by my family's insistence. I was so sick I couldn't even make the the phone call, my sister called for me, my mom took me to the intake and I started the program immediately due to my severe state at the time. The program is intensive group therapy 6 hours a day 1-5 days a week depending on the client (yes we are called clients or consumers NOT patients, personally I think it's silly but if makes other people feel better then why not, I'm fine with patient myself). There are 5-6 groups a day each a different “topic” for example meditation, relapse prevention, humor therapy, WRAP (wellness recovery action plan) and so on. There are also groups called units which is where you work in the kitchen, thrift store, clerical and newsletter. I tended to not do well in the units so stuck mainly to groups. I did this for 3 years and was released into just individual therapy in January but my therapist thinks I need to go back 1-2 days for more structure… Let me say that instead of looking at this as a bad thing I have come so far in my recovery that I can see why and accept it. In the last 3.5 years I came from not leaving my house to having a part time job I love, friendships I can keep up with, and am able to recognize what I do need help-wise. Yes I live with my mom. It took until literally 2 months ago for me to accept that I am still unable to live alone successfully and that I need the help of my mom and step-dad. And you know what, it's ok. To everyone who puts down people for living with their family realize there is usually a good reason. No I don't have a full time job, no I don't have my own place, no Im not married, I don't have kids but you know what I'm ok with that. I'm actually happier than I have been that I can remember. Recently I was at an event where someone made a comment about how “terrible” my life was being on disability and delivering pizzas and it bothered me at the time and still does but now it bothers me that there are people out there who judge others that way. My life isn't terrible it's wonderful. I have family and friends who love me and I'm working on myself… that's not terrible, that's life, it's my life so now thinking back at that moment I wish I said fuck off to him, but alas my social anxiety caught in my brain and I don't even remember my reply. It's because of this guy, some posts I see on FB putting down people who can't work, and because it's time I do my part to end the stigma of mental illness that I write this post. So I beg of any of you still reading please before you judge someone or something you don't understand ask about it. Research it. Find out reasons before you look down on anyone. They may be like me, severely mentally ill so much so that it has affected my ENTIRE life. Living with it is hard but it's possible. As a side note to this post I refer to the people that attend these programs and the mentally ill in general as the “Forgotten People” we do so much for homelessness, autism, cancer you name it we help but with mental illness we turn away because it makes “normal” people uncomfortable. I bet you that in 90% of people's neighborhoods there is a group home that you don't even know about housing the mentally ill not lucky enough to have family support. There are tons of programs in every county like mine… We are all around you, you just don't realize it. We may be bat shit crazy but we are humans and awesome ones at that! If you're still reading thank you, if you have questions please ask, if you want resources tell me I'll help, please just don't forget about me because I don't go to every event or because I'm not “normal”

#mental health #mental illness #bipolor #agoraphobia #actually ocd #honesty #coming out #anxiety #social anxious #opening up

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fitnesswomenshealth-blog · 6 years ago

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Mental health does not discriminate. Forget this at your peril.

New Post has been published on https://cialiscom.org/mental-health-does-not-discriminate-forget-this-at-your-peril.html

Mental health does not discriminate. Forget this at your peril.

A new psychological wellbeing guidance plan to assistance all physicians in England is a big move ahead. That, of training course, is to be welcomed.

The push launch relating to this is listed here.

I’ve been in recovery — not only abstinent, but dwelling a fulfilled everyday living in the absence of the drug — from alcoholism for over 11 yrs now. A best storm of my psychological wellness, my regulator and other situations led me to being admitted with a cardiac arrest and coma in 2007.

At that time, the NHS Practitioner Overall health Programme did not exist. I feel the programme is remarkable.

You just cannot “half do” integration of NHS and social treatment. The occupation title of the Secretary of Condition has now even been modified to involve “social care”.

One issue that truly struck a chord with me when I was fascinated in marketing ‘dementia awareness’ is how dementia “doesn’t discriminate”.

The stigma for alcoholism, like dementia, is very powerful. The stigma of getting investigated by the GMC (permit alone staying struck off and then being publicly humiliated in general public which include in prestigious healthcare journals) could potentially be as poor as that arising from staying diagnosed with a stigmatising long-term extensive expression situation.

Your buddies depart. People ostracise you. There’s no ‘easy way out’ (while some individuals I understood have killed themselves.)

I’ve considered about it a little bit given that Simon Stevens, CEO of NHS England, created the big funding announcement to us at the RCGP on Friday. This was in the last throws of an exhilarating and emotionally demanding meeting referred to as #woundedhealer18.

I experience individually that physicians aren’t “special”. I was pressured to expend 8 many years of my lifestyle not becoming a registered Doctor (I was restored to the register in 2014). Acquiring a distinctive company for them, compared to other clinicians, at worst gives out the unintended information of self-entitlement and significance.

But I do imagine they have a especially crap regulator, which is appalling undesirable at discovering.

No matter what your views on no matter whether health professionals advantage specific pleading, it’s the scenario that the solution is not to pull the funding from covering physicians in England, but to open up similar products and services to other professionals and practitioners.

Nurses make a difference.

Social care matters.

Equality matters, as is even shown in further publicity from NHS England.

In any other case, it seems like “I’m all correct Jack”.

I am not persuaded that, typically, we’ve had comprehensive solidarity amongst specialists and practitioners anyway. Some #juniordoctors looked terribly disinterested in #bursaryorbust, a major challenge facing nurses in education. Junior doctors’ putting amassed media duplicate in the way that the plight of other teams of people today did not.

I speculate irrespective of whether this is even ‘deliberate divide and rule’, or simply just demonstrates a longstanding tradition.

So I am sympathetic to this.

The draft consensus statements arising out of the conference are superb, I assume.

I know from my possess expertise, and that of hundreds of “shares” I’ve witnessed in countless conferences, that men and women with habit complications can are likely to have very little insight into their problems, or the wreckage from their alcoholism, at the starting.

I lost all standpoint. So significantly was I riddled with an overriding perception of guilt and disgrace, I tried using to convince other health care gurus that my impulsivity and erratic conduct was a end result of bipolar ailment, a little something I could possibly have been born with. This was deeply fraudulent — and fully due to my perceived stigma.

For the medical regulator, a physician who thinks he’s risk-free to do even further ‘experimenting’, or ‘further research’, but that ends in tears, is a massive problem. Affected individual safety is paramount.

I loved my lawful studies (Bachelor and Grasp of Law) right after I obtained struck off in 2006. This was not for the reason that I preferred to impress folks with even further skills. It is since I experienced no task, I’d just come to be physically disabled, I was intrigued in the regulation, and, quite basically, I may well have very easily committed suicide otherwise at the time.

So you should indulge me with a bit of jurisprudence. ‘But for’ my alcoholism, the other regulatory concerns in competence and carry out would not have arisen. There is a direct url of causation. For ages, I didn’t find help from my GP due to the fact of the disgrace, and the paranoia around the GMC getting punitive motion as a outcome of disclosures. Unless of course health professionals get experienced health care assist for addictions, their life will slide aside, including any hope of holding down a career. I assume finding safe assistance is of key worth. Some individuals, like I did, put regulation and employment previously mentioned their enable. This is a slip-up.

I think when you get the GMC sending you strongly worded letters by courier, and they never inform you how long their inquiries will acquire (from clinicians whom you labored for, but who hardly ever helped you or discussed the dilemma sensibly to your facial area), all have faith in goes out of the window. There is no humanity.

I uncovered the Worldwide Practitioner Well being Convention 2018 deeply relocating, empowering and academic. But I actually do not want us to fall out above it being ‘Doctor only’. It’s taken time to get this far (bear in thoughts this facility didn’t exist when I was heading as a result of my torments, and this programme only exists due to the dogged dedication of Clare Gerada, Lucy Warner and team.)

But nurses, for example, who have a substantial rate of suicide and who have an similarly crap regulator (I would argue), require this service far too. Memes this sort of as ‘valuing your workforce’ are somewhat cheap — but if acquire-home shell out lags in contrast to the price of living for just about a ten years, it is challenging not to conclude that ‘actions speak louder than words’.

I hope we can rejoice the press release higher than, but also preserve a momentum for solidarity, fairness and fairness for all professionals and practitioners in this context?

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