#i definitely feel like my psychosis also plays a huge role in this

[dxntbreathein]

also i know people dont really take systems seriously whenever the word fictive is mentioned especially but in my specific experience its more complicated than just . oh thats me

its liek imprinting onto the character in the media so vividly and harshly and mixing their similar experiences to my very unrememebred ones to the point where they seem unseparable in my mind and i emotionally react off of it as if it were what happened. my perception of the character in the media also plays a huge role, not what the character ACTUALLY is like . ones perception of a thing is very impotant i feel like whjen it comes to stuff like this.

ofc this might not be "The True System Experience" [or whatever the fuck people wanna call it] but its the closest to what i experience and what ive found researching online . for reference i mostly heavily identify with OSDD-1A rather than OSDD-1B .. if that .. makes sense.

[cannibal-nightmares]

talking in tongues here Language and psychosis is so frustrating, and thats the topic of this post so this is going to be a bit jumbled. I'm going to write and not edit this much

physically Physically, it's very simple: sometimes it feels like it takes immense exertion to move your tongue to speak, to get your vocal chords to make noise. personally, sometimes it feels like the words feel like water spilling out out of your mouth. its exhausting to an extent I can't exactly describe.

internally Internally, it gets more complicated as it also applies to writing and also magical thinking. You have a lot of thoughts. A lot. And some of them dont even feel like your own. I've always described it as... Listening to your own internal ideas in your head, but theyre in a different language, and you have to translate them before saying them out loud. And then sometimes you get the translation wrong. Going back to physically, sometimes this means you stumble on your words and straight up accidentally say the wrong thing (anything from accidentally saying "chair" instead of "stair" because they sound similar, to utter nonsense that has no origin or relation), and sometimes it means mistranslating intention (not in emotionality--though that is an element at play--but in diction) idk if this is making any sense. Like saying "go right" when you were absolutely thinking and intending "go left." I think, similarly, an example is.. I can *barely* speak to my phone assistant. It's *really* difficult* for me to say out loud "Okay, Google, play 'Eternal Blue' by Spiritbox on Spotify," I just CANT get the thoughts in order. it's why I like going off-script. It's kind of faascinatiing when you see this happen in writing, though very time-consuming to catch and fix it all (too bad writing is one of my hobbies haha)

magical thinking here's the most prominent monster, in my opinion. Magical thinking and paranoia is what governs my writing and speech 100% of the time. One-hundred-percent-of-the-time. I know it plays a huge role in my introverted tendencies. it's where.. You say or write something and you think that because you've said it out loud or someone has heard it/read it, something will happen. This can be something so much as "I said the car will crash, so now it most definitely will" to, far more abstract, "I included the word 'granite' in describing something and now because i chose to use that word instead of something else, my food at home will be poisoned" (this is also a tell of OCD, btw).

anyways im making this post this because I think about having this discussion every time i mention things like "the geiger counter." Sometimes alternative wording feels safer to me. in this instance, "geiger counter" refers to "paranoia" or "I'm getting more paranoid." it gags me just to admit to it here. but I hope it paints a picture I know I'm missing some things I wanted to discuss (oof, there's an example, I wanted to use a different word other than "discuss" here), but everything is like static sludge rn. I hope this grants some insight to anyone.

[gerrydelano]

to make a more lighter note: i know you (or was it ren?) had the list of avatar tim's and how likely theyd be. what are your opinions on au's where jon is an avatar of anything other than the beholding? personally ive found a sort of... fondness for vast!jon and im not entirely sure why, might just be my personal love for the vast -🐗

that was ren, yep! as for jon, hm... okay, yeah, this is a genuinely tough question! and through process of elimination, we discovered that the one that makes the most sense to us is actually the buried? which we were not expecting in the slightest!

like ren said while passing behind me as i typed: “warthog anon used surprise ronologue! it’s super effective!” shut up jhffkjnr it sure was!

SIKE! it’s also the end. it’s end/buried. let’s go.

overall, neither of us are super invested in any particular other entity alignment for him? it’s definitely not something we’d begrudge other people for exploring though because we’ll be the first to agree that the context of an AU changes Everything. i’m literally doing corruption!sasha in PBR, and other really startling choices are to come for other characters you wouldn’t guess that route for, either! making weird shit make sense is so much fun.

but there’s a reason i’m openly Not aligning jon with any singular entity in PBR! there’s a reason he’s going to be “studying under” adelard, and fall into a category of people who operate on the fringes like him, leitner, mary, even gerry before a wrench got thrown into his story for this AU.

BUT enough on that, i’ll go by canon jon and traits he has, and then the contradicting elements you’d have to justify to make something work!

vast!jon isn’t something we can really see happening based on what pulled him towards the eye and the things about him that made him suit it. if you’re looking for someone who could suit the vast through this angle, though, vast!basira would be REALLY cool. i considered it for PBR but i’m having trouble finding a way to make it work, so honestly i’d love to see it elsewhere!

but i think jon is too attached to the pursuit of One Real Answer (despite knowing that’s not even possible) to be all that Big Picture about anything. i do write a lot of vast into his backstory and i plan to play with it in the future in PBR, but i don’t think he’s necessarily inclined towards it in an avatar sense.

that’s another reason web!jon isn’t quite right, either, even without his personal trauma. the web relies too much on the big picture and also getting others to do things for you, and he’s way too intent on doing everything Himself.

and even with that in mind, it’s not a lonely thing, either? he’s still fairly forthcoming about things and does seek people out even if he doesn’t regard it later. he does crave connection, he does crave support, but his roadblocks lie in being able to play his role in keeping them.

and you can’t say corruption because of that, either, because it’s not quite enough! despite how heavily marked he was by it in canon. again, that’s one that would fuck him right up. a huge part of the reason i’m doing corruption!sasha is because so much in canon went tits up because they loved her and lost her. that combined with how little we actually know about her character allows me to reverse engineer and give her a similar impact if she lives. her threads come back to grief, family, guilt, expendability and value. those are all things that you could connect to her story in canon, too! jon has less of that kind of thing going on where he would turn to it, i think.

you could play on the way he keeps secrets and mess around with the dark? because he wants to know things but doesn’t particularly care if other people do, but i think there’s too much willful ignorance involved to really make it feel right for him.

same with spiral and stranger, he’s far too black and white for those, despite any issues he might have with psychosis or identity disturbance. having those things going on does not make a person suited for using the fear of it against people, it’d be. potentially kind of ableist to try justifying those choices with any of his implied mental health/any HCs you go with for him in that vein. those two in particular messed him up so badly in ways that i don’t see translating all that well even in AUs because those marks relied on fundamental pieces of who he is at his core, even if the environment and story might change. every avatar has to be at least a little afraid of their patron to make it work but they also have to be willing to weaponize it and i don’t think he would be, with these.

on a purely surface level, you could even say hunt for the same reasons adelard seems inclined towards it (based solely on how he dedicates himself to an intellectual pursuit for decades on end, doesn’t give up until he’s figured it out or put something Away, etc) but imo there’s way too much baggage with his canon experience with it to feel comfortable given that everyone portrays him as a brown guy on top of that. like, there’s definitely some merit in exploring the elements of the hunt that exist outside of police allegory but i don’t think jon is the character to use for it.

slaughter and desolation straight up make, like. no sense whatsoever. next.

flesh.... meh? jon has a lot of trauma surrounding his autonomy, being used to achieve an end, being physically hurt and torn up by the people around him, and i feel like that’s once again just. something he’s way more susceptible to as a victim than someone who would ever turn to it for solace, comfort, power. but consider flesh!martin, though. now THAT’S sexy.

this leaves the buried and the end! both of which are actually a little stronger, and my personal favorites. i think these are the ones you could best justify in an AU where he’s in a position to make these choices, and i might actually check it out instead of scrolling past like “nope.” i’d be interested in seeing if anyone could make them work.

the end is a pretty decent candidate because of his history. so much of jon’s life and his path are shaped by loss through death. his parents died in such quick succession before he was even 5, and that set the tone for how he was raised by his grandmother (who i personally portray as being marked by the vast! but there is a lot of end in there due to just how much she’s lost, especially growing up during wartime.) this, in turn, influences what he comes to expect from the world. how practical or acceptant he might be about the idea of death after such early exposure to it, constant exposure to it later on. he was willing to smite people in canon in this righteous sort of way, his usage of death specifically as a tool. it’s one he second guesses a shitload in canon, but in an AU, you never know! it might start out that way and as time goes on, it changes, too - which, it also kind of does in canon.

but i didn’t expect to consider the buried for him! this man can fit so much mental illness and guilt and shame in him. personally, jon reads as very OCD to me and that aligns way too well with the buried; usually i would say that it also means he’s more susceptible to being its victim like the rest of the ones up there, but there’s more to it than just the illness. it’s also about the responsibility he takes and doesn’t take, his willingness to (even inadvertently) burden other people with preventable weights; like georgie asking him and asking him what the hell is going on and how can i help you and him just brushing her off, over and over. he buried himself in his work, he dug himself a grave and just hopped right in; multiple times, both literally and figuratively tbh!

so much of tragedies are rooted in preventable things that could have been avoided but weren’t. it feels like a buried concept, and i’d love to see that explored with jon given the choices he does make in canon that throw dirt all over everyone.

g-d yeah wow it just hit me that you favor vast!jon and then subsequently awoke a liking for buried!jon in me. which is REALLY fun because as much as they oppose each other, they also overlap! so, a lot of the things i said about the buried could even apply to an attempt at vast!jon, if you played your cards right! i am INTO this. UP TOP!

to quote jacob geller: “have you ever thought about how agoraphobia and claustrophobia are the same thing? because Now i can’t think about ANYTHING ELSE. 🙃”

thank you for this question i had fun jhbkjn <3

EDIT 5/20/2021: I HAVE MORE END!JON! from sammy @treeroutes​!

ron! i love your boar anon. i clicked on the read more on your answer to their jon ask like 'please say end!jon please say end!jon please say end!jon'. i think it could make sense, and also it could make his and georgie's relationship very different depending on who gets marked first (and potentially make their break up more painful).

and in the context of being the archivist/an archival assistant like. they're all basically surrounded by statements from dead people, he maybe wouldn't have this need to Know that comes from the eye (though he'd still have his own curiosity) so his approach to statements would be different. but i can see him still being drawn towards them in a way

also! you mentionned OCD for buried!jon (which is so smart acftually!) and i think i could fit with end!jon too. because (maybe that's stretching it but bear with me) the end is a 'clean' entity. not as in not dirty but as in, there are rules you cannot break because if you do something bad will happen (see that guy who cheated death) which is a big OCD mood for me.

link that to oliver being an accountant and jon being an archivist, those are two professions where your job is basically to sort and order stuff (be it statements or numbers). *and perhaps end!jon could give a hug to early rtd tim 🥺*

and i LOVE this. the end was honestly my thought when we first started writing this and at first i thought the buried overtook that a bit but HONESTLY. it’s literally neck and neck. end/buried dual wielding GO. like, being end with buried tones? sexy. that’s the answer for me.

[travllingbunny]

The 100 episode 6x01: Sanctum

I have mixed feelings about this episode. I'm very glad that I got to see this and 6x02 together, since 6x02 was amazing. 

Season premieres on The 100 are rarely among my favorites of the season (and in season 1 and 4, were the weakest of the season), except for season 5. Season 2 premiere was also pretty strong. Here’s how I’d rank them:

Season 5 (Eden) 9/10

Season 2 (The 48) 8.5/10

Season 3 (Wanheda, Part One) 7/10

Season 6 (Sanctum) 6.5/10

Season 4 (Echoes) 6/10

Season 1 (Pilot) 4.5/10

First to get it out of the way - the things that bothered me about this episode:

So, Shaw is another black guy who got Killed First, and Zaven got Clexaed. Was this really necessary? JRoth says it was because Jordan Bolger got a role on another show, but They could have left him cryo-frozen for some time until Jordan finished his other obligation, like they did with Kane/HIC, who also now has a major role on another show.In any case, killing him off in the premiere not long after he and Raven had sex for the first time is a really lame old trope. And I wasn't even particularly invested in that relationship or his character, but it's such a waste after he was introduced in season 5, let's face it, pretty much just to be Raven's love interest and finally give her a good relationship.

I am glad that the show is following up on the things that happened in season 5 and that everyone is talking about their issues with each other. For them, it happened yesterday (I am just going to ignore the 125 time jump, since it practically didn't exist for any of the characters other than Monty, Harper and Jordan, and the people of the new planet).  And I was in favor of characters not forgiving Clarke immediately, before I saw this episode. However, the way they did felt so forced and unnatural. Murphy's remarks made no sense, as if he forgot or re-wrote all of seasons 1-4. Not only was he hypocritical, but I don't even know what he was on about. Clarke's 5th chance? What?? Does he mean all the times when she saved them? Did he confuse Clarke with, well... himself? Shaw felt particularly OOC. It's like JRoth wanted random characters to blame Clarke and deliver speeches about morality and redemption to her, and didn't care who it was, or as if Shaw was a stand-in for Raven, Sure, it makes some sense he's angry she gave them up, but to that extent and in such a personal way? Especially since we don't see him showing anger over the fact that Echo wanted to murder him? Or that Raven at one point was OK with Echo murdering him? The latter would have actually been more of a reason to feel hurt personally, since they already had some kind of a relationship up to that point, and he had helped her. But he was not Clarke's friend - she did betray her friends when she sided with McCreary: Raven, Murphy, Emori - but Shaw was nothing to her. Their only interaction in S5 was when he was one of the people (together with McCreary and Diyoza) who had her captured and tortured and threatened her daughter.

Echo lecturing Bellamy about forgiveness made me roll my eyes. Is this an even worse line than her season 5 line about finding each other in a cage? "Who knows that better than us". Err, I don't think "I did so many horrible things to you, and you forgave me (after being stuck with me for years in close quarters and with just 5 other people and I tried to make you forgive me for 3 years)" is such a great selling point or a positive thing about a relationship. And no, Bellamy doesn't have to forgive Octavia. I think he will eventually, but it's certainly not an obligation or Octavia's right, or anyone's right. No one has to forgive anyone. It's entirely due to the person who was hurt/wronged. Nor is "well, you forgave other people who hurt you, so why not that other person?" a good argument. Also, did she forget that he only forgave her after 3 years? Octavia threw him into a fighting pit (not to mention everything else she did) just a few days ago (obviously I'm not counting the cryo-sleep time). Their relationship is also complicated and different,, Bellamy probably has a time dealing with what his little sister has become and didn't expect that from her.

On the plus side:

The visuals are amazing, and everything about the new planet moon is really interesting. Including the setup for the next episode, with all the mysteries of the new planet, including the past of the people from Eligius, and the  psychosis that first overcame Emori. I love the bright colors - they feel both hopeful and fun, and psychedelic and sort of disturbing. For once, it's great to see a post-apocalyptic drama that doesn't have muted colors and dark cinematography.

Jordan is lovely - it's great to have an optimistic, innocent character, as a contrast to all the damaged, angry people, and he also obviously has many capabilities worthy of his father.

All the callbacks to season 1 were fun., especially Murphy playing the role of season 1 Octavia. Also, Bellamy telling Clarke that others will come around felt like a callback to their season 4 scene where Clarke was comforting him and telling him that Octavia would come around and forgive him.

Jackson was so excited to realize he and the other humans are "aliens" now, LOL.

Even though it was awkward in execution, I generally like the fact that they're dealing with everyone's issues, guilt and resentment from season 5. Clarke and Octavia are both set up to have great arcs. Abby and Miller also deal with guilt. There are so many interesting relationships between people who need to sort out their issues: Bellamy and Octavia, Abby and Raven, Octavia and Abby, Bellamy and Clarke...

I think Abby has a very interesting storyline now - trying to stay on the wagon and not relapse into addiction and trying to do better and make up to Raven, and her relationships with both Raven and Octavia will be interesting to watch. Kane might not really have a story of his own now, but, contrary to what many think, it would have sucked if he had died now, with how Abby felt guilty over letting him down and then tried everything to save him.

The scenes between Abby and Raven were really strong. Raven is very hurt and angry and unforgiving - of Clarke, but most of all of Abby, her substitute mother figure who really let her down and hurt her in season 5, in ways that reminded her of her biological mother. Neither of them beat around the bush, and this relationship will be interesting to watch.

Octavia scenes were amazing. I really don't get those stans of hers who justify everything she did, but I do appreciate her more and more as a great character. She acted exactly the way I'd expect her to act - angry, confrontational, unable to apologize and admit to her mistakes. While Raven is refusing to forgive, Octavia is refusing to say sorry to anyone. We saw at the end of last season that she feels guilty, and she wanted to have a big heroic redemptive death, but she didn't get that, and now she has to work harder for that redemption in the way she isn't used to - to try to really change, accept responsibility, admit mistakes and change her way of dealing with things. She'll have a long way to go and a lot of character growth to do. Octavia talked about Kane's past, but Kane did acknowledge his mistakes, almost 7 years ago, and changed and learned from them, something Octavia needs to do.

Niylah waking up Octavia after explicitly being told not to was funny - it's not a great thing to do, but I could have guessed she would, with her huge crush on O.

I'm glad that Bellamy is not forgiving Octavia easily. I think their relationship had been pretty dysfunctional way before season 5, and that she treated him like crap way before season 5 (including that time she chained him and beat him bloody because she needed a punching bag for he pain, and after that, it was still somehow all about her having to forgive him for an entire season...) so I don't want them to make up immediately. That relationship needs to be changed and reinvented, and Octavia has to change, and learn how to  treat both Bellamy and others in a different way, before they can be reconciliation.

The Bellarke moments were great - especially the radio calls conversation. It's clear that this is definitely not the last time they talk about that: that plot point has been brought up since the beginning of season 5. It took the whole season for Bellamy to learn about them, after Clarke was too embarrassed to tell him. Now she knows he knows - and it was cute to see the panic on her face when she thought he had heard all that she was saying (and we never heard all the things she said during those 6 years, so who knows what else she said!), and then the way he used a joke to lower the tension and let her off the hook. But we know from the trailer that both the radio calls and the fact she left him behind to die in 5x09 would be brought up. Yes, he has been forgiving and supportive of her since he found out the truth about those radio calls - his real problem was that he thought Clarke left him because she didn't' care, so learning that it was the farthest thing from the truth changed everything - but that doesn't mean he has fully forgiven her in his heart. He still wants to understand how exactly she feels about him, and they have so many issues to discuss.

And just look at that plAtOnIc chemistry:

I generally don't mind the Becho stuff, which continues to be along the same lines as season 5: no matter how forced those scenes feel, they're very easy to ignore, since their one-on-one interactions take up about 30 seconds of screentime (which could as well been written by some computer program for how to insert a perfunctory scene to remind people that characters are in a relationship), and, no surprise, a lot of their overall screentime is scenes where Bellamy, Echo and Clarke happen to be in the same scene or same shot, and their narrative purpose is not hard to figure out:

(How awkward when you're the third wheel to your own boyfriend and his... whatever exactly Clarke is to Bellamy.)

[equinoxparanormal]

A Checklist: 5 Considerations When Examining Paranormal Phenomena

This article was written by Sarah Soderlund - Sitting here in the dark, watching the moon shine over the autumn landscape (my favorite time of year) I find myself reflecting on the question that is most frequently asked of me: "How do I know if my house is haunted?" The question seems so simple, so endearing and direct, but it is as complex as the human mind or the spiritual realm and it remains an unanswered question to many. As a forensic psychologist and parapsychology researcher, I would stress the importance of perception and the power of the human mind but at the same time I don't want to downplay the spiritual ingredient. I am a skeptical believer. I find that each individual case must remain subjective, unique and scrupulously held in its own paranormal light but to be done so with a phenomenological approach.

When someone asks me, the girl who grew up in a haunted house, how to "know" if a house is haunted, I usually outline a sense of direction toward self-guidance through the paranormal labyrinth that is the human experience. In my book, Haunted by the Abyss, I talk about my other worldly experiences, presenting them in a way that others can identify with subjectively and are open-ended in conclusion; it could be demonic or alien, a dark shadow or a product of the mind's chasm of fears. The language, the experience, the perceptions are all so important they cannot be denied but they also cannot be guaranteed, diagnosed, or easily explained. For that reason, my Halloween treat to you is a step by step guide that I often use as a road map to exploring each paranormal circumstance. The following check-list helps me to determine, through rigorous assessment and observation, if the occurrences and phenomena in question are indeed paranormal and other worldly or if it might be a conjuring of the inner energies we all possess.

1.       Is the Phenomena Caused by Mental Health? So much of the paranormal is, well, normal. Sleep disorders, addictions, attention-seeking behaviors, and even adverse side effects of a medication or drug can rationally and logically explain most paranormal phenomena. For example, the folklore behind "Old Hag Syndrome" (wherein an individual wakes up to a heavy chest, difficulty breathing, and even the inability to move their limbs) can be explained by sleep apnea or waking during certain points of the sleep cycle. While this does not make your experience of waking up numb in the night any less scary, it does give you an option for a more regular, less "paranormal" cause (one in five people struggle with sleep disorders!). Also, many chemicals (such as drugs or even caffeinated drinks) that we put into our bodies on a regular basis can contribute to some very scary and perceived paranormal phenomena. Caffeine can cause insomnia, nervousness and restlessness, upset stomach, nausea and vomiting, increased heart rate and respiration, and many other scary side effects. In a potential paranormal situation, many investigators will wave their EMF (electromagnetic frequency) detectors around to dismiss the possibility of electrical illnesses, but still take into consideration the coffee, soda, and energy drinks that a person might be consuming.  These are just a few of the mental health correlations that easily insert their way into the paranormal realm. Mental illnesses like schizophrenia, psychosis, or even external traumas causing PTSD (post-traumatic stress disorder) are just a handful of other common explanations for symptoms like delusion, panic, anxiety, insomnia, and other fearful experiences. It is always important to include a mental health assessment into your check-list of what might be occurring when you feel something "off" is haunting you or a client. Remember, these explanations, though not paranormal in nature, do not make the experiences any less scary or valid. 

2.       Is the Phenomena Caused by a Fear Response? When something scary happens around us, our human body reacts by way of the central nervous system, what is known as our "fight or flight" response. This self-defense mechanism is natural and healthy, but it also changes our perception of reality. This hyperarousal state stimulated by stress is a physiological reaction that occurs in response to a perceived harmful event, attack, or threat to survival. While the perceived "threat" might not be real, the body's physiological response is very real. This acute stress response starts by release of adrenaline and norepinephrine from the adrenal glands—and that's just the start of the body's reaction. Our metabolism slows down, our respiratory response speeds up, our pupils dilate, and our judgement falls secondary to our behavioral responses. I can recall experiences, being completely level-headed (or so I thought), as I was walking the long, broken corridors of a scary mental health asylum a few years ago. I was calm and collected until I heard something call out my name, and immediately my heart seemed to burst out of my chest. My feet began running before I even realized I was on the move down the hallway! I tried to recall the details of the event later that night but everything seemed hazy (as we frequently see in eye witness testimony of stressful situations). Our observations almost become secondary to our biological response to the stress or fear. Sometimes the terrifying experience in question is not paranormal in nature but instead simply terrifying, and our mind is filling in the gaps via social suggestion or false hope. I wish I could say I hear spirits screaming quite frequently on my paranormal investigations, but usually it is a crispy branch against the window, a stray animal darting behind a trash can, or an outside shadow casted by nearby traffic that just stimulates my body into "scare mode." 

3.       Is the Phenomena Caused by Perception? I keep hitting on perception, but it really is key to understanding what may or may not be a paranormal phenomenon. Once you grasp the ability to include this into your logical assessment it can actually help to alleviate stress as well as validate truly paranormal occurrences in your life. Gestalt psychology is one of my favorite topics when lecturing about the paranormal field, and it helps me explain many of the scary experiences that go bump in the night. Gestalt psychology illustrates the brain's way of organizing information as it is perceived by our body, and categorizes some of the auto-pilot responses our brain uses to jump to conclusions. Paradolia is the explanation for making "something out of nothing" when gazing into a hallway too long or listening to white noise in your ghost box. Continuation helps to describe the movement we see on the battlefields of Gettysburg when staring down long winding roads decorated with directional fence lines. (Your mind "continues" the movement of the incomplete image to a perceived satisfactory conclusion; sometimes creating a ghost out of thin air!) Staring into the flashlight on a paranormal investigation and suddenly seeing it pulse can also be described by Gestalt psychology or even the organization of coincidental factors into false belief…all psychology of the healthy mind! Again, this doesn't mean that the apparition at the end of the hall is not valid, but knowing how the mind works allows you to contest what skeptical believers will clearly ask you later when recounting your paranormal tale. 

4.       Is the Phenomena Caused by Biology? The psychology of the mind plays a huge role in the "paranormal encounter," but so does the rest of the body. Have you ever seen floaters in your vision or stared up at the spackle before going to bed and then as you close your eyes you begin to see movement? Your mind wanders into the "what if" as you clearly and definitively see something in your mind's eye and even again as you blink in disbelief. It's this background activity that is responsible for your unusual visual experience in the absence of light. The technical term for this phenomena is a "Phosphene," and it is very healthy and natural. 

5.       Is the Phenomena Caused by the Unknown? When people that are having scary paranormal occurrences in their home and after investigation there is still no feasible explanations of the experience, I sometimes conclude with the "unknown." This does not mean you do or do not have a spirit haunting you, a demon stealing your jewelry, or an alien abducting you in the night, but what it does mean is that there is much to learn about the human experience. Telekinesis, projection (poltergeist theories), the unconscious power of the mind, and even the power of suggestion are difficult to systematically fit into a scientific method, and most parapsychological research (though built on centuries of documented occurrences) is still in a scientific infancy. The unknown is scary because, for most of us in the present world, things are explainable. Not having explanation, not being able to control the environment, and being unsure of the mystery behind the paranormal world can be for some curious while for others it is terrifying. Just because you are perceiving something to be scary, the unknown source does not have to be scary or negative in nature. Sometimes it is simply unknown.

Studying the mind in a forensic setting, my professional day job, helps to fuel my exploration of the unknown at night on paranormal investigations for clients. I never proclaim to be an expert, but instead hope to empower those clients who are responding with fear to their stress and strange phenomenon. Having an assessment guide like this on hand during an investigation can not only deter hateful criticisms of a personal and sometimes spiritual experience, but can also alleviate stress at the time of the scary occurrence. In my experience, I have counted down a check-list similar to this while a dark figure moves towards me just feet away. Questioning my eyes, my mind, my surroundings, my stress response, my fear response, and even what I had eaten earlier helps distract me while deducing what explanations could be used to decrease my fear. Perhaps, during this Halloween season, you find yourself reading my book Haunted by the Abyss, and looking up to see a dark figure, you'll use your own check list to help minimize the fear and explain your own paranormal experience.

[Sarah Soderlund, Llewellyn]

[michiigii-writes-mysme]

The Mad Hatter Expecting

Saeran’s pregnancy woes, Part 2/2

Pairing:  Saeran x MC/Reader

Summary:  The RFA and MC experience complications with their pregnancy.  After Saeyoung’s Extra Story, in my Ideal World, but still somewhat canon.

Genre: Angst, Humour (?), and Fluff (#truestory)

Rating:  M for gratuitous swearing and some psychosis.  How do ratings even work?

Word Count:  Approx. 3300

Part one found here

You had been living in your apartment for months.  Your belly was getting huge, but still you kept busy, visiting your doctor regularly, collecting baby things, and checking out stores for the best diaper bargains.  Saeran refused to let you into his own home, but he and Saeyoung had been sending you pictures of the nursery they were working on.

“I want you to live with us,” he wrote into the messenger, where your nearest and dearest could see, “Both of you.  But not yet.  I promise I'll be strong enough when you and the baby come, but right now, I'm not.  Not yet.”

Well, he had pined for you, for a while, back when you were interested in Saeyoung.  You supposed that it was your turn to wait, now.

The first week after making you leave, Saeran had kept his distance.  He had called you that night, apologizing for his behaviour and making it clear to you that he loved you and wanted this baby, but also that it was going to be a struggle for him.  He only ever messaged you in the app, so that your friends could keep him accountable to what he said.

He knew he couldn't only rely on you and his brother to get him through this.  He needed all the help he could get.

After that week, Saeran had shown up on your doorstep with Saeyoung and Zen, of all people.  You had looked curiously between Saeran and Zen, knowing that they weren't really friends, until Zen explained.

“Saeyoung might be able to talk him down, but if it comes down to it, I'm strong enough to pull him away from you, even without help,” your self-proclaimed bodyguard said confidently, “He knows how protective I am of you, so he asked me to come.”

Saeran had been scared to touch you, that first day, but he had not pulled away when you greeted him with a light kiss.  He never refused you when you reached out to hold his hand, or when you asked him to hold you.  He was never even stiff, or awkward when he touched you; his body melted into yours when he embraced you, and his kisses were still affectionate.  But for the first few months, he never made the first move; you had to ask for him.

He made a point of visiting you daily, even if it was just for a short visit, or to see you to one of your appointments.  He even went grocery shopping with you a few times, holding your basket for you while Zen and Saeyoung kept a watchful eye at a subtle distance.  But his favourite was when you both stayed home, him resting his head in your lap while you stroked his hair, the two of you just...talking.

“Sometimes, I think I have to get rid of it,” he explained to you, once, in hushed tones.  Saeyoung was on his laptop, nearby, while Zen studied a script silently in an armchair, across the room.  “Children leave, right?  They're supposed to.  It's your job as a parent to help your kid leave.  So why put off that pain?  Just end it now.”

It will hurt me when our child grows up and leaves us.

This was how he opened up to you.  Him saying one thing, and meaning another.  The days past, and Saeran would share more dark secrets with you.

“I think, sometimes, the kid will be happier never being born.  Never having me as a parent.”

The world is cruel.  What if I am, too?

Eventually, your belly got too big for Saeran to lay on your lap.  So he started to kneel in front of you while you sat, resting his forehead lightly on the bump, or lying down beside you on the couch, holding one of your hands like a lifeline.

“I had a dream, last night.  I was screaming that the baby was a naughty child.  It would never be good, it would never be useful, it would never amount to anything.  I couldn't stop screaming...and then the voice wasn't mine, anymore; it was my mother's.”

What if I can't break the cycle?

“Sometimes, I think of the labour.  How terrible it is.  How it will hurt you. How you will suffer.  How it might break you.  I can't lose you!  I can't...!  How dare the baby take you?!  You're mine. I can't live without you!  I can't...so kill it. KILL IT.  KILL IT BEFORE IT HURTS YOU.”

Zen and Saeyoung both had need to subdue Saeran, that day, but not because he had been attacking you.

He had started clawing at his own face.

What if you get hurt?  What will I do without you?

Better being an orphan than only having me.

You hated seeing him struggle, like this.  Saeran had just started getting back onto his own feet, and now he was desperate to do it faster.  Get better sooner.  Every time you saw him slip, your heart broke a little for him.

But you were so proud of how hard he was trying.  Your brave, broken sweetheart, doing everything in his power to get healthy.  For you. For your baby.

It was not pretty.

It was not easy.

It was not even steady.

But it was progress.

Saeran was getting there.

-

You were very far along by the time Saeran was willing to reach out and hold you, again.  He adored lying down before you, of course, a silent declaration of his trust for you.  I have no guards.  My life is yours. But he also loved having you in his arms.  You were his treasure. Holding you against his body, his face buried in the crook of your neck, drowning in your scent...he could easily pretend that only the two of you existed in the world.  This always calmed him down.

Before, he held you around your arms, facing him, your elbows pinned comfortably against yourself.  You were deliciously trapped with him, never to escape.  You never felt the need to escape; feeling him breathe slowly, his heartbeat right beside yours, was soothing for you, too.

But now, he preferred holding you from behind, his arms lower, around your belly.  Saeran could breathe you in and protect your bump, all at once.

That's how he felt your baby's first kicks.  His head had shot up when he felt a little bump against one of his arms.  He had stared hard, almost with hostility, at the spot on your belly that had offended him, until you guided the palm of his hand onto the spot and let him really feel it.

“...is that...?” he whispered into your ear, while a gentle staccato played against his palm.

“Yes, love,” you smiled, twisting your head to awkwardly smooch him on the lips, “Our baby's saying 'hello'.”

“...hello...” he said in a small voice, as if not wanting to scare the little one off.

Then, when the kicking stopped, in an even tinier voice, “...bye-bye...”

Your heart seized.  That was the cutest thing that had ever come out of anyone's mouth.  Ever.

You glanced around the room and were glad to see Saeyoung tactfully put his headphones on.  Zen seemed to have sneaked away at some point, no doubt within earshot, but out of sight.  Silently, you thanked them.

“...Move in with me,” Saeran said suddenly.

You blinked, then turned your body to see him a little more properly. His hand stayed on your belly, but his emerald eyes were looking straight into yours.

“Move in with me,” he said again, more firmly this time, “I miss you. And I can handle it, now.  I love you.  I want you.  I want...I want you, too,” he said haltingly, directing his gaze at your bellybutton before turning back to you, “Please.  The house is ready for you.  I'm ready.  ...And I hate leaving you every night.”

No need for internal translation, this time.  Everything was honest and out in the open.

“Of course,” you agreed readily, stroking his cheek, “We've been waiting for you.”

-

He didn't dare set foot in the delivery room.

You had both figured out a plan, beforehand.  He hated seeing you in pain.  It twisted him, and made him dark and scary, and his first instinct was always to destroy whatever was responsible.  And in this particular situation, he could not be allowed to do that.

So, you made a plan.

Jumin, at your request, was willing to send his finest to drive you to the hospital.  Nothing but the best for the one woman who did not see him as a robot or credit card.  Saeyoung would take Saeran in a separate car, so that he wouldn't need to hear you in pain.  Jaehee or Yoosung (whoever was more readily available) would go with you, in case you needed help in your car.  Zen and Saeyoung would make sure Saeran left the delivery wing or even the hospital if things became too much for him.

The plan was ready.  You all had your roles.  The game was set.

Except there was a huge flaw in the plan.

And there had been no way any of you could have seen it, until after your water had definitely broken.

You were in labour, and everyone was out in the street, trying to get into your separate cars, when you all realized it:

Saeran refused to leave your side.

“GET YOUR FUCKING HANDS OFF OF ME!” he screamed, kicking Saeyoung in the stomach with both legs.  The hacker went down to the ground with a strained grunt, but Zen held Saeran determinedly in a half-Nelson. “NO, SHE NEEDS ME!  GET THE FUCK OFF!”

Plan? What plan?

“I don't think this is gonna work,” you groaned, trying to remember in your pain-hazed state how to breathe, “Saeran isn't gonna...oh, god, this is a big one!”

“Angel, breathe!” Saeran was still yelling, but on a more sane level, “In, out-out-out...in, out-out-out...”

As he kept coaching you, you obeyed.  Big breath, puff-puff-puff, in, out-out-out...

To your labour-addled brain's amazement, the black spots receded from your vision.  Oh, good!  You weren't going to pass out!

“...It's working!” Yoosung exclaimed, seeing clarity return to your eyes, “She's getting a handle on the pain!”

“LET ME STAY WITH HER!” Saeran roared, again.

Maybe he head-butted Zen?  You weren't sure; you were trying to visualize your happy place:  eating ice cream out of a carton, watching crappy movies with Saeran on the couch.  Visualizing the happy place was what you were supposed to do, right?

“Fuck you, right up your fucking ginger ass,” Zen growled, tightening his hold on Saeran and trying to ignore the blood flowing from his nose, “If you broke my fucking nose, I will fucking throttle you right here...!”

“LET ME GO!”

“E-everyone needs to calm down!” Yoosung stammered, trying to stay level-headed; the friend that had helped him get his life back on track was in labour, so now he had to be the strong one, “Can you walk, MC?  Let's try to cross the sidewalk...”

“Ok...”

“I think they need to go in the same car,” Saeyoung wheezed from his place on the ground, his glasses askew; he was still recovering from that kick, “Fuck the plan!”

“Angel, breathe!  Just focus on breathing!”

“But what if he hurts her?” Zen grunted, never releasing his death grip on the father-to-be.

“FUCK YOU, YOU RED-EYED SHIT.”

“I don't think he will,” Yoosung answered, opening one of the doors to Driver Kim's car with one arm, while supporting you with the other. Slowly, slowly, you were walking over.

“One step at a time, baby, you've got this!”

“How do you know?” Zen asked dubiously, while easily dodging Saeran's hands as they blindly and awkwardly tried to reach back and gouge his eyes.

“Angel, just let yourself down on the seat and Yoosung will help your legs in.  LET ME GO, YOU ALBINO FUCK.”

“Well, aside from all the yelling at you, everything coming out of his mouth has been supporting MC,” Yoosung said, holding your arms as you slowly eased yourself into the car.

“And it's working,” you gasped, feeling the pain start to temporarily recede, “Saeran, I'm so glad you're here!”

“Aw, fuck, now they have to get into the same car,” Saeyoung groaned, seeing the fevered devotion in his twin's eyes strengthen.  The former terrorist was triggered, alright, but it was to help you.

“I'm here for you, Angel.  SO GET OFF ME, ASSWIPE.”

Frowning stormily, Zen let Saeran go, then braced himself for retribution. However, rather than attack his captor, Saeran rushed over to you, helping you get comfortable in the car.

“But what if?” Zen insisted, still not giving up.  RFA's princess had to stay safe, dammit!

“Then get in the car with them,” Saeyoung answered, wondering inwardly if Saeran had cracked one of his ribs. Good thing they were on their way to a hospital?

“WHERE IS HER FUCKING BAG.”

Seeing your bag of necessities in Yoosung's hands, Saeran snatched it from him before laying it neatly on the seat beside you.  Yoosung tried to get into the car from the other side, and received a glare from Saeran for his pains.

“...Yeah, Saeyoung, I'm going with you,” the college student said, after seeing a fiery, godless pit in Saeran’s eyes, I choose life.

Zen, however, Saeran let into the car.

He was the only one who could subdue Saeran, right now, after all.

So much for your damned plan.

-

The rest of the RFA was in the waiting room, while Saeran stayed with you.  The last any of them had seen of you, Saeran had been behind you on the delivery bed, holding one of your hands and stroking your hair, whispering into your ear to breathe or push or relax or whatever it was that you needed to hear.  It wasn't exactly that he was taking your labour well.  It was more that he saw you needed him, and he was desperate to fill that role to the best of his abilities.

And he was doing so well.  Even Zen was impressed.

“How long have they been in there?” Jaehee asked, looking at Zen from her seat but speaking to the rest of the room.  She and Jumin had gotten to the hospital after the others had arrived, having been tied up at work.

Zen shook his head at her question.  He hadn't been keeping track; he was focused on pacing.

“It's been about 6 hours,” Jumin answered, consulting his watch.  He was leaning against a wall, looking for all intents and purposes as if he were waiting for a town car.  Except that there was a crease on his forehead that Jaehee didn't recognize.

“Is it normally this long?” Zen asked Yoosung, who was actively non-studying at the waiting room's small table.

“I'm not gonna be a people doctor, Zen,” the blonde reminded flatly, “A bit different with dogs and horses.”

“But you knew what the other thing was,” Zen insisted, “What did the doctor call it?  The baby was 'breech'?”

“Ok, that's an exception,” Yoosung nodded, fiddling with one of his notebooks absentmindedly, “But I don't know!  Maybe it's long?”

Saeyoung frowned harder from his seat in the corner.  His laptop was open, but he wasn't working.  Something felt wrong.  After years of experience watching people, he knew that the hospital staff had been nervous around you and Saeran.  They were informed about Saeran's situation, of course, but they had been more off around you, for some reason.  But why?

You had no history with them.  Was a baby being born feet-first really that big of a deal?

Then everyone's phone buzzed, all at once.  The hospital staff gave the RFA a few dirty looks for having their phones on, but nobody noticed.

It was a message on the app from Saeran!

<Healthy baby girl!> it read.

Then:

<Pink. Squeaky.>

“Thank God,” Jaehee breathed, as Yoosung ran over to hug Saeyoung.

“The hell does 'squeaky' mean?” Zen demanded.

“She's all right,” Jumin shrugged, smiling serenely, “That's all that matters.”

“I wasn't talking to you-” Zen started, but then his phone buzzed again.

<SHE PASSED OUT.>

!!!

<THEY'RE KICKING ME OUT.>

And then Saeran left the messenger.

-

“...Doctor, what happened?...”

“...Lost a lot of blood...”

“Baby is safe.”

“...How long...?”

“...Time will tell...”

“Sir, visiting hours are over.”

“GET AWAY!”

“...He's the one...”

“Let him stay!”

“...Not the husband...”

“...special case...”

“...waiting game...”

“...patient...”

“...Sh...”

“...buy...looking glass...!”

“...sh...!”

“...sh...”

-

The first think you thought was how cold the room was.  Not uncomfortable, but definitely chilly.  Your face was cold.  Your feet were cold.

But then there was warmth beside you.  Wrapped around you.  A comfortable, warm weight on your chest, and soft pressure on you shoulder.

The room was dim.  Maybe it was nighttime?  Or all the lights were out?

Your eyes started to focus.

Yes. Night.  There was the night sky, moonlight flowing in through the window.

You looked down.  A tiny, pink, almost bald little bundle.  Your heart leaped.

Baby.

Daughter.

She made it!  She's here!

Thank God...!

Then you turned your head to your shoulder.

Pinkish-white hair.

You blinked.  That couldn't be right.  You looked again.

...Ah. The moonlight playing tricks.

Red hair.  Sleepyhead.

Furrowed brow.  Not good.

Softly, you placed a kiss there.

Smooth brow.  Peaceful.  Good.

And then those beautiful, green eyes were all you could see.

“Saeran...!”

He whispered you name in reply like a prayer, relief flooding his face before pulling you into a kiss.  Somehow, his lips were gentle and possessive all at once...but filled with love.  So much love.

“You scared me...” he murmured, trying to sound scolding, but his voice hitching at the end.

“It was an accident,” you answered, speaking against his lips, not wanting to pull back, yet.

“...I know,” he relented, lightly running a finger along the side of your face, as if seeing it for the first time, “...we keep having accidents.”

“I like this one the best,” you smile, looking down at the baby still sleeping between your breasts, “Is she okay?  Did she eat?”

“Hospital has formula.  She drank,” he answered, wrapping his arms around you both, careful not to jostle your daughter.

You lay there quietly, his forehead against your temple.  What a long day.  You wanted to ask Saeran how long you were out, and where everyone else was, but just thinking about the questions you had made you feel heavy.  You were so tired...

You figured you should sleep while you could.  Sleep when the baby slept, right?  Just a few more moments to sleep...

“...marry me.”

Your eyes snapped open, and your head whipped around to see if he was serious.  He was.

“Saeran...”

“They almost kicked me out for not being your husband.  Zen had to talk them into letting me stay.  Marry me.”

You stared at him blankly.  Was this happening?

He looked down to the side, to your daughter.

“We have a baby together.  Marry me.”

You felt yourself starting to shake your head.  

Those were good reasons, but-

His eyes flicked back to hold yours, freezing you.

“I love you.  And you love me.  And when you die, I die.  Please. ...please.  I love you.  Marry me.”

A breath.

A heartbeat.

Then a smile and a teary kiss.

“Yes.”

Uuugh, it’s done.

This is how I figured the Unknown route would go.  You go for Saeyoung, but he ends up not wanting you enough, so you move on, and then discover that Saeran was waiting for you.

ENJOY YOUR AFTER STORY.

[brentrogers]

Inside Schizophrenia: Impact of Schizophrenia in Minority Communities

Rates of psychosis are more strongly influenced by ethnicity and socioeconomic status than any other mental health condition. In this episode of Inside Schizophrenia host Rachel Star Withers, a diagnosed schizophrenic, and co-host Gabe Howard discuss the impact of schizophrenia in minority communities. Guest Sakinah “The Muslim Hippie” joins to share her experiences in mental health care.

Highlights of “Impact of Schizophrenia in Minority Communities

[01:00] The realization

[02:08] Sociology definition of the word minority

[04:30] The stats of mental health and minorities

[09:00] Diagnosing differences

[12:00] Is the medical community racially bias?

[14:00] Two people, same symptoms but different diagnosis

[15:40] The privilege of not having to worry

[16:30] Two people, same diagnosis but different treatment

[21:50] Guest Interview with Sakinah “The Muslim Hippie” Karen Michelle

[32:00] Police intervention in the minority mental health community

[39:35] What to do for someone who is suicidal

[51:00] So what is the answer?

About Our Guest

Sakinah “The Muslim Hippie” – Karen Michelle

Mental Health Advocate, Crisis Counselor, Speaker

Sakinah (Karen) Kaiser, also known as The Muslim Hippie lives in Baltimore, MD where she is currently a writer and mental health advocate. She hopes to go back to a school for a degree in social work with a concentration in substance use disorders.

www.Twitter.com/TheMuslimHippie

www.Facebook.com/Sakinah.Karen

    Computer Generated Transcript of “Impact of Schizophrenia in Minority Communities” Episode

Editor’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.

Announcer: Welcome to Inside Schizophrenia, a look in to better understanding and living well with schizophrenia. Hosted by renowned advocate and influencer Rachel Star Withers and featuring Gabe Howard.

Sponsor: Listeners, could a change in your schizophrenia treatment plan make a difference?  There are options out there you might not know about. Visit OnceMonthlyDifference.com to find out more about once monthly injections for adults with schizophrenia.

Rachel Star Withers: Welcome to Inside Schizophrenia, a Psych Central podcast. I’m Rachel Star Withers here with my co-host Gabe Howard. Today’s episode, we’re going to be discussing schizophrenia and how it relates to minorities and also the treatment that minorities receive.

Gabe Howard: I think this is a very timely episode because I really believed before all this started that everybody received the same level of care and that things like gender or race or nationality or religion really didn’t play a role in it. I just thought this was just basic science. So, I was surprised to learn during the research that, yeah, things like gender, race, nationality, religion play a huge role in the treatment options that are offered, that are available. It was stunning to learn.

Rachel Star Withers: And I think with me, when we’re looking at the idea of minorities, you always immediately think discrimination, but so much is things that might just be like these subtle biases that we don’t even realize that we’re doing, whether it’s other people or even to ourselves. In the U.S., whenever I hear minority, most of us usually think it has to do with race. But of course, we have religion differences, gender, sexual orientation, age, lifestyles. So, this episode, we’re going to be looking all across that and explore kind of how those differences affect other stuff around us.

Gabe Howard: Rachel, let’s establish some guidelines so we don’t get off track. So, this episode is called Schizophrenia and Minorities. What is the exact definition that we’re using for this show?

Rachel Star Withers: So, Gabe, I had to look it up because I wasn’t 100% sure. Like I said, I, in the U.S., here, we kind of just think race. But

Gabe Howard: That’s all we think.

Rachel Star Withers: Yeah. Yeah.

Gabe Howard: We don’t kind of think, that’s what we think 100% of the time.

Rachel Star Withers: According to sociology, a minority group refers to a category or people who experience relative disadvantage as compared to members of the dominant social group.

Gabe Howard: So, Rachel, in sociology terms, a minority is not just a few of something, but also it puts you in a disadvantaged class because of it. Now, wouldn’t somebody living with schizophrenia then fall under this definition?

Rachel Star Withers: Yes, and disabilities also can put you into a minority group. So, we’re talking about mental health. We’re talking about physical anything that sets you apart that might hinder you compared to everybody else.

Gabe Howard: And then even in this subset of people living with schizophrenia, there’s a minority group of people inside the minority group. This is where it gets complicated. The general principle that we’re trying to establish here is that, let’s just call it out, white people with schizophrenia often have better access and get better care than African-Americans with schizophrenia. It’s the exact same illness, even in some cases the exact same socioeconomic class. Different outcomes based on race.

Rachel Star Withers: Yes. And here in the U.S., that’s very correct. But you also look that across different countries, different areas, that changes depending on what the dominant race may be.

Gabe Howard: And the reason that we’re pushing this so far into the ground is because it’s not so easy to say that, oh, well, if you’re a minority and you have schizophrenia, people don’t care about you. It’s just racism. It’s not that simple. It’s these cultural and societal biases that we’re completely unaware of. And hopefully this show will shed some light on that because it really is unfair what is happening. And we’d like to think that in some small way Inside Schizophrenia can help maybe educate people on that. Let’s talk about what we found out, because we found out a lot of just straight up facts. This isn’t Rachel and Gabe’s opinion. We’re going to hit you with some straight up Internet knowledge.

Rachel Star Withers: And you’re also probably wondering why does all of this matter? OK. Rates of psychosis are more strongly influenced by ethnicity and socio-economic status than any other mental health conditions. So not just schizophrenia, psychosis, which can, of course, extend into other mental disorders. I found that very interesting. If you were to ask me, Rachel, what do you think your ethnicity and, you know, economically where you fall, what that would affect the most mental health? I would assume depression. That’s what I would assume. Like, well, if you’re poorer, you’re probably going to be more depressed. So, the fact that it’s tied to psychosis really is eye opening. It’s just not what I, at least, would expect.

Gabe Howard: Now, we found an interesting study while we did this because, again, we just don’t want our flapping gums, because let’s be honest here, a couple of white people talking about minority mental health has its own challenges and issues. We just happened to be the hosts. Later on in the episode, we’re going to talk to Karen who bills herself as the Muslim Hippie. She is a very cool mental health advocate, and she taught us all kinds of things. That’s coming up later in the episode. But back to the study and it was done in the United Kingdom.  You know, I want to do a little aside here, the reason we’re using a study from the United Kingdom is because in America, we’re not actually doing a lot of studies on how these biases are impacting the minority community, and that’s very telling in and of itself. It sort of appears, from my perspective, that we don’t care.

Rachel Star Withers: I did find some studies and I was like, yes, finally. OK. And then I went to read through them and the words were very dated, for instance, describing race. And I was like, oh, and I’d have to like, oh, OK. I see. This was done in the 60’s. A lot has changed. But I immediately, like once I realized that, I’d have to start checking the dates and there are very few concrete studies, I would say, that have been done in the past few years, especially with minorities and schizophrenia. It was easier to find for like mental health in general. But definitely the schizophrenia community, almost, almost nothing.

Gabe Howard: Rachel, I think it’s important to remind our audience that there is no definitive test for schizophrenia. Schizophrenia is diagnosed observationally. A professional observes the patient and comes up with a diagnosis that way. And in the United States, black people are four times more likely to be diagnosed with schizophrenia than white people and Hispanic people more than three times. Now, that doesn’t sound right to me. Again, I am not a researcher. But schizophrenia doesn’t. It doesn’t discriminate against race or gender or religion. So, the fact that it’s four times and three times more likely to be diagnosed, shows me that there’s a flaw in the way that we diagnose. What did you find?

Rachel Star Withers: So in the U.K., they found that rates for psychotic disorders, again, not just schizophrenia, but psychosis in general, were five times higher in the minority group of people of black Caribbean heritage. Very, very specific. Black Caribbean, five times higher. That’s a lot. And I feel that if I were one those researchers, I’d be like, wow, there clearly is a genetic link. Right? But there’s actually no pattern found if you go to Caribbean countries that suggests this. So, it’s just found when the Caribbean black people there in the U.K. are a minority. That’s interesting, Gabe. It definitely makes you look at, you know, kind of that nature versus nurture situation.

Gabe Howard: Well, that’s certainly one possibility. Or it could be the trauma of living. There’s so many tangents that we could go off on here if we believed that there was no bias, that this is just the way that it was, then nature versus nurture could be an argument, like you said. But I don’t think that’s it. I don’t think that there is any nurture that causes schizophrenia. And the research holds up that you’re born with schizophrenia. So now we’re talking about diagnosis prevalence rates, not actual schizophrenia prevalence rates. And I think the disturbing thing is that there is a debate. Anybody listening to this should have grave concerns if they’re a member of the minority class. Are you feeling that you’re getting the best care when there’s all of this debate on how it’s diagnosed? It would be disturbing to me if I were an African-American living with schizophrenia. And I find out that it’s diagnosed four times more than in my white counterparts because I’m thinking that’s a lot of margin for error. Am I taking medications that I don’t need? Am I receiving treatments that I don’t need? Was I misdiagnosed? Now, Rachel, please, I imagine that it is very difficult living with schizophrenia, and I imagine that it would be even worse if there was a doubt. If there was an asterisk, if you were wondering to yourself, am I actually schizophrenic or am I a victim of a flawed system? I know that you’re a white woman, but what are your thoughts on that?

Rachel Star Withers: That can be really scary. You know, it takes so long to get a diagnosis and you kind of start to doubt yourself. It isn’t just America or the UK. They’ve done international studies and immigrant communities usually are assigned psychotic disorders way more frequently than the natives of that country who have the racial majority. This is like, OK, well, in America, it’s because they’re dealing with this. No, it’s across the world that if you’re different, they’re more willing to label you with a psychotic disorder.

Gabe Howard: Rachel, let’s do a little segue and talk about the individual patient doctor relationship. Let’s forget about all of the research, the bias and all of that. Let’s just talk about what many people with schizophrenia see for themselves, which is themselves sitting in front of a doctor. Do you think a lack of diversity among mental health professionals can lead to unequal health care?

Rachel Star Withers: Absolutely. For the most part, Gabe, I think me and you are very privileged. Most of the doctors I’ve been to have been white. So, all of the psychiatrists, specifically, have been white males. I’ve never walked in and thought, you know, I’ve never, I’ve never felt out of my element or, like, worried. That’s just, it hasn’t entered my mind. I’ve never looked at the person and thought, oh, you know, they don’t understand me. And that’s kind of interesting. And I was playing in my head being like, let’s say that I’ve never went to a white doctor. But let’s say they were always a different race than me. Would I second guess them? Would I be less willing to trust them almost if they were a different race?

Gabe Howard: It’s interesting because various studies have shown that people of color report more dissatisfaction with their care. And it was interesting when you were saying that all of your providers have been Caucasian, they’ve been white. I am shocked at this. And I didn’t even think about it before this very moment. One hundred percent of my doctors, mental health and physical health, have been white. And I don’t know how that has impacted my care. I don’t know how that has impacted my comfort level because they’ve always been white. A hundred percent of the time. It’s making me uncomfortable to think about. It’s stirring up feelings in me. And again, I’m a white male. Nobody should feel bad for me. But I’m thinking if I’m having this much trouble thinking about it in the abstract. This is a hypothetical. Gabe, how would you feel if all of your doctors were of a different race? And my brain is twisting. I can only imagine how it must feel if all of your doctors were of a different race in practice, not just in theory. But that then makes me ask, do you think that these are terrible psychiatrists, that just we’re intentionally providing bad care? By we I mean, the global we. Bad care to members of the minority class? I mean, is this deliberate? Are we filled with racism and hate? Like, it’s gotta be deeper than that. I don’t want to believe that the entire medical community is just filled with this. This. I don’t know. I just. Obviously, that makes me uncomfortable, too. I don’t want to believe that these are bad people because it does mean that Gabe and Rachel are getting care from bad people, too.

Rachel Star Withers: Of course, outright discrimination, that absolutely exists. But a lot of times it’s not that outright, it’s just more subtleness. And when you look at someone, you right away, you make all these kind of assumptions about them. When you hear someone, you make a lot of assumptions about them.

Gabe Howard: I’m always, of course, fascinated by people that say, well, I don’t see differences, I only see a fellow person in front of me and always think, well, if I went missing, what would you say? Would you say, oh, I’m looking for a tall white redhead? Well, but that means you noticed that I was tall, you noticed that I was white and you noticed that I had red hair. I mean, you certainly know how to identify me in a crowd. Like when you see me over there, you aren’t looking into a group of one hundred people and you’re like, well, I have no idea who is who. I don’t see anything. It’s just disingenuous to say that we don’t notice these things. And I’m wondering if all of this leads to creating criteria for diagnoses that while beneficial to the majority, are not beneficial to the minority.

Rachel Star Withers: Rutgers found that African-Americans with severe depression are actually more likely to be misdiagnosed with schizophrenia. So, you have two people who are coming in to the doctor saying the exact same thing. I’m having, let’s say, visual hallucinations. I’m having audio hallucinations, these different delusions. And they’re quicker to say the African-American person is a schizophrenic.

Gabe Howard: And you can see how devastating that could be, getting the incorrect diagnosis means that you’re getting the incorrect care. It means that you are not presented with options that are most beneficial to you. So therefore, you don’t have the opportunity to lead your best life. This is terrible. It’s terrible to consider. And speaking as a man who lives with bipolar disorder, I can only imagine that if in addition to managing bipolar disorder, which is devastatingly awful, I also had to wonder if I actually had bipolar disorder. Have you ever doubted your schizophrenia diagnosis, Rachel?

Rachel Star Withers: I haven’t doubted it in the past, you know, let’s say 10 years. In the very beginning, when I was first getting diagnosed, my early twenties? Yes. Mainly because the doctors kept, they were giving me different diagnoses. So, I was going, wait, which one of you should I believe? You know, one saying one thing, one saying another. However, I’ve never once thought it had to do anything with me. The psychologist was saying one thing. The psychiatrist was saying something else. I never said, oh, it’s probably because I’m a woman. That’s why this one thinks that. Oh, it might be because I’m white that one. That never occurred to me. I really just thought, you know, they’re different types of doctors. That’s why they maybe have different opinions. Never occurred to me that I in any way influence that. I was putting a lot of trust just in the doctors. And that goes back to what we’re saying earlier. That could very well be a privilege that I have, that it wouldn’t occur to me that I can’t trust this person.

Gabe Howard: I think it is an incredible privilege that you and I have. It’s wonderful not to have to wonder, because it just takes something off the table. There is a lot to manage with a severe and persistent mental illness. Schizophrenia is a scary illness. And also having to wonder if you are getting the best care based on the available research, based on your race or religion, socioeconomic status, etc. I just cannot imagine and I want to be very, very clear that there’s only so much understanding that Rachel and I can have, because it’s just not possible to walk a mile in these shoes. But one of the things that I’m wondering, Rachel, is we’ve talked about the bias in diagnosis. Now let’s pretend that it’s the correct diagnosis. Let get out of our mind that it might be incorrect. It’s 100% the right diagnosis. What about treatment? Are minorities with schizophrenia getting the best treatment?

Rachel Star Withers: And that’s what’s crazy. We go back to if we have two people walk in. Same symptoms walking into the same doctor. They found that all racial minorities. OK. So not just a specific race. All of them are less likely to be offered cognitive behavioral therapy than a white person. They’re more, it’s almost like they’re more willing, like, OK, like you have a lot of different options here. And then with minorities, let’s not give them as many options. And I don’t think it’s always, you know, an outright discriminatory thing. But, yeah, across the board, they’ve found that out. They’ve noticed that black patients are far less likely to be offered family therapy. I can see that definitely being a bias. Thinking the family’s less stronger in African-Americans, the family’s less stronger in Hispanics. Yeah. I easily see that being a bias with different doctors.

Gabe Howard: And that, of course, is, one, it’s just outright offensive. But let’s move that aside for a moment. I know that I would not be living as well as I am now if I didn’t have strong family support. And, Rachel, you’ve talked too. Your mom was on an episode of Inside Schizophrenia and talked about how much you two partner and work together to help you lead the best life possible. There is a tremendous amount of research that people living with schizophrenia do better if they have a strong support system. And listen, I always take this opportunity to point out that everybody does better.

Rachel Star Withers: Yes.

Gabe Howard: You don’t have to have a mental illness. No one is an island. So now this is being taken away from somebody based solely on the color of their skin. That, to me, is a tremendous loss.

Rachel Star Withers: Yes, and with Asian people, as far as being a minority, they are actually less likely to receive copies of care plans. Like isn’t that random? They’re less likely at the end of it to be given, OK, here is what we talked about today. This is our plan going forward. That’s worrisome because when I’m in the doctor’s, I have to take notes because the minute I walk out, I don’t remember anything. So, if me and that doctor are coming up with a care plan and then they don’t even like, let me walk away with it. You know, that’s odd to me. I’ve never had that situation. Like that would never occur to me that the doctors wouldn’t be wanting me to do this plan.

Gabe Howard: Rachel, along those same lines, what about the role of medication, is that at least the same for everybody in the treatment of schizophrenia?

Rachel Star Withers: No. Minorities have been found that they are prescribed typical antipsychotics over atypical antipsychotics. So, the typical ones tend to be the older ones. OK. The kinds we’ve been using since the 40’s. And if you’ve ever taken those type, like I have, the side effects are intense. They’re just so much worse than the newer drugs. Whenever you talk about movement disorders, that unfortunately are a side effect of many antipsychotics, the majority come from typical antipsychotics. So, if you have tremors, shaking that’s been brought on as a side effect, it’s going to be more of those older ones. So here we have minorities, they’re less likely to be offered therapy. They are less likely to be given a set plan and they’re more likely to be given medication without that support system. That can be very hard to deal with.

Gabe Howard: I’m really just speechless because, you know, I became a mental health advocate because I believe that people weren’t getting access to the care that they needed. And listen, this was largely from my own experience, seeing mostly middle-class white people. I thought that middle class white people weren’t getting the right care. And I still stand by that. And you’re saying that there is worse care based on gender, religion, the color of your skin. That’s just altogether frightening. In general, from what I’m seeing, from my perspective, from my eyes, from my vantage point, which I understand is only mine, I think that we need to do way, way better. And everything that we’re reading shows that it’s worse based on nothing more than who you are, where you were born or the color of your skin. And that’s, it’s a lot to take in, Rachel. It’s a lot to take in.

Rachel Star Withers: And we’ll be right back after this message from our sponsor.

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Rachel Star Withers: And we’re back to talking about schizophrenia in minorities.

Gabe Howard: Rachel, I think this is a good spot to introduce our guest, Sakinah, the Muslim Hippie, Karen Michelle. Clearly, we can only understand and process the world from our own vantage point, with our own eyes. The same with Sakinah. She is an incredible mental health advocate. She has done so much. And I’m so glad we had the opportunity to speak with her. So, go ahead and roll the interview.

Rachel Star Withers: So, we’re talking with our guest for this episode, Sakinah. And she’s also known as The Muslim Hippie.

Sakinah: Yes.

Rachel Star Withers: So, tell us a little bit about your background.

Sakinah: So I grew up in the D.C. area. That actually is why I call myself a Muslim hippie. When I started with my journey with mental health slash mental illness, one of the first hospitals that I went to was in Takoma Park. And Takoma Park has a really eclectic history to it. And I like it because when I was growing up, I was really attached to some schools in that area. And I kind of felt like since I got better, or started getting better, there, I wanted to remind myself of what I liked about that part of D.C. and I like being a hippie. So, I just called myself a Muslim hippie and it just stuck. And then people were like, Oh, that’s cool. What do you mean by that? I know that people have a negative association with the name Karen. But my dad named me Karen. So that’s kind of why I also stick to my given name, because he really wanted me to have that name and he liked the meaning of it, which is pure. So, I go by Sakinah because that’s my Muslim name. But I stick with Karen, too. So that’s me in a nutshell.

Rachel Star Withers: And you are a mental health advocate, crisis counselor, speaker and a mentor.

Sakinah: Yes.

Rachel Star Withers: Can you tell us a little bit about your mental health journey?

Sakinah: I did not intend to be a mental health advocate at all. I just dealt with mental health in one way or another since high school. And I kind of stumbled into all of this. And then when I started talking about my journey, I started blogging just because I like writing. And a few of my friends from elementary school, they read my stuff and they’re like, oh, you’re a really good writer. And a friend of mine, she’s a professional writer. She encouraged me to talk about what I was going through. And initially what I noticed was depression. So, I started talking about my depression issues. And then when I got online, which was mostly Twitter, I developed a following. And then it was kind of like I was healing and writing and like learning how to blog and do all that stuff all at the same time. So, then I learned about advocacy work. So, I used my journey online to kind of teach people about mental health. And as I was learning and healing, I decided, okay, why don’t I do this full time? So, then I started going to classes and things like that. And then I told people, OK. This is what I’m doing intentionally. So, let’s learn about mental health together. And then once I started going to the doctor and stuff, I actually told people, well, I didn’t know things and like maybe you don’t know either. And so that’s kind of how I got started. And there are so many mistakes that I made or that other people made. And rather than use my blogs to just say this didn’t work and hurt me, I used it to teach people about what I thought they should know about mental health.

Rachel Star Withers: So, our episode today is about minorities, and we were discussing that what a minority is, of course, changes depending on where you’re at.

Sakinah: Right.

Rachel Star Withers: And it can be, you know, a lot of different factors. A big one, though, however, usually is race. Can you tell us what race you are? Do you feel comfortable talking about that?

Sakinah: I’m actually African-American. My dad is black. My mom is black. They’re both American. My dad is from D.C. and my mom is from Georgia. The funny thing is people don’t know where I’m from because I cover with this scarf, this hijab, because I’m Muslim. So, when they see me, they assume actually, because I look racially ambiguous, they will assume that I am other, like Somali or Ethiopian or, you know, something. And my dad, they usually think he’s Egyptian or Moroccan. So, it’s hard for me when I identify. I’m kind of, I get stuck because when I was working in a hospital, I was a CNA for a while. And they would say things like, oh, you don’t have an accent. And it was hard for me to understand what they meant by that. Because I didn’t know if they meant I don’t have a D.C. accent? Or I don’t have a Maryland accent? Or if they meant I don’t have an American accent? I didn’t know what they meant. And then I realized they meant that I don’t have an accent for someone who they thought was Ethiopian or whatever. So, I’m African-American.

Rachel Star Withers: You should have said, well, my mother’s from Georgia, not me.

Sakinah: Yes.

Rachel Star Withers: For like a Southern accent. And they’d be like, oh, okay.

Sakinah: Yes. And what’s funny is I’ll actually, yeah. Well, funny enough where I was working was in northeast D.C. and I ended up saying things like, no, my dad’s from, and then I would say the street where he was from. That’s how I found out, because they just kind of look like what? And then even when I take the scarf off, people will say things like, are you mixed Black and Spanish? Are you mixed Black and White? So, it’s still kind of a thing where people don’t know where I am. So that mixes the race and ethnicity. So, I’m like, I’m black African-American. You know, I try to get both in because let me explain and clarify. And I shouldn’t have to do that. When it comes to mental health and the conversations that we have, if I’m talking about being a Muslim with mental health issues, being a black person and African-American. It actually does matter because when I go to the hospital, it depends on how they look at me, how they’ll treat me. Like, if they think that I speak English but they don’t care that I’m black, they’ll be really nice. But if they think that I am a Muslim who doesn’t have a good handle on English, then they’re really rude. That’s something that I’ve had to do.

Rachel Star Withers: Very interesting. So, you can tell right away, like how they’re interpreting you?

Sakinah: Yeah. Because you can see, especially because my name. I have not changed my name legally. My name is Karen Kaiser. I mean, that’s easy. But also, no one is expecting someone black when they hear it. Karen Kaiser, because it doesn’t sound black at all. And then they see me and always, oh, OK. And sometimes they’ll say, how did you get that last name? And I used to be like really rude. I’d say, slavery and then like

Rachel Star Withers: Oh.

Sakinah: Somebody said please don’t say slavery, but. You know, that isn’t a nice thing to say. But I don’t know what people want me to say because I don’t really know my whole lineage yet.

Rachel Star Withers: And they’re implying something else also.

Sakinah: Well, exactly. Exactly. And the thing is, though, when I go to the hospital or to the doctor, it depends on if the doctor is black or African-American. It depends on their background and how educated they are. And if they have a prejudice, how they’re going to treat me. So what I’ve noticed is sometimes I prefer to use my name, Karen Kaiser. I don’t want to deal with, oh, where are you from? And I had doctors that I grew up with, they knew me. But then when I put my scarf on, they didn’t recognize me and they were really mean to me. And then they’re like, wait

Rachel Star Withers: Oh.

Sakinah: A minute, we recognize this name. We just didn’t. And they did. We didn’t notice that something. Oh, so you’re saying that you’re going to be prejudiced against this until you know who I am. Sometimes you can see it right away and sometimes they won’t say anything. But it’s in how they will. And one time I went to the hospital and I was really very sick. I almost died. And I asked someone for Sprite and she, on purpose, brought me back apple juice because she thought that I wouldn’t understand the difference. And there is a black guy there who is also attending to my care. And he said, you heard her ask for such and such. Why did you do that? So, it’ll be little things like that. I don’t know how to tell the person you’re doing this because you think that I’m from someplace else. And by that time, it won’t matter if I take my scarf off. And then when I go to inpatient, it’s the same thing. So, I can hear things that people will say and they’re thinking, I don’t hear because I have the scarf on. So actually, when I was in Dallas, I had been able to explain it to them. Because I was in the hospital and they were doing things like making me take my scarf.

Sakinah: They would say that I can’t wear a scarf in the room because I’m going to harm myself with the scarf. And then they have bedsheets in there. So, there are things that like they will have cultural hang ups that they don’t realize. And I don’t know how to explain it to them easily. So that’s one thing that I’d like to work on with my advocacy is being able to clearly share with people how I can see their prejudices. And I’m not that eloquent sometimes in my speech, because if I’m unwell, if I’m in psychosis, I don’t have time to educate you. One time I was at a hospital and they said, well, there’s our patient line, you can tell us what we’re doing wrong and I shouldn’t have to do that when I’m not feeling well. So, it’s something that I want to work on when I’m like now when I’m passionate but not feeling hurt or upset, because I think that in the long run, it helps people to see how they can better help someone like me.

Rachel Star Withers: As far as, we’re talking about on the small scale of things right away, people seeing you. What about the larger scale as far as like diagnoses? How do you feel race or religion might have played a difference?

Sakinah: Well, so what I have noticed, this is just a small bit of research that I’ve done. What I noticed and what I’ve heard is that African-Americans, so we tend to be more easily diagnosed with bipolar and schizophrenia and definitely more psychotic disorders, whether that’s that or not. So, let’s say that you see me in a trauma setting. So, you might just put a label of bipolar or schizophrenia, and that might not be what it is. That’s easier because you just assume all of us, if I’m loud and I’m yelling and I’m assuming they think that is what the data supports, that it’s easier to put us with that label. Just how they would say, like with young black boys, they’ll get the label of ADHD. When it comes to psychotic disorders, black people will get the label of a psychotic disorder, and without getting much research. A lot of diagnoses are missed because we just get one thing slapped on us and then nothing else is looked into. And I think that is really so sad because we could get help. And also, there is a rush to overmedicate. Even if it is a psychotic disorder, I might be on a really high dosage or something when I could be on a lower dose just because it’s almost like criminalization of symptoms. Whereas someone else may just do with a lower dose because they’re not looking at her as a criminal. So that’s on a larger scale where it just is with African-Americans. It’s more of just you have that psychotic label and then we’re just going to medicate. Almost like a prison type thing within the medication.

Rachel Star Withers: Just asking, because this is obviously in the news a lot and it is a major issue and problem is African-American people specifically, but people of color being I don’t want to say harassed, but unfortunately, yeah, harassed in a lot of like legal situations, kind of police tend to jump where they’ll stand and might talk to a white person who’s, like waving a gun for hours and talk them down,

Sakinah: Yes. Yeah.

Rachel Star Withers: And they’ll tend to see a black person doing something like lighting a cigarette, thinking it’s a gun and overreacting. Mental health wise, how does that make you feel? You know, you’ve talked about being inpatient some. Are you scared to get help sometimes? That maybe things could escalate?

Sakinah: Now, that’s an interesting topic and how that plays out is it depends on your presentation, gender and how you look. Because as a Muslim, let’s say I’m five one and I’m light skinned. I might be Muslim and I am African-American and I cover. But if I’m not seen as a threat, well then no, I’m not scared. But then they won’t help me because they don’t see me as someone that they need to pay attention to. So, they’re not interested in getting me the help that I need. And since I’m not a criminal, they don’t want to pay me any attention. So let’s say that someone calls the police because I’m exhibiting psychotic symptoms. They usually will say, OK, she’s African-American, she’s dangerous. But then if they come out and I’m not dangerous, then they just walk away. So, they don’t give me any help. Do you see what I mean? So it is that criminalization of African Americans with any type of psychiatric symptoms. It’s automatically we have to harm this person. Then if they aren’t a danger to us, then we’re not going to help them. In order for me to get impatient, I have to take myself. Because when it comes to someone calling for me, nobody wants to deal with me because it’s almost like they’re like, OK, there, there. You know, we’re not dealing with you. Now, if it were my son, who is a darker skinned male who is bigger, yeah, I’d be afraid for him because the minute they see him, they’re thinking, is he a threat? OK, we’ll shoot him. So we talk about the privilege of being light skinned. If you have pretty privilege, that kind of thing, because certain people, they’re not looking for you. So they’re not going to do anything.

Rachel Star Withers: Now, as you just mentioned, you’re also a mother of teenagers.

Sakinah: Yes, two teenagers and a 20 year old.

Rachel Star Withers: What do you tell them? Do you warn your kids as far about, hey, when you go to the doctor, you might want to be careful about this? Do you ever worry?

Sakinah: I do, but I’m careful how I warn them because I don’t want to put in them this idea. This inferiority complex, like, OK, you do this so you don’t get hurt because then that raises someone with this idea that it’s OK for me to victim blame. At the same time, I don’t give them the idea that they can do whatever they want. It’s this tightrope, this walk that I have to do that. OK. And when it comes to psychiatric symptoms, if you need help, you have to know how to reach out. And then it’s a difficult thing. But I want them to know how to talk to me. I just have to let them know how to advocate for themselves. And I think that’s the best way to do it. But I do let them know they can look at my social media pages if they need to understand mental health and if they need to ask for help. I really try not to let me enter into it because I want young people to look at the adults in their lives to know how to get help. And that’s kind of the way that I’m steering my advocacy work.

Rachel Star Withers: Earlier in the episode, me and Gabe, we discussed that we’re both white and I have never been in a situation where I did not feel comfortable due to my race as far as like a medical setting. I’ve never thought when the doctor came in, they’re going to treat me differently. I’ve never worried about that. The nurse practitioners and other ones have been more diverse. But like the psychiatrists that I’ve seen, the vast of the doctors have all been white males, with the exception of two, and I’ve seen a lot. So that exception is under five percent. You know, at the end of the day, I can’t understand. What would you tell other people like me and Gabe?

Sakinah: Well, what I would say is that. See someone like me has also had a bit of a privileged experience when it comes to clinicians. So, I had to have that explained to me. And I didn’t know that because I grew up in the DMV area that which is the D.C., Maryland, Virginia area. I have had, I’d say about 98% really good experiences because those doctors are so well, not just well educated. These are the specialists of the specialists. So all of the really good hospitals, there are such good hospitals. And I’m not in a rural area. So if I had bad experiences, I can name them on one hand. And even if my friends had bad experiences, we are the anomaly. What I would say is for African-Americans, each person’s experience is going to be different. And then it’s going to depend on their life circumstances. Unfortunately, it depends on appearance. It depends on how well educated they are about their situation. And it also depends on money.

Rachel Star Withers: Yes.

Sakinah: For me, every single time I went to get diagnosed, it all lined up to what I have today, which is so rare. I’ve never had a different diagnosis. With all the times I’ve been to different hospitals, that’s unusual. Usually people say, oh, well, first they thought this and they never thought something different. And they hadn’t. They had no reason to say that. So I think I had one doctor who did something that was so unusual that it was racially based. It was abusive. But I can be mad at that one doctor. It might have been as bad as I should’ve sued the hospital. But again, I would say that as a patient who’s African-American. Like, I can’t even speak for all African-American patients, you know, with mental illness

Sakinah: Because my situation would be different, too, because of being Muslim. After 9/11, the difference is a lot of Muslims have trouble with trusting mental health professionals because some people are afraid of things like surveillance or afraid of stigma. And I never thought of that because my mom raised me to be so open with I’m going to the doctor that I didn’t think about it until people had told me, like, you’re so clueless. And so that’s, again, a privilege that I didn’t have bad experiences. And what I would tell to you guys is Gabe was probably the first advocate who came to me and said, OK, I don’t know about what you do and your experience. So how do I learn? I’m going to be honest, that’s unusual to me. You guys have been so open with me. And that was really helpful. If I talk about race and I talk about ignorance it is because some people, they just never were open. And what I like about when I meet advocates like you is that you asked me to tell you about my experience. So that helps me to see how I can teach you. So, I think that if each person shares their experience with one another, then we all can learn.

Rachel Star Withers: Oh, I like that. What the world needs more of is people willing to learn.

Sakinah: Yeah, yeah, I think so.

Rachel Star Withers: As you know, with mental health, depression and suicide comes up a lot. A few years ago, I’d given a response, we’re talking about as far as suicide. Pretty much, my rule is if your friend or loved one or whoever is talking about suicide, don’t treat it as a joke. If you think they’re going to hurt themselves or others, you need to call the police. And I had a lot of backlash because a lot of people said because you’re white, you think that means they’re going to get help. And yeah, unfortunately, a lot of times if the person isn’t white, they’re not going to get help. It’s going to be a very different response. And I know there is no correct answer. There is no. Well, this is what.

Sakinah: Right.

Rachel Star Withers: What advice, though, would you give me as far as dealing with those situations?

Sakinah: What I would say is a lot of areas now are starting to adopt warm lines. And like, I won’t say, a crisis text line. But there is a difference between the 911 number and a crisis line. But things like, in my area, they have either 211 or 311, which is the county services. And if you call them, which is a non-emergency number, they should have a mobile crisis. Now the problem with mobile crisis is that sometimes they will send the police. So unfortunately, in that sense, there’s nothing you can do. But I think by state, I think people are having these numbers for mobile crisis. Or you can ask for an ambulance when you call the cops. You can say maybe it’s not an emergency or when you call crisis text line. I also take crisis text line calls. What we can do on crisis text line is you can call on behalf of someone else and say, I think this person might need help and they can call someone for them. It doesn’t have to be the police. So, one of the things I want people to think about is if it is a person of color, African-American or somebody else, find somebody different to call besides the police. And if you’re not sure who, then you can look it up, because for whatever reason, there’s just such a stigma against us when it comes to law enforcement or they don’t know how to de-escalate. I’ve seen and retweeted videos of white Americans, they can walk at the police with all kinds of machetes and everything, and the police will just stand there like, oh, it’s OK. And then me, I can have nothing, and like, I’m like, I’m compliant, I’m on the ground and they’ll shoot us. And I don’t know why that is. Rather than figure that out, I would try to help by just call a different number. But I think until you get African-Americans to deal positively with law enforcement and share our experiences and teach, I don’t think that it will change that we’re getting hurt.

Rachel Star Withers: And something you said earlier. So Gabe’s a pretty big, big guy. You’ve met him in real life. He’s like six something, huge towering guy.

Sakinah: Yeah.

Rachel Star Withers: And let’s say there’s a situation and I feel that, yeah, he needs help. I wouldn’t think twice about calling the police. It would never occur to me that, like, oh, they’ll make it worse. And he’s huge.

Sakinah: Ok.

Rachel Star Withers: So, you should think that, hey, if anyone. Yeah, I would be worried that they might shoot him because he’s such a big dude, but that never entered my mind.

Sakinah: Right.

Rachel Star Withers: But that’s almost like that privilege that people don’t realize. I wouldn’t have thought about race having any effect.

Sakinah: Right.

Rachel Star Withers: Yeah.

Sakinah: And the thing with privilege, regardless of the scenario, you almost don’t realize it until someone lets you know where you have it. One time I was tweeting about something, about maybe going to the E.R. or why would you wait to get a doctor? And whatever I tweeted about, someone said, you know, you think that because you have privilege. You know where I am, even if you’re in crisis, if you call the doctor, they won’t see you for about a month. And I said, oh. And they were letting me know that your privilege is such that. Like, if I call my doctor, they’ll call me right back. Sometimes I have my doctor’s cell phone number. So I was sorta like, oh, I can just go to the E.R. right then and get evaluated by a psychiatric social worker so they’ll let me know if I need to go to inpatient. Like, why would you wait? And a couple things I said. And they’re like, you are in the D.C. area. Of course you have. And I was talking about like I just go and I just did this. And you don’t even understand how much privilege you have. We can’t go even in an emergency. And then I said, oh, OK, I get it. And I think we all have privilege. Even if you don’t realize this. So, sometimes someone has to tell you, oh, you didn’t realize. That was easy for you. That’s why you think that. So, yes, the same type of thing. And I think even for me, the way that my stature is with if you see cops, most of them, it’s obvious they are bigger than me and they have more like they have authority over me.

Sakinah: But when someone calls for me, there are six of them. Six of them came out and I’m just sitting there and they keep saying like, well, that your friend said that you were suicidal. And I said, I’m not. I just asked them out of it and like, OK, you can leave. But her son, they talked to him in such a way, it was obvious they wanted to harm him, you know, and they’re making fun of him and like, have you taken your medicine? And they weren’t really trying to de-escalate the situation. They didn’t do any of that to me. So, the way that they treat people like us is so different. And they weren’t interested in getting him out. They were just trying to, like, let her know that she had messed up by not giving him his meds. So that’s the kind of thing where if you don’t see that happen, you won’t really know. That’s how they deal with it. There were actually only three of them, and there were six for me. You know, there’s no need to. Like, they’re trying to strong arm us and let us know. None of that makes any sense.

Rachel Star Withers: And that goes whether you’re in a city or rural area, like how many? Obviously, you always hear where not everyone’s bad, which is correct. But when you look at like, the responses. Yeah. If you’re in an area that the police have more of a budget, they’ll probably send more. And it could probably escalate quicker than if you’re from where I’m from. And I don’t know, like five cops for like half of South Carolina. You know, the idea that a whole bunch coming out wouldn’t happen and be like, well, where are you going to find them? But yeah, usually, like, things change.

Sakinah: See, I didn’t even think of that. Yeah.

Rachel Star Withers: Mm hmm.

Sakinah: Yeah, because for me, I’m like, why are these six cops in a room? And like, they’re all like just trying to stand in front of a window where if I fell out, I’m not even going to die. And then I’m like, what are you even doing? It was really, really odd. And then I kept telling them, look why are you all around the windows? We don’t want you to jump out. Of this window? Yes. None of that makes sense. OK. Yeah. Then they had an actual budget. And then finally they’re like, all right, let’s just go, we’re wasting our time. I told you that. Yes.

Rachel Star Withers: So we’ve hit on a lot of different things, and I’ve loved talking with you. What overall advice do you have for people whenever they’re in a minority situation dealing with mental health, whether it’s a crisis or just worried about getting general help?

Sakinah: Ok, I’ll say two things. If you are a minority and you are concerned about your mental health, don’t be afraid to ask. What you don’t know, that is what can hurt you. And it is not a shame on you to say, hey, I’m dealing with this issue. And you won’t know what it is wrong with you unless you ask a professional. You cannot assume. Everything isn’t depression. Everything isn’t anxiety. You need to know and you deserve to feel well. And I have a friend who always told me that. So you should check into it. You should reach out. But especially if you are black or African-American, you need to take care of yourself because you need, you have to be strong in today’s society. But if you’re dealing with someone who’s black or African-American, same thing. Don’t assume that they know what’s going on with them and don’t look at them and think, oh, that person’s angry all the time. Or that person is whatever. They may be dealing with trauma and they don’t know how to get help. So, if you say something, let’s say online, you say, oh, reach out or take care of your mental health. They won’t know how to do that unless they’ve been taught. So, don’t assume that like one size fits all. Or if you’re an advocate or even a doctor, that they’ll know how to do that. And then you might be thinking, well, I said it. They won’t know. And so for us, you really almost are going to have to go into those communities and teach people and just be kind of patient because some people have such a stigma. Like in black communities, we have such a stigma. And you may need someone who looks like them or who they will take that information from. So, it’s OK if he will kind of push back. They’re not pushing back against you. They’re just a little bit scared sometimes. Just like no assumptions. No assumptions.

Rachel Star Withers: And how can our audience learn more about you?

Sakinah: The best way to learn about me, I would say, is through my social media, Twitter and Facebook is where I’m most active. My Twitter handle is @TheMuslimHippie. You can find me on Facebook /Sakinah.Karen. And both of those have all information on any other projects that I’m working on. You’ll find those. I’m working on the second book about substance use disorders. I want to write a book about Muslims dealing with substance use and how being in a marginalized community, if you don’t take care of your substance use disorder, you can die quicker. That’s kind of what that project is, but it’s going to be positive. And it’s a story of hope because I’m always looking forward. So, Twitter and Facebook is where you can find me.

Rachel Star Withers: Thank you so much for coming on here and teaching us and our audience. And I kind of hope we will all just continue to learn from each other.

Sakinah: Thank you for having me.

Rachel Star Withers: Thank you so much. Loved speaking with you today.

Gabe Howard: Rachel, that was incredible. I’m so glad that we have the opportunity to interview people on this podcast, not just Sakinah, but all of our guests have just been so incredible. What do you think?

Rachel Star Withers: I learned so much from her. Especially when we talk about, like religious wear. For the most part, when I walk into a doctor’s office, they’re not going to know what religion I am. It’s pretty hard to judge me off that, whereas they know right away with her, you know, and you make assumptions off that, whether you mean to or not.

Gabe Howard: One of the major takeaways that I learned from Sakinah was it’s not intentional. I think this is just such an important point to bring up. This debate is always tabled with you are a malicious racist or you’re perfectly fine. There’s like willful racism or nothing to improve upon. And the reality is, it’s so much more complex than that. I’m not saying that there’s not willful racists. There absolutely are. I don’t think Sakinah is denying that either. Her point was that some of the major issues that people of color, that minorities, have aren’t that willful racism. It’s the unexplored biases. It’s the misunderstandings that go unchecked that lead to people like her not getting the best care. That was a real aha moment for me because it would just be so much cleaner if it was, oh, you’re a racist and you’re evil. Oh, you’re not a racist and you’re wonderful. Like that would be so much easier, but it’s not that way. So, I’m really glad that she pointed that out and I can see where that would be very impactful on her care.

Rachel Star Withers: And sometimes you don’t have access, you know, where you’re living at. So how I dress, let’s say I walk in and the doctor, I’ll go, you know, a week without showering because I’m so depressed and I’m, like, mentally out of it. So imagine if I show up to a very first doctor’s appointment and they’re thinking, oh, wow, this girl looks rough. They make these assumptions that, oh, she probably has no support care system. Oh, wow. We need to, you know, up her meds right away. People look at you and they make assumptions based on the way you dress. There’s so many things that can affect our health care. And it, it’s scary, Gabe. I’m not gonna lie. It’s scary, especially for people with schizophrenia. And there is no like, OK, well, here’s the answer, guys. Like there isn’t. We have no answer for how do you deal with subtle biases? Because unfortunately, every single thing is going to be different and so much of it people don’t even realize they’re doing.

Gabe Howard: Our listeners probably aren’t aware of this, but Rachel is a stuntwoman and she’s also a model and quite accomplished at both. And I am just, I am lucky to have Rachel as a friend. And I bought a new wardrobe recently that Rachel helped me with. So, one, I just wanted to publicly thank you, because now I look stellar.

Rachel Star Withers: True.

Gabe Howard: But people are like, Gabe, you’re really stepping up your game. And I said, yeah, I have a friend who’s a model, Rachel, and she gave me all kinds of hints and tips because this is her experience. And that’s like, oh, that’s awesome. I wish I had a model friend. And the reason I’m telling this story is because recently one of my friends realized that my schizophrenic friend Rachel and my model friend Rachel were the same person. It never occurred to her that my model friend Rachel could live with schizophrenia. She very much considered them separate. Now, my friend is a very good person. She’s a very nice person. She’s not, she doesn’t have a mean bone in her body. This was not malicious, but she was unable to connect the two and she was quite surprised when she found out. That, in my mind, is an excellent example of just an internal bias that you miss. And obviously, the stakes aren’t very high on that. Health care is a matter of life and death. And that’s why we’ve got to do better.

Rachel Star Withers: Absolutely. This episode is a very hard one for me to kind of wrap up. I’m very upbeat. You’ve noticed that, I’m sure, throughout the episodes. So, I always want to leave on an upbeat note. And this is hard because as we’ve said multiple times, me and Gabe, in a lot of ways are very privileged. And we’ve never been outright discriminated against. We’ve never kind of been held back from health care due to being a minority. And I don’t wanna give upbeat words for something that I know nothing about. During this episode, we’ve talked about all different stats and acknowledged that so much goes into the way people perceive us and we perceive other people, how we subconsciously even connect to people. How you’re like, oh, hey, this person’s like me and the opposite there and that’s across the board. That’s something that’s scary to me, that there are people out there and they almost never feel like they connect with a doctor. And I do wish I could be like, oh, well just go find another one. As Sakinah pointed out, especially when you’re not in a city, there may only be one doctor. Depending on your financial status, you might not be able to go to anybody else. You might have to stick with a free clinic or something like that. So, there are no good answers that blanket everything. We all have blind spots. Some of them are self-imposed. Others are put on us. I think we all just kind of have to realize that we have these blind spots and try to do better.

Gabe Howard: Rachel, I could not agree more.

Rachel Star Withers: Thank you so much for listening to this episode of Inside Schizophrenia, a Psych Central podcast. Please, like, share, subscribe. Send it to all of your friends, any of your friends who are dealing with schizophrenia, caretakers, your medical friends, or just some really cool people you know.

Gabe Howard: See you all next time.

Announcer: Inside Schizophrenia is presented by PsychCentral.com, America’s largest and longest operating independent mental health website. Your host, Rachel Star Withers, can be found online at RachelStarLive.com. Co-host Gabe Howard can be found online at gabehoward.com. For questions, or to provide feedback, please e-mail talkback@PsychCentral.com. The official website for Inside Schizophrenia is PsychCentral.com/IS. Thank you for listening, and please, share widely.

Inside Schizophrenia: Impact of Schizophrenia in Minority Communities syndicated from

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Inside Schizophrenia: Impact of Schizophrenia in Minority Communities

Rates of psychosis are more strongly influenced by ethnicity and socioeconomic status than any other mental health condition. In this episode of Inside Schizophrenia host Rachel Star Withers, a diagnosed schizophrenic, and co-host Gabe Howard discuss the impact of schizophrenia in minority communities. Guest Sakinah “The Muslim Hippie” joins to share her experiences in mental health care.

Highlights of “Impact of Schizophrenia in Minority Communities

[01:00] The realization

[02:08] Sociology definition of the word minority

[04:30] The stats of mental health and minorities

[09:00] Diagnosing differences

[12:00] Is the medical community racially bias?

[14:00] Two people, same symptoms but different diagnosis

[15:40] The privilege of not having to worry

[16:30] Two people, same diagnosis but different treatment

[21:50] Guest Interview with Sakinah “The Muslim Hippie” Karen Michelle

[32:00] Police intervention in the minority mental health community

[39:35] What to do for someone who is suicidal

[51:00] So what is the answer?

About Our Guest

Sakinah “The Muslim Hippie” – Karen Michelle

Mental Health Advocate, Crisis Counselor, Speaker

Sakinah (Karen) Kaiser, also known as The Muslim Hippie lives in Baltimore, MD where she is currently a writer and mental health advocate. She hopes to go back to a school for a degree in social work with a concentration in substance use disorders.

www.Twitter.com/TheMuslimHippie

www.Facebook.com/Sakinah.Karen

    Computer Generated Transcript of “Impact of Schizophrenia in Minority Communities” Episode

Editor’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.

Announcer: Welcome to Inside Schizophrenia, a look in to better understanding and living well with schizophrenia. Hosted by renowned advocate and influencer Rachel Star Withers and featuring Gabe Howard.

Sponsor: Listeners, could a change in your schizophrenia treatment plan make a difference?  There are options out there you might not know about. Visit OnceMonthlyDifference.com to find out more about once monthly injections for adults with schizophrenia.

Rachel Star Withers: Welcome to Inside Schizophrenia, a Psych Central podcast. I’m Rachel Star Withers here with my co-host Gabe Howard. Today’s episode, we’re going to be discussing schizophrenia and how it relates to minorities and also the treatment that minorities receive.

Gabe Howard: I think this is a very timely episode because I really believed before all this started that everybody received the same level of care and that things like gender or race or nationality or religion really didn’t play a role in it. I just thought this was just basic science. So, I was surprised to learn during the research that, yeah, things like gender, race, nationality, religion play a huge role in the treatment options that are offered, that are available. It was stunning to learn.

Rachel Star Withers: And I think with me, when we’re looking at the idea of minorities, you always immediately think discrimination, but so much is things that might just be like these subtle biases that we don’t even realize that we’re doing, whether it’s other people or even to ourselves. In the U.S., whenever I hear minority, most of us usually think it has to do with race. But of course, we have religion differences, gender, sexual orientation, age, lifestyles. So, this episode, we’re going to be looking all across that and explore kind of how those differences affect other stuff around us.

Gabe Howard: Rachel, let’s establish some guidelines so we don’t get off track. So, this episode is called Schizophrenia and Minorities. What is the exact definition that we’re using for this show?

Rachel Star Withers: So, Gabe, I had to look it up because I wasn’t 100% sure. Like I said, I, in the U.S., here, we kind of just think race. But

Gabe Howard: That’s all we think.

Rachel Star Withers: Yeah. Yeah.

Gabe Howard: We don’t kind of think, that’s what we think 100% of the time.

Rachel Star Withers: According to sociology, a minority group refers to a category or people who experience relative disadvantage as compared to members of the dominant social group.

Gabe Howard: So, Rachel, in sociology terms, a minority is not just a few of something, but also it puts you in a disadvantaged class because of it. Now, wouldn’t somebody living with schizophrenia then fall under this definition?

Rachel Star Withers: Yes, and disabilities also can put you into a minority group. So, we’re talking about mental health. We’re talking about physical anything that sets you apart that might hinder you compared to everybody else.

Gabe Howard: And then even in this subset of people living with schizophrenia, there’s a minority group of people inside the minority group. This is where it gets complicated. The general principle that we’re trying to establish here is that, let’s just call it out, white people with schizophrenia often have better access and get better care than African-Americans with schizophrenia. It’s the exact same illness, even in some cases the exact same socioeconomic class. Different outcomes based on race.

Rachel Star Withers: Yes. And here in the U.S., that’s very correct. But you also look that across different countries, different areas, that changes depending on what the dominant race may be.

Gabe Howard: And the reason that we’re pushing this so far into the ground is because it’s not so easy to say that, oh, well, if you’re a minority and you have schizophrenia, people don’t care about you. It’s just racism. It’s not that simple. It’s these cultural and societal biases that we’re completely unaware of. And hopefully this show will shed some light on that because it really is unfair what is happening. And we’d like to think that in some small way Inside Schizophrenia can help maybe educate people on that. Let’s talk about what we found out, because we found out a lot of just straight up facts. This isn’t Rachel and Gabe’s opinion. We’re going to hit you with some straight up Internet knowledge.

Rachel Star Withers: And you’re also probably wondering why does all of this matter? OK. Rates of psychosis are more strongly influenced by ethnicity and socio-economic status than any other mental health conditions. So not just schizophrenia, psychosis, which can, of course, extend into other mental disorders. I found that very interesting. If you were to ask me, Rachel, what do you think your ethnicity and, you know, economically where you fall, what that would affect the most mental health? I would assume depression. That’s what I would assume. Like, well, if you’re poorer, you’re probably going to be more depressed. So, the fact that it’s tied to psychosis really is eye opening. It’s just not what I, at least, would expect.

Gabe Howard: Now, we found an interesting study while we did this because, again, we just don’t want our flapping gums, because let’s be honest here, a couple of white people talking about minority mental health has its own challenges and issues. We just happened to be the hosts. Later on in the episode, we’re going to talk to Karen who bills herself as the Muslim Hippie. She is a very cool mental health advocate, and she taught us all kinds of things. That’s coming up later in the episode. But back to the study and it was done in the United Kingdom.  You know, I want to do a little aside here, the reason we’re using a study from the United Kingdom is because in America, we’re not actually doing a lot of studies on how these biases are impacting the minority community, and that’s very telling in and of itself. It sort of appears, from my perspective, that we don’t care.

Rachel Star Withers: I did find some studies and I was like, yes, finally. OK. And then I went to read through them and the words were very dated, for instance, describing race. And I was like, oh, and I’d have to like, oh, OK. I see. This was done in the 60’s. A lot has changed. But I immediately, like once I realized that, I’d have to start checking the dates and there are very few concrete studies, I would say, that have been done in the past few years, especially with minorities and schizophrenia. It was easier to find for like mental health in general. But definitely the schizophrenia community, almost, almost nothing.

Gabe Howard: Rachel, I think it’s important to remind our audience that there is no definitive test for schizophrenia. Schizophrenia is diagnosed observationally. A professional observes the patient and comes up with a diagnosis that way. And in the United States, black people are four times more likely to be diagnosed with schizophrenia than white people and Hispanic people more than three times. Now, that doesn’t sound right to me. Again, I am not a researcher. But schizophrenia doesn’t. It doesn’t discriminate against race or gender or religion. So, the fact that it’s four times and three times more likely to be diagnosed, shows me that there’s a flaw in the way that we diagnose. What did you find?

Rachel Star Withers: So in the U.K., they found that rates for psychotic disorders, again, not just schizophrenia, but psychosis in general, were five times higher in the minority group of people of black Caribbean heritage. Very, very specific. Black Caribbean, five times higher. That’s a lot. And I feel that if I were one those researchers, I’d be like, wow, there clearly is a genetic link. Right? But there’s actually no pattern found if you go to Caribbean countries that suggests this. So, it’s just found when the Caribbean black people there in the U.K. are a minority. That’s interesting, Gabe. It definitely makes you look at, you know, kind of that nature versus nurture situation.

Gabe Howard: Well, that’s certainly one possibility. Or it could be the trauma of living. There’s so many tangents that we could go off on here if we believed that there was no bias, that this is just the way that it was, then nature versus nurture could be an argument, like you said. But I don’t think that’s it. I don’t think that there is any nurture that causes schizophrenia. And the research holds up that you’re born with schizophrenia. So now we’re talking about diagnosis prevalence rates, not actual schizophrenia prevalence rates. And I think the disturbing thing is that there is a debate. Anybody listening to this should have grave concerns if they’re a member of the minority class. Are you feeling that you’re getting the best care when there’s all of this debate on how it’s diagnosed? It would be disturbing to me if I were an African-American living with schizophrenia. And I find out that it’s diagnosed four times more than in my white counterparts because I’m thinking that’s a lot of margin for error. Am I taking medications that I don’t need? Am I receiving treatments that I don’t need? Was I misdiagnosed? Now, Rachel, please, I imagine that it is very difficult living with schizophrenia, and I imagine that it would be even worse if there was a doubt. If there was an asterisk, if you were wondering to yourself, am I actually schizophrenic or am I a victim of a flawed system? I know that you’re a white woman, but what are your thoughts on that?

Rachel Star Withers: That can be really scary. You know, it takes so long to get a diagnosis and you kind of start to doubt yourself. It isn’t just America or the UK. They’ve done international studies and immigrant communities usually are assigned psychotic disorders way more frequently than the natives of that country who have the racial majority. This is like, OK, well, in America, it’s because they’re dealing with this. No, it’s across the world that if you’re different, they’re more willing to label you with a psychotic disorder.

Gabe Howard: Rachel, let’s do a little segue and talk about the individual patient doctor relationship. Let’s forget about all of the research, the bias and all of that. Let’s just talk about what many people with schizophrenia see for themselves, which is themselves sitting in front of a doctor. Do you think a lack of diversity among mental health professionals can lead to unequal health care?

Rachel Star Withers: Absolutely. For the most part, Gabe, I think me and you are very privileged. Most of the doctors I’ve been to have been white. So, all of the psychiatrists, specifically, have been white males. I’ve never walked in and thought, you know, I’ve never, I’ve never felt out of my element or, like, worried. That’s just, it hasn’t entered my mind. I’ve never looked at the person and thought, oh, you know, they don’t understand me. And that’s kind of interesting. And I was playing in my head being like, let’s say that I’ve never went to a white doctor. But let’s say they were always a different race than me. Would I second guess them? Would I be less willing to trust them almost if they were a different race?

Gabe Howard: It’s interesting because various studies have shown that people of color report more dissatisfaction with their care. And it was interesting when you were saying that all of your providers have been Caucasian, they’ve been white. I am shocked at this. And I didn’t even think about it before this very moment. One hundred percent of my doctors, mental health and physical health, have been white. And I don’t know how that has impacted my care. I don’t know how that has impacted my comfort level because they’ve always been white. A hundred percent of the time. It’s making me uncomfortable to think about. It’s stirring up feelings in me. And again, I’m a white male. Nobody should feel bad for me. But I’m thinking if I’m having this much trouble thinking about it in the abstract. This is a hypothetical. Gabe, how would you feel if all of your doctors were of a different race? And my brain is twisting. I can only imagine how it must feel if all of your doctors were of a different race in practice, not just in theory. But that then makes me ask, do you think that these are terrible psychiatrists, that just we’re intentionally providing bad care? By we I mean, the global we. Bad care to members of the minority class? I mean, is this deliberate? Are we filled with racism and hate? Like, it’s gotta be deeper than that. I don’t want to believe that the entire medical community is just filled with this. This. I don’t know. I just. Obviously, that makes me uncomfortable, too. I don’t want to believe that these are bad people because it does mean that Gabe and Rachel are getting care from bad people, too.

Rachel Star Withers: Of course, outright discrimination, that absolutely exists. But a lot of times it’s not that outright, it’s just more subtleness. And when you look at someone, you right away, you make all these kind of assumptions about them. When you hear someone, you make a lot of assumptions about them.

Gabe Howard: I’m always, of course, fascinated by people that say, well, I don’t see differences, I only see a fellow person in front of me and always think, well, if I went missing, what would you say? Would you say, oh, I’m looking for a tall white redhead? Well, but that means you noticed that I was tall, you noticed that I was white and you noticed that I had red hair. I mean, you certainly know how to identify me in a crowd. Like when you see me over there, you aren’t looking into a group of one hundred people and you’re like, well, I have no idea who is who. I don’t see anything. It’s just disingenuous to say that we don’t notice these things. And I’m wondering if all of this leads to creating criteria for diagnoses that while beneficial to the majority, are not beneficial to the minority.

Rachel Star Withers: Rutgers found that African-Americans with severe depression are actually more likely to be misdiagnosed with schizophrenia. So, you have two people who are coming in to the doctor saying the exact same thing. I’m having, let’s say, visual hallucinations. I’m having audio hallucinations, these different delusions. And they’re quicker to say the African-American person is a schizophrenic.

Gabe Howard: And you can see how devastating that could be, getting the incorrect diagnosis means that you’re getting the incorrect care. It means that you are not presented with options that are most beneficial to you. So therefore, you don’t have the opportunity to lead your best life. This is terrible. It’s terrible to consider. And speaking as a man who lives with bipolar disorder, I can only imagine that if in addition to managing bipolar disorder, which is devastatingly awful, I also had to wonder if I actually had bipolar disorder. Have you ever doubted your schizophrenia diagnosis, Rachel?

Rachel Star Withers: I haven’t doubted it in the past, you know, let’s say 10 years. In the very beginning, when I was first getting diagnosed, my early twenties? Yes. Mainly because the doctors kept, they were giving me different diagnoses. So, I was going, wait, which one of you should I believe? You know, one saying one thing, one saying another. However, I’ve never once thought it had to do anything with me. The psychologist was saying one thing. The psychiatrist was saying something else. I never said, oh, it’s probably because I’m a woman. That’s why this one thinks that. Oh, it might be because I’m white that one. That never occurred to me. I really just thought, you know, they’re different types of doctors. That’s why they maybe have different opinions. Never occurred to me that I in any way influence that. I was putting a lot of trust just in the doctors. And that goes back to what we’re saying earlier. That could very well be a privilege that I have, that it wouldn’t occur to me that I can’t trust this person.

Gabe Howard: I think it is an incredible privilege that you and I have. It’s wonderful not to have to wonder, because it just takes something off the table. There is a lot to manage with a severe and persistent mental illness. Schizophrenia is a scary illness. And also having to wonder if you are getting the best care based on the available research, based on your race or religion, socioeconomic status, etc. I just cannot imagine and I want to be very, very clear that there’s only so much understanding that Rachel and I can have, because it’s just not possible to walk a mile in these shoes. But one of the things that I’m wondering, Rachel, is we’ve talked about the bias in diagnosis. Now let’s pretend that it’s the correct diagnosis. Let get out of our mind that it might be incorrect. It’s 100% the right diagnosis. What about treatment? Are minorities with schizophrenia getting the best treatment?

Rachel Star Withers: And that’s what’s crazy. We go back to if we have two people walk in. Same symptoms walking into the same doctor. They found that all racial minorities. OK. So not just a specific race. All of them are less likely to be offered cognitive behavioral therapy than a white person. They’re more, it’s almost like they’re more willing, like, OK, like you have a lot of different options here. And then with minorities, let’s not give them as many options. And I don’t think it’s always, you know, an outright discriminatory thing. But, yeah, across the board, they’ve found that out. They’ve noticed that black patients are far less likely to be offered family therapy. I can see that definitely being a bias. Thinking the family’s less stronger in African-Americans, the family’s less stronger in Hispanics. Yeah. I easily see that being a bias with different doctors.

Gabe Howard: And that, of course, is, one, it’s just outright offensive. But let’s move that aside for a moment. I know that I would not be living as well as I am now if I didn’t have strong family support. And, Rachel, you’ve talked too. Your mom was on an episode of Inside Schizophrenia and talked about how much you two partner and work together to help you lead the best life possible. There is a tremendous amount of research that people living with schizophrenia do better if they have a strong support system. And listen, I always take this opportunity to point out that everybody does better.

Rachel Star Withers: Yes.

Gabe Howard: You don’t have to have a mental illness. No one is an island. So now this is being taken away from somebody based solely on the color of their skin. That, to me, is a tremendous loss.

Rachel Star Withers: Yes, and with Asian people, as far as being a minority, they are actually less likely to receive copies of care plans. Like isn’t that random? They’re less likely at the end of it to be given, OK, here is what we talked about today. This is our plan going forward. That’s worrisome because when I’m in the doctor’s, I have to take notes because the minute I walk out, I don’t remember anything. So, if me and that doctor are coming up with a care plan and then they don’t even like, let me walk away with it. You know, that’s odd to me. I’ve never had that situation. Like that would never occur to me that the doctors wouldn’t be wanting me to do this plan.

Gabe Howard: Rachel, along those same lines, what about the role of medication, is that at least the same for everybody in the treatment of schizophrenia?

Rachel Star Withers: No. Minorities have been found that they are prescribed typical antipsychotics over atypical antipsychotics. So, the typical ones tend to be the older ones. OK. The kinds we’ve been using since the 40’s. And if you’ve ever taken those type, like I have, the side effects are intense. They’re just so much worse than the newer drugs. Whenever you talk about movement disorders, that unfortunately are a side effect of many antipsychotics, the majority come from typical antipsychotics. So, if you have tremors, shaking that’s been brought on as a side effect, it’s going to be more of those older ones. So here we have minorities, they’re less likely to be offered therapy. They are less likely to be given a set plan and they’re more likely to be given medication without that support system. That can be very hard to deal with.

Gabe Howard: I’m really just speechless because, you know, I became a mental health advocate because I believe that people weren’t getting access to the care that they needed. And listen, this was largely from my own experience, seeing mostly middle-class white people. I thought that middle class white people weren’t getting the right care. And I still stand by that. And you’re saying that there is worse care based on gender, religion, the color of your skin. That’s just altogether frightening. In general, from what I’m seeing, from my perspective, from my eyes, from my vantage point, which I understand is only mine, I think that we need to do way, way better. And everything that we’re reading shows that it’s worse based on nothing more than who you are, where you were born or the color of your skin. And that’s, it’s a lot to take in, Rachel. It’s a lot to take in.

Rachel Star Withers: And we’ll be right back after this message from our sponsor.

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Rachel Star Withers: And we’re back to talking about schizophrenia in minorities.

Gabe Howard: Rachel, I think this is a good spot to introduce our guest, Sakinah, the Muslim Hippie, Karen Michelle. Clearly, we can only understand and process the world from our own vantage point, with our own eyes. The same with Sakinah. She is an incredible mental health advocate. She has done so much. And I’m so glad we had the opportunity to speak with her. So, go ahead and roll the interview.

Rachel Star Withers: So, we’re talking with our guest for this episode, Sakinah. And she’s also known as The Muslim Hippie.

Sakinah: Yes.

Rachel Star Withers: So, tell us a little bit about your background.

Sakinah: So I grew up in the D.C. area. That actually is why I call myself a Muslim hippie. When I started with my journey with mental health slash mental illness, one of the first hospitals that I went to was in Takoma Park. And Takoma Park has a really eclectic history to it. And I like it because when I was growing up, I was really attached to some schools in that area. And I kind of felt like since I got better, or started getting better, there, I wanted to remind myself of what I liked about that part of D.C. and I like being a hippie. So, I just called myself a Muslim hippie and it just stuck. And then people were like, Oh, that’s cool. What do you mean by that? I know that people have a negative association with the name Karen. But my dad named me Karen. So that’s kind of why I also stick to my given name, because he really wanted me to have that name and he liked the meaning of it, which is pure. So, I go by Sakinah because that’s my Muslim name. But I stick with Karen, too. So that’s me in a nutshell.

Rachel Star Withers: And you are a mental health advocate, crisis counselor, speaker and a mentor.

Sakinah: Yes.

Rachel Star Withers: Can you tell us a little bit about your mental health journey?

Sakinah: I did not intend to be a mental health advocate at all. I just dealt with mental health in one way or another since high school. And I kind of stumbled into all of this. And then when I started talking about my journey, I started blogging just because I like writing. And a few of my friends from elementary school, they read my stuff and they’re like, oh, you’re a really good writer. And a friend of mine, she’s a professional writer. She encouraged me to talk about what I was going through. And initially what I noticed was depression. So, I started talking about my depression issues. And then when I got online, which was mostly Twitter, I developed a following. And then it was kind of like I was healing and writing and like learning how to blog and do all that stuff all at the same time. So, then I learned about advocacy work. So, I used my journey online to kind of teach people about mental health. And as I was learning and healing, I decided, okay, why don’t I do this full time? So, then I started going to classes and things like that. And then I told people, OK. This is what I’m doing intentionally. So, let’s learn about mental health together. And then once I started going to the doctor and stuff, I actually told people, well, I didn’t know things and like maybe you don’t know either. And so that’s kind of how I got started. And there are so many mistakes that I made or that other people made. And rather than use my blogs to just say this didn’t work and hurt me, I used it to teach people about what I thought they should know about mental health.

Rachel Star Withers: So, our episode today is about minorities, and we were discussing that what a minority is, of course, changes depending on where you’re at.

Sakinah: Right.

Rachel Star Withers: And it can be, you know, a lot of different factors. A big one, though, however, usually is race. Can you tell us what race you are? Do you feel comfortable talking about that?

Sakinah: I’m actually African-American. My dad is black. My mom is black. They’re both American. My dad is from D.C. and my mom is from Georgia. The funny thing is people don’t know where I’m from because I cover with this scarf, this hijab, because I’m Muslim. So, when they see me, they assume actually, because I look racially ambiguous, they will assume that I am other, like Somali or Ethiopian or, you know, something. And my dad, they usually think he’s Egyptian or Moroccan. So, it’s hard for me when I identify. I’m kind of, I get stuck because when I was working in a hospital, I was a CNA for a while. And they would say things like, oh, you don’t have an accent. And it was hard for me to understand what they meant by that. Because I didn’t know if they meant I don’t have a D.C. accent? Or I don’t have a Maryland accent? Or if they meant I don’t have an American accent? I didn’t know what they meant. And then I realized they meant that I don’t have an accent for someone who they thought was Ethiopian or whatever. So, I’m African-American.

Rachel Star Withers: You should have said, well, my mother’s from Georgia, not me.

Sakinah: Yes.

Rachel Star Withers: For like a Southern accent. And they’d be like, oh, okay.

Sakinah: Yes. And what’s funny is I’ll actually, yeah. Well, funny enough where I was working was in northeast D.C. and I ended up saying things like, no, my dad’s from, and then I would say the street where he was from. That’s how I found out, because they just kind of look like what? And then even when I take the scarf off, people will say things like, are you mixed Black and Spanish? Are you mixed Black and White? So, it’s still kind of a thing where people don’t know where I am. So that mixes the race and ethnicity. So, I’m like, I’m black African-American. You know, I try to get both in because let me explain and clarify. And I shouldn’t have to do that. When it comes to mental health and the conversations that we have, if I’m talking about being a Muslim with mental health issues, being a black person and African-American. It actually does matter because when I go to the hospital, it depends on how they look at me, how they’ll treat me. Like, if they think that I speak English but they don’t care that I’m black, they’ll be really nice. But if they think that I am a Muslim who doesn’t have a good handle on English, then they’re really rude. That’s something that I’ve had to do.

Rachel Star Withers: Very interesting. So, you can tell right away, like how they’re interpreting you?

Sakinah: Yeah. Because you can see, especially because my name. I have not changed my name legally. My name is Karen Kaiser. I mean, that’s easy. But also, no one is expecting someone black when they hear it. Karen Kaiser, because it doesn’t sound black at all. And then they see me and always, oh, OK. And sometimes they’ll say, how did you get that last name? And I used to be like really rude. I’d say, slavery and then like

Rachel Star Withers: Oh.

Sakinah: Somebody said please don’t say slavery, but. You know, that isn’t a nice thing to say. But I don’t know what people want me to say because I don’t really know my whole lineage yet.

Rachel Star Withers: And they’re implying something else also.

Sakinah: Well, exactly. Exactly. And the thing is, though, when I go to the hospital or to the doctor, it depends on if the doctor is black or African-American. It depends on their background and how educated they are. And if they have a prejudice, how they’re going to treat me. So what I’ve noticed is sometimes I prefer to use my name, Karen Kaiser. I don’t want to deal with, oh, where are you from? And I had doctors that I grew up with, they knew me. But then when I put my scarf on, they didn’t recognize me and they were really mean to me. And then they’re like, wait

Rachel Star Withers: Oh.

Sakinah: A minute, we recognize this name. We just didn’t. And they did. We didn’t notice that something. Oh, so you’re saying that you’re going to be prejudiced against this until you know who I am. Sometimes you can see it right away and sometimes they won’t say anything. But it’s in how they will. And one time I went to the hospital and I was really very sick. I almost died. And I asked someone for Sprite and she, on purpose, brought me back apple juice because she thought that I wouldn’t understand the difference. And there is a black guy there who is also attending to my care. And he said, you heard her ask for such and such. Why did you do that? So, it’ll be little things like that. I don’t know how to tell the person you’re doing this because you think that I’m from someplace else. And by that time, it won’t matter if I take my scarf off. And then when I go to inpatient, it’s the same thing. So, I can hear things that people will say and they’re thinking, I don’t hear because I have the scarf on. So actually, when I was in Dallas, I had been able to explain it to them. Because I was in the hospital and they were doing things like making me take my scarf.

Sakinah: They would say that I can’t wear a scarf in the room because I’m going to harm myself with the scarf. And then they have bedsheets in there. So, there are things that like they will have cultural hang ups that they don’t realize. And I don’t know how to explain it to them easily. So that’s one thing that I’d like to work on with my advocacy is being able to clearly share with people how I can see their prejudices. And I’m not that eloquent sometimes in my speech, because if I’m unwell, if I’m in psychosis, I don’t have time to educate you. One time I was at a hospital and they said, well, there’s our patient line, you can tell us what we’re doing wrong and I shouldn’t have to do that when I’m not feeling well. So, it’s something that I want to work on when I’m like now when I’m passionate but not feeling hurt or upset, because I think that in the long run, it helps people to see how they can better help someone like me.

Rachel Star Withers: As far as, we’re talking about on the small scale of things right away, people seeing you. What about the larger scale as far as like diagnoses? How do you feel race or religion might have played a difference?

Sakinah: Well, so what I have noticed, this is just a small bit of research that I’ve done. What I noticed and what I’ve heard is that African-Americans, so we tend to be more easily diagnosed with bipolar and schizophrenia and definitely more psychotic disorders, whether that’s that or not. So, let’s say that you see me in a trauma setting. So, you might just put a label of bipolar or schizophrenia, and that might not be what it is. That’s easier because you just assume all of us, if I’m loud and I’m yelling and I’m assuming they think that is what the data supports, that it’s easier to put us with that label. Just how they would say, like with young black boys, they’ll get the label of ADHD. When it comes to psychotic disorders, black people will get the label of a psychotic disorder, and without getting much research. A lot of diagnoses are missed because we just get one thing slapped on us and then nothing else is looked into. And I think that is really so sad because we could get help. And also, there is a rush to overmedicate. Even if it is a psychotic disorder, I might be on a really high dosage or something when I could be on a lower dose just because it’s almost like criminalization of symptoms. Whereas someone else may just do with a lower dose because they’re not looking at her as a criminal. So that’s on a larger scale where it just is with African-Americans. It’s more of just you have that psychotic label and then we’re just going to medicate. Almost like a prison type thing within the medication.

Rachel Star Withers: Just asking, because this is obviously in the news a lot and it is a major issue and problem is African-American people specifically, but people of color being I don’t want to say harassed, but unfortunately, yeah, harassed in a lot of like legal situations, kind of police tend to jump where they’ll stand and might talk to a white person who’s, like waving a gun for hours and talk them down,

Sakinah: Yes. Yeah.

Rachel Star Withers: And they’ll tend to see a black person doing something like lighting a cigarette, thinking it’s a gun and overreacting. Mental health wise, how does that make you feel? You know, you’ve talked about being inpatient some. Are you scared to get help sometimes? That maybe things could escalate?

Sakinah: Now, that’s an interesting topic and how that plays out is it depends on your presentation, gender and how you look. Because as a Muslim, let’s say I’m five one and I’m light skinned. I might be Muslim and I am African-American and I cover. But if I’m not seen as a threat, well then no, I’m not scared. But then they won’t help me because they don’t see me as someone that they need to pay attention to. So, they’re not interested in getting me the help that I need. And since I’m not a criminal, they don’t want to pay me any attention. So let’s say that someone calls the police because I’m exhibiting psychotic symptoms. They usually will say, OK, she’s African-American, she’s dangerous. But then if they come out and I’m not dangerous, then they just walk away. So, they don’t give me any help. Do you see what I mean? So it is that criminalization of African Americans with any type of psychiatric symptoms. It’s automatically we have to harm this person. Then if they aren’t a danger to us, then we’re not going to help them. In order for me to get impatient, I have to take myself. Because when it comes to someone calling for me, nobody wants to deal with me because it’s almost like they’re like, OK, there, there. You know, we’re not dealing with you. Now, if it were my son, who is a darker skinned male who is bigger, yeah, I’d be afraid for him because the minute they see him, they’re thinking, is he a threat? OK, we’ll shoot him. So we talk about the privilege of being light skinned. If you have pretty privilege, that kind of thing, because certain people, they’re not looking for you. So they’re not going to do anything.

Rachel Star Withers: Now, as you just mentioned, you’re also a mother of teenagers.

Sakinah: Yes, two teenagers and a 20 year old.

Rachel Star Withers: What do you tell them? Do you warn your kids as far about, hey, when you go to the doctor, you might want to be careful about this? Do you ever worry?

Sakinah: I do, but I’m careful how I warn them because I don’t want to put in them this idea. This inferiority complex, like, OK, you do this so you don’t get hurt because then that raises someone with this idea that it’s OK for me to victim blame. At the same time, I don’t give them the idea that they can do whatever they want. It’s this tightrope, this walk that I have to do that. OK. And when it comes to psychiatric symptoms, if you need help, you have to know how to reach out. And then it’s a difficult thing. But I want them to know how to talk to me. I just have to let them know how to advocate for themselves. And I think that’s the best way to do it. But I do let them know they can look at my social media pages if they need to understand mental health and if they need to ask for help. I really try not to let me enter into it because I want young people to look at the adults in their lives to know how to get help. And that’s kind of the way that I’m steering my advocacy work.

Rachel Star Withers: Earlier in the episode, me and Gabe, we discussed that we’re both white and I have never been in a situation where I did not feel comfortable due to my race as far as like a medical setting. I’ve never thought when the doctor came in, they’re going to treat me differently. I’ve never worried about that. The nurse practitioners and other ones have been more diverse. But like the psychiatrists that I’ve seen, the vast of the doctors have all been white males, with the exception of two, and I’ve seen a lot. So that exception is under five percent. You know, at the end of the day, I can’t understand. What would you tell other people like me and Gabe?

Sakinah: Well, what I would say is that. See someone like me has also had a bit of a privileged experience when it comes to clinicians. So, I had to have that explained to me. And I didn’t know that because I grew up in the DMV area that which is the D.C., Maryland, Virginia area. I have had, I’d say about 98% really good experiences because those doctors are so well, not just well educated. These are the specialists of the specialists. So all of the really good hospitals, there are such good hospitals. And I’m not in a rural area. So if I had bad experiences, I can name them on one hand. And even if my friends had bad experiences, we are the anomaly. What I would say is for African-Americans, each person’s experience is going to be different. And then it’s going to depend on their life circumstances. Unfortunately, it depends on appearance. It depends on how well educated they are about their situation. And it also depends on money.

Rachel Star Withers: Yes.

Sakinah: For me, every single time I went to get diagnosed, it all lined up to what I have today, which is so rare. I’ve never had a different diagnosis. With all the times I’ve been to different hospitals, that’s unusual. Usually people say, oh, well, first they thought this and they never thought something different. And they hadn’t. They had no reason to say that. So I think I had one doctor who did something that was so unusual that it was racially based. It was abusive. But I can be mad at that one doctor. It might have been as bad as I should’ve sued the hospital. But again, I would say that as a patient who’s African-American. Like, I can’t even speak for all African-American patients, you know, with mental illness

Sakinah: Because my situation would be different, too, because of being Muslim. After 9/11, the difference is a lot of Muslims have trouble with trusting mental health professionals because some people are afraid of things like surveillance or afraid of stigma. And I never thought of that because my mom raised me to be so open with I’m going to the doctor that I didn’t think about it until people had told me, like, you’re so clueless. And so that’s, again, a privilege that I didn’t have bad experiences. And what I would tell to you guys is Gabe was probably the first advocate who came to me and said, OK, I don’t know about what you do and your experience. So how do I learn? I’m going to be honest, that’s unusual to me. You guys have been so open with me. And that was really helpful. If I talk about race and I talk about ignorance it is because some people, they just never were open. And what I like about when I meet advocates like you is that you asked me to tell you about my experience. So that helps me to see how I can teach you. So, I think that if each person shares their experience with one another, then we all can learn.

Rachel Star Withers: Oh, I like that. What the world needs more of is people willing to learn.

Sakinah: Yeah, yeah, I think so.

Rachel Star Withers: As you know, with mental health, depression and suicide comes up a lot. A few years ago, I’d given a response, we’re talking about as far as suicide. Pretty much, my rule is if your friend or loved one or whoever is talking about suicide, don’t treat it as a joke. If you think they’re going to hurt themselves or others, you need to call the police. And I had a lot of backlash because a lot of people said because you’re white, you think that means they’re going to get help. And yeah, unfortunately, a lot of times if the person isn’t white, they’re not going to get help. It’s going to be a very different response. And I know there is no correct answer. There is no. Well, this is what.

Sakinah: Right.

Rachel Star Withers: What advice, though, would you give me as far as dealing with those situations?

Sakinah: What I would say is a lot of areas now are starting to adopt warm lines. And like, I won’t say, a crisis text line. But there is a difference between the 911 number and a crisis line. But things like, in my area, they have either 211 or 311, which is the county services. And if you call them, which is a non-emergency number, they should have a mobile crisis. Now the problem with mobile crisis is that sometimes they will send the police. So unfortunately, in that sense, there’s nothing you can do. But I think by state, I think people are having these numbers for mobile crisis. Or you can ask for an ambulance when you call the cops. You can say maybe it’s not an emergency or when you call crisis text line. I also take crisis text line calls. What we can do on crisis text line is you can call on behalf of someone else and say, I think this person might need help and they can call someone for them. It doesn’t have to be the police. So, one of the things I want people to think about is if it is a person of color, African-American or somebody else, find somebody different to call besides the police. And if you’re not sure who, then you can look it up, because for whatever reason, there’s just such a stigma against us when it comes to law enforcement or they don’t know how to de-escalate. I’ve seen and retweeted videos of white Americans, they can walk at the police with all kinds of machetes and everything, and the police will just stand there like, oh, it’s OK. And then me, I can have nothing, and like, I’m like, I’m compliant, I’m on the ground and they’ll shoot us. And I don’t know why that is. Rather than figure that out, I would try to help by just call a different number. But I think until you get African-Americans to deal positively with law enforcement and share our experiences and teach, I don’t think that it will change that we’re getting hurt.

Rachel Star Withers: And something you said earlier. So Gabe’s a pretty big, big guy. You’ve met him in real life. He’s like six something, huge towering guy.

Sakinah: Yeah.

Rachel Star Withers: And let’s say there’s a situation and I feel that, yeah, he needs help. I wouldn’t think twice about calling the police. It would never occur to me that, like, oh, they’ll make it worse. And he’s huge.

Sakinah: Ok.

Rachel Star Withers: So, you should think that, hey, if anyone. Yeah, I would be worried that they might shoot him because he’s such a big dude, but that never entered my mind.

Sakinah: Right.

Rachel Star Withers: But that’s almost like that privilege that people don’t realize. I wouldn’t have thought about race having any effect.

Sakinah: Right.

Rachel Star Withers: Yeah.

Sakinah: And the thing with privilege, regardless of the scenario, you almost don’t realize it until someone lets you know where you have it. One time I was tweeting about something, about maybe going to the E.R. or why would you wait to get a doctor? And whatever I tweeted about, someone said, you know, you think that because you have privilege. You know where I am, even if you’re in crisis, if you call the doctor, they won’t see you for about a month. And I said, oh. And they were letting me know that your privilege is such that. Like, if I call my doctor, they’ll call me right back. Sometimes I have my doctor’s cell phone number. So I was sorta like, oh, I can just go to the E.R. right then and get evaluated by a psychiatric social worker so they’ll let me know if I need to go to inpatient. Like, why would you wait? And a couple things I said. And they’re like, you are in the D.C. area. Of course you have. And I was talking about like I just go and I just did this. And you don’t even understand how much privilege you have. We can’t go even in an emergency. And then I said, oh, OK, I get it. And I think we all have privilege. Even if you don’t realize this. So, sometimes someone has to tell you, oh, you didn’t realize. That was easy for you. That’s why you think that. So, yes, the same type of thing. And I think even for me, the way that my stature is with if you see cops, most of them, it’s obvious they are bigger than me and they have more like they have authority over me.

Sakinah: But when someone calls for me, there are six of them. Six of them came out and I’m just sitting there and they keep saying like, well, that your friend said that you were suicidal. And I said, I’m not. I just asked them out of it and like, OK, you can leave. But her son, they talked to him in such a way, it was obvious they wanted to harm him, you know, and they’re making fun of him and like, have you taken your medicine? And they weren’t really trying to de-escalate the situation. They didn’t do any of that to me. So, the way that they treat people like us is so different. And they weren’t interested in getting him out. They were just trying to, like, let her know that she had messed up by not giving him his meds. So that’s the kind of thing where if you don’t see that happen, you won’t really know. That’s how they deal with it. There were actually only three of them, and there were six for me. You know, there’s no need to. Like, they’re trying to strong arm us and let us know. None of that makes any sense.

Rachel Star Withers: And that goes whether you’re in a city or rural area, like how many? Obviously, you always hear where not everyone’s bad, which is correct. But when you look at like, the responses. Yeah. If you’re in an area that the police have more of a budget, they’ll probably send more. And it could probably escalate quicker than if you’re from where I’m from. And I don’t know, like five cops for like half of South Carolina. You know, the idea that a whole bunch coming out wouldn’t happen and be like, well, where are you going to find them? But yeah, usually, like, things change.

Sakinah: See, I didn’t even think of that. Yeah.

Rachel Star Withers: Mm hmm.

Sakinah: Yeah, because for me, I’m like, why are these six cops in a room? And like, they’re all like just trying to stand in front of a window where if I fell out, I’m not even going to die. And then I’m like, what are you even doing? It was really, really odd. And then I kept telling them, look why are you all around the windows? We don’t want you to jump out. Of this window? Yes. None of that makes sense. OK. Yeah. Then they had an actual budget. And then finally they’re like, all right, let’s just go, we’re wasting our time. I told you that. Yes.

Rachel Star Withers: So we’ve hit on a lot of different things, and I’ve loved talking with you. What overall advice do you have for people whenever they’re in a minority situation dealing with mental health, whether it’s a crisis or just worried about getting general help?

Sakinah: Ok, I’ll say two things. If you are a minority and you are concerned about your mental health, don’t be afraid to ask. What you don’t know, that is what can hurt you. And it is not a shame on you to say, hey, I’m dealing with this issue. And you won’t know what it is wrong with you unless you ask a professional. You cannot assume. Everything isn’t depression. Everything isn’t anxiety. You need to know and you deserve to feel well. And I have a friend who always told me that. So you should check into it. You should reach out. But especially if you are black or African-American, you need to take care of yourself because you need, you have to be strong in today’s society. But if you’re dealing with someone who’s black or African-American, same thing. Don’t assume that they know what’s going on with them and don’t look at them and think, oh, that person’s angry all the time. Or that person is whatever. They may be dealing with trauma and they don’t know how to get help. So, if you say something, let’s say online, you say, oh, reach out or take care of your mental health. They won’t know how to do that unless they’ve been taught. So, don’t assume that like one size fits all. Or if you’re an advocate or even a doctor, that they’ll know how to do that. And then you might be thinking, well, I said it. They won’t know. And so for us, you really almost are going to have to go into those communities and teach people and just be kind of patient because some people have such a stigma. Like in black communities, we have such a stigma. And you may need someone who looks like them or who they will take that information from. So, it’s OK if he will kind of push back. They’re not pushing back against you. They’re just a little bit scared sometimes. Just like no assumptions. No assumptions.

Rachel Star Withers: And how can our audience learn more about you?

Sakinah: The best way to learn about me, I would say, is through my social media, Twitter and Facebook is where I’m most active. My Twitter handle is @TheMuslimHippie. You can find me on Facebook /Sakinah.Karen. And both of those have all information on any other projects that I’m working on. You’ll find those. I’m working on the second book about substance use disorders. I want to write a book about Muslims dealing with substance use and how being in a marginalized community, if you don’t take care of your substance use disorder, you can die quicker. That’s kind of what that project is, but it’s going to be positive. And it’s a story of hope because I’m always looking forward. So, Twitter and Facebook is where you can find me.

Rachel Star Withers: Thank you so much for coming on here and teaching us and our audience. And I kind of hope we will all just continue to learn from each other.

Sakinah: Thank you for having me.

Rachel Star Withers: Thank you so much. Loved speaking with you today.

Gabe Howard: Rachel, that was incredible. I’m so glad that we have the opportunity to interview people on this podcast, not just Sakinah, but all of our guests have just been so incredible. What do you think?

Rachel Star Withers: I learned so much from her. Especially when we talk about, like religious wear. For the most part, when I walk into a doctor’s office, they’re not going to know what religion I am. It’s pretty hard to judge me off that, whereas they know right away with her, you know, and you make assumptions off that, whether you mean to or not.

Gabe Howard: One of the major takeaways that I learned from Sakinah was it’s not intentional. I think this is just such an important point to bring up. This debate is always tabled with you are a malicious racist or you’re perfectly fine. There’s like willful racism or nothing to improve upon. And the reality is, it’s so much more complex than that. I’m not saying that there’s not willful racists. There absolutely are. I don’t think Sakinah is denying that either. Her point was that some of the major issues that people of color, that minorities, have aren’t that willful racism. It’s the unexplored biases. It’s the misunderstandings that go unchecked that lead to people like her not getting the best care. That was a real aha moment for me because it would just be so much cleaner if it was, oh, you’re a racist and you’re evil. Oh, you’re not a racist and you’re wonderful. Like that would be so much easier, but it’s not that way. So, I’m really glad that she pointed that out and I can see where that would be very impactful on her care.

Rachel Star Withers: And sometimes you don’t have access, you know, where you’re living at. So how I dress, let’s say I walk in and the doctor, I’ll go, you know, a week without showering because I’m so depressed and I’m, like, mentally out of it. So imagine if I show up to a very first doctor’s appointment and they’re thinking, oh, wow, this girl looks rough. They make these assumptions that, oh, she probably has no support care system. Oh, wow. We need to, you know, up her meds right away. People look at you and they make assumptions based on the way you dress. There’s so many things that can affect our health care. And it, it’s scary, Gabe. I’m not gonna lie. It’s scary, especially for people with schizophrenia. And there is no like, OK, well, here’s the answer, guys. Like there isn’t. We have no answer for how do you deal with subtle biases? Because unfortunately, every single thing is going to be different and so much of it people don’t even realize they’re doing.

Gabe Howard: Our listeners probably aren’t aware of this, but Rachel is a stuntwoman and she’s also a model and quite accomplished at both. And I am just, I am lucky to have Rachel as a friend. And I bought a new wardrobe recently that Rachel helped me with. So, one, I just wanted to publicly thank you, because now I look stellar.

Rachel Star Withers: True.

Gabe Howard: But people are like, Gabe, you’re really stepping up your game. And I said, yeah, I have a friend who’s a model, Rachel, and she gave me all kinds of hints and tips because this is her experience. And that’s like, oh, that’s awesome. I wish I had a model friend. And the reason I’m telling this story is because recently one of my friends realized that my schizophrenic friend Rachel and my model friend Rachel were the same person. It never occurred to her that my model friend Rachel could live with schizophrenia. She very much considered them separate. Now, my friend is a very good person. She’s a very nice person. She’s not, she doesn’t have a mean bone in her body. This was not malicious, but she was unable to connect the two and she was quite surprised when she found out. That, in my mind, is an excellent example of just an internal bias that you miss. And obviously, the stakes aren’t very high on that. Health care is a matter of life and death. And that’s why we’ve got to do better.

Rachel Star Withers: Absolutely. This episode is a very hard one for me to kind of wrap up. I’m very upbeat. You’ve noticed that, I’m sure, throughout the episodes. So, I always want to leave on an upbeat note. And this is hard because as we’ve said multiple times, me and Gabe, in a lot of ways are very privileged. And we’ve never been outright discriminated against. We’ve never kind of been held back from health care due to being a minority. And I don’t wanna give upbeat words for something that I know nothing about. During this episode, we’ve talked about all different stats and acknowledged that so much goes into the way people perceive us and we perceive other people, how we subconsciously even connect to people. How you’re like, oh, hey, this person’s like me and the opposite there and that’s across the board. That’s something that’s scary to me, that there are people out there and they almost never feel like they connect with a doctor. And I do wish I could be like, oh, well just go find another one. As Sakinah pointed out, especially when you’re not in a city, there may only be one doctor. Depending on your financial status, you might not be able to go to anybody else. You might have to stick with a free clinic or something like that. So, there are no good answers that blanket everything. We all have blind spots. Some of them are self-imposed. Others are put on us. I think we all just kind of have to realize that we have these blind spots and try to do better.

Gabe Howard: Rachel, I could not agree more.

Rachel Star Withers: Thank you so much for listening to this episode of Inside Schizophrenia, a Psych Central podcast. Please, like, share, subscribe. Send it to all of your friends, any of your friends who are dealing with schizophrenia, caretakers, your medical friends, or just some really cool people you know.

Gabe Howard: See you all next time.

Announcer: Inside Schizophrenia is presented by PsychCentral.com, America’s largest and longest operating independent mental health website. Your host, Rachel Star Withers, can be found online at RachelStarLive.com. Co-host Gabe Howard can be found online at gabehoward.com. For questions, or to provide feedback, please e-mail talkback@PsychCentral.com. The official website for Inside Schizophrenia is PsychCentral.com/IS. Thank you for listening, and please, share widely.

from World of Psychology https://ift.tt/32huJ3r via theshiningmind.com

[whorchataaa]

Inside Schizophrenia: Impact of Schizophrenia in Minority Communities

Rates of psychosis are more strongly influenced by ethnicity and socioeconomic status than any other mental health condition. In this episode of Inside Schizophrenia host Rachel Star Withers, a diagnosed schizophrenic, and co-host Gabe Howard discuss the impact of schizophrenia in minority communities. Guest Sakinah “The Muslim Hippie” joins to share her experiences in mental health care.

Highlights of “Impact of Schizophrenia in Minority Communities

[01:00] The realization

[02:08] Sociology definition of the word minority

[04:30] The stats of mental health and minorities

[09:00] Diagnosing differences

[12:00] Is the medical community racially bias?

[14:00] Two people, same symptoms but different diagnosis

[15:40] The privilege of not having to worry

[16:30] Two people, same diagnosis but different treatment

[21:50] Guest Interview with Sakinah “The Muslim Hippie” Karen Michelle

[32:00] Police intervention in the minority mental health community

[39:35] What to do for someone who is suicidal

[51:00] So what is the answer?

About Our Guest

Sakinah “The Muslim Hippie” – Karen Michelle

Mental Health Advocate, Crisis Counselor, Speaker

Sakinah (Karen) Kaiser, also known as The Muslim Hippie lives in Baltimore, MD where she is currently a writer and mental health advocate. She hopes to go back to a school for a degree in social work with a concentration in substance use disorders.

www.Twitter.com/TheMuslimHippie

www.Facebook.com/Sakinah.Karen

    Computer Generated Transcript of “Impact of Schizophrenia in Minority Communities” Episode

Editor’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.

Announcer: Welcome to Inside Schizophrenia, a look in to better understanding and living well with schizophrenia. Hosted by renowned advocate and influencer Rachel Star Withers and featuring Gabe Howard.

Sponsor: Listeners, could a change in your schizophrenia treatment plan make a difference?  There are options out there you might not know about. Visit OnceMonthlyDifference.com to find out more about once monthly injections for adults with schizophrenia.

Rachel Star Withers: Welcome to Inside Schizophrenia, a Psych Central podcast. I’m Rachel Star Withers here with my co-host Gabe Howard. Today’s episode, we’re going to be discussing schizophrenia and how it relates to minorities and also the treatment that minorities receive.

Gabe Howard: I think this is a very timely episode because I really believed before all this started that everybody received the same level of care and that things like gender or race or nationality or religion really didn’t play a role in it. I just thought this was just basic science. So, I was surprised to learn during the research that, yeah, things like gender, race, nationality, religion play a huge role in the treatment options that are offered, that are available. It was stunning to learn.

Rachel Star Withers: And I think with me, when we’re looking at the idea of minorities, you always immediately think discrimination, but so much is things that might just be like these subtle biases that we don’t even realize that we’re doing, whether it’s other people or even to ourselves. In the U.S., whenever I hear minority, most of us usually think it has to do with race. But of course, we have religion differences, gender, sexual orientation, age, lifestyles. So, this episode, we’re going to be looking all across that and explore kind of how those differences affect other stuff around us.

Gabe Howard: Rachel, let’s establish some guidelines so we don’t get off track. So, this episode is called Schizophrenia and Minorities. What is the exact definition that we’re using for this show?

Rachel Star Withers: So, Gabe, I had to look it up because I wasn’t 100% sure. Like I said, I, in the U.S., here, we kind of just think race. But

Gabe Howard: That’s all we think.

Rachel Star Withers: Yeah. Yeah.

Gabe Howard: We don’t kind of think, that’s what we think 100% of the time.

Rachel Star Withers: According to sociology, a minority group refers to a category or people who experience relative disadvantage as compared to members of the dominant social group.

Gabe Howard: So, Rachel, in sociology terms, a minority is not just a few of something, but also it puts you in a disadvantaged class because of it. Now, wouldn’t somebody living with schizophrenia then fall under this definition?

Rachel Star Withers: Yes, and disabilities also can put you into a minority group. So, we’re talking about mental health. We’re talking about physical anything that sets you apart that might hinder you compared to everybody else.

Gabe Howard: And then even in this subset of people living with schizophrenia, there’s a minority group of people inside the minority group. This is where it gets complicated. The general principle that we’re trying to establish here is that, let’s just call it out, white people with schizophrenia often have better access and get better care than African-Americans with schizophrenia. It’s the exact same illness, even in some cases the exact same socioeconomic class. Different outcomes based on race.

Rachel Star Withers: Yes. And here in the U.S., that’s very correct. But you also look that across different countries, different areas, that changes depending on what the dominant race may be.

Gabe Howard: And the reason that we’re pushing this so far into the ground is because it’s not so easy to say that, oh, well, if you’re a minority and you have schizophrenia, people don’t care about you. It’s just racism. It’s not that simple. It’s these cultural and societal biases that we’re completely unaware of. And hopefully this show will shed some light on that because it really is unfair what is happening. And we’d like to think that in some small way Inside Schizophrenia can help maybe educate people on that. Let’s talk about what we found out, because we found out a lot of just straight up facts. This isn’t Rachel and Gabe’s opinion. We’re going to hit you with some straight up Internet knowledge.

Rachel Star Withers: And you’re also probably wondering why does all of this matter? OK. Rates of psychosis are more strongly influenced by ethnicity and socio-economic status than any other mental health conditions. So not just schizophrenia, psychosis, which can, of course, extend into other mental disorders. I found that very interesting. If you were to ask me, Rachel, what do you think your ethnicity and, you know, economically where you fall, what that would affect the most mental health? I would assume depression. That’s what I would assume. Like, well, if you’re poorer, you’re probably going to be more depressed. So, the fact that it’s tied to psychosis really is eye opening. It’s just not what I, at least, would expect.

Gabe Howard: Now, we found an interesting study while we did this because, again, we just don’t want our flapping gums, because let’s be honest here, a couple of white people talking about minority mental health has its own challenges and issues. We just happened to be the hosts. Later on in the episode, we’re going to talk to Karen who bills herself as the Muslim Hippie. She is a very cool mental health advocate, and she taught us all kinds of things. That’s coming up later in the episode. But back to the study and it was done in the United Kingdom.  You know, I want to do a little aside here, the reason we’re using a study from the United Kingdom is because in America, we’re not actually doing a lot of studies on how these biases are impacting the minority community, and that’s very telling in and of itself. It sort of appears, from my perspective, that we don’t care.

Rachel Star Withers: I did find some studies and I was like, yes, finally. OK. And then I went to read through them and the words were very dated, for instance, describing race. And I was like, oh, and I’d have to like, oh, OK. I see. This was done in the 60’s. A lot has changed. But I immediately, like once I realized that, I’d have to start checking the dates and there are very few concrete studies, I would say, that have been done in the past few years, especially with minorities and schizophrenia. It was easier to find for like mental health in general. But definitely the schizophrenia community, almost, almost nothing.

Gabe Howard: Rachel, I think it’s important to remind our audience that there is no definitive test for schizophrenia. Schizophrenia is diagnosed observationally. A professional observes the patient and comes up with a diagnosis that way. And in the United States, black people are four times more likely to be diagnosed with schizophrenia than white people and Hispanic people more than three times. Now, that doesn’t sound right to me. Again, I am not a researcher. But schizophrenia doesn’t. It doesn’t discriminate against race or gender or religion. So, the fact that it’s four times and three times more likely to be diagnosed, shows me that there’s a flaw in the way that we diagnose. What did you find?

Rachel Star Withers: So in the U.K., they found that rates for psychotic disorders, again, not just schizophrenia, but psychosis in general, were five times higher in the minority group of people of black Caribbean heritage. Very, very specific. Black Caribbean, five times higher. That’s a lot. And I feel that if I were one those researchers, I’d be like, wow, there clearly is a genetic link. Right? But there’s actually no pattern found if you go to Caribbean countries that suggests this. So, it’s just found when the Caribbean black people there in the U.K. are a minority. That’s interesting, Gabe. It definitely makes you look at, you know, kind of that nature versus nurture situation.

Gabe Howard: Well, that’s certainly one possibility. Or it could be the trauma of living. There’s so many tangents that we could go off on here if we believed that there was no bias, that this is just the way that it was, then nature versus nurture could be an argument, like you said. But I don’t think that’s it. I don’t think that there is any nurture that causes schizophrenia. And the research holds up that you’re born with schizophrenia. So now we’re talking about diagnosis prevalence rates, not actual schizophrenia prevalence rates. And I think the disturbing thing is that there is a debate. Anybody listening to this should have grave concerns if they’re a member of the minority class. Are you feeling that you’re getting the best care when there’s all of this debate on how it’s diagnosed? It would be disturbing to me if I were an African-American living with schizophrenia. And I find out that it’s diagnosed four times more than in my white counterparts because I’m thinking that’s a lot of margin for error. Am I taking medications that I don’t need? Am I receiving treatments that I don’t need? Was I misdiagnosed? Now, Rachel, please, I imagine that it is very difficult living with schizophrenia, and I imagine that it would be even worse if there was a doubt. If there was an asterisk, if you were wondering to yourself, am I actually schizophrenic or am I a victim of a flawed system? I know that you’re a white woman, but what are your thoughts on that?

Rachel Star Withers: That can be really scary. You know, it takes so long to get a diagnosis and you kind of start to doubt yourself. It isn’t just America or the UK. They’ve done international studies and immigrant communities usually are assigned psychotic disorders way more frequently than the natives of that country who have the racial majority. This is like, OK, well, in America, it’s because they’re dealing with this. No, it’s across the world that if you’re different, they’re more willing to label you with a psychotic disorder.

Gabe Howard: Rachel, let’s do a little segue and talk about the individual patient doctor relationship. Let’s forget about all of the research, the bias and all of that. Let’s just talk about what many people with schizophrenia see for themselves, which is themselves sitting in front of a doctor. Do you think a lack of diversity among mental health professionals can lead to unequal health care?

Rachel Star Withers: Absolutely. For the most part, Gabe, I think me and you are very privileged. Most of the doctors I’ve been to have been white. So, all of the psychiatrists, specifically, have been white males. I’ve never walked in and thought, you know, I’ve never, I’ve never felt out of my element or, like, worried. That’s just, it hasn’t entered my mind. I’ve never looked at the person and thought, oh, you know, they don’t understand me. And that’s kind of interesting. And I was playing in my head being like, let’s say that I’ve never went to a white doctor. But let’s say they were always a different race than me. Would I second guess them? Would I be less willing to trust them almost if they were a different race?

Gabe Howard: It’s interesting because various studies have shown that people of color report more dissatisfaction with their care. And it was interesting when you were saying that all of your providers have been Caucasian, they’ve been white. I am shocked at this. And I didn’t even think about it before this very moment. One hundred percent of my doctors, mental health and physical health, have been white. And I don’t know how that has impacted my care. I don’t know how that has impacted my comfort level because they’ve always been white. A hundred percent of the time. It’s making me uncomfortable to think about. It’s stirring up feelings in me. And again, I’m a white male. Nobody should feel bad for me. But I’m thinking if I’m having this much trouble thinking about it in the abstract. This is a hypothetical. Gabe, how would you feel if all of your doctors were of a different race? And my brain is twisting. I can only imagine how it must feel if all of your doctors were of a different race in practice, not just in theory. But that then makes me ask, do you think that these are terrible psychiatrists, that just we’re intentionally providing bad care? By we I mean, the global we. Bad care to members of the minority class? I mean, is this deliberate? Are we filled with racism and hate? Like, it’s gotta be deeper than that. I don’t want to believe that the entire medical community is just filled with this. This. I don’t know. I just. Obviously, that makes me uncomfortable, too. I don’t want to believe that these are bad people because it does mean that Gabe and Rachel are getting care from bad people, too.

Rachel Star Withers: Of course, outright discrimination, that absolutely exists. But a lot of times it’s not that outright, it’s just more subtleness. And when you look at someone, you right away, you make all these kind of assumptions about them. When you hear someone, you make a lot of assumptions about them.

Gabe Howard: I’m always, of course, fascinated by people that say, well, I don’t see differences, I only see a fellow person in front of me and always think, well, if I went missing, what would you say? Would you say, oh, I’m looking for a tall white redhead? Well, but that means you noticed that I was tall, you noticed that I was white and you noticed that I had red hair. I mean, you certainly know how to identify me in a crowd. Like when you see me over there, you aren’t looking into a group of one hundred people and you’re like, well, I have no idea who is who. I don’t see anything. It’s just disingenuous to say that we don’t notice these things. And I’m wondering if all of this leads to creating criteria for diagnoses that while beneficial to the majority, are not beneficial to the minority.

Rachel Star Withers: Rutgers found that African-Americans with severe depression are actually more likely to be misdiagnosed with schizophrenia. So, you have two people who are coming in to the doctor saying the exact same thing. I’m having, let’s say, visual hallucinations. I’m having audio hallucinations, these different delusions. And they’re quicker to say the African-American person is a schizophrenic.

Gabe Howard: And you can see how devastating that could be, getting the incorrect diagnosis means that you’re getting the incorrect care. It means that you are not presented with options that are most beneficial to you. So therefore, you don’t have the opportunity to lead your best life. This is terrible. It’s terrible to consider. And speaking as a man who lives with bipolar disorder, I can only imagine that if in addition to managing bipolar disorder, which is devastatingly awful, I also had to wonder if I actually had bipolar disorder. Have you ever doubted your schizophrenia diagnosis, Rachel?

Rachel Star Withers: I haven’t doubted it in the past, you know, let’s say 10 years. In the very beginning, when I was first getting diagnosed, my early twenties? Yes. Mainly because the doctors kept, they were giving me different diagnoses. So, I was going, wait, which one of you should I believe? You know, one saying one thing, one saying another. However, I’ve never once thought it had to do anything with me. The psychologist was saying one thing. The psychiatrist was saying something else. I never said, oh, it’s probably because I’m a woman. That’s why this one thinks that. Oh, it might be because I’m white that one. That never occurred to me. I really just thought, you know, they’re different types of doctors. That’s why they maybe have different opinions. Never occurred to me that I in any way influence that. I was putting a lot of trust just in the doctors. And that goes back to what we’re saying earlier. That could very well be a privilege that I have, that it wouldn’t occur to me that I can’t trust this person.

Gabe Howard: I think it is an incredible privilege that you and I have. It’s wonderful not to have to wonder, because it just takes something off the table. There is a lot to manage with a severe and persistent mental illness. Schizophrenia is a scary illness. And also having to wonder if you are getting the best care based on the available research, based on your race or religion, socioeconomic status, etc. I just cannot imagine and I want to be very, very clear that there’s only so much understanding that Rachel and I can have, because it’s just not possible to walk a mile in these shoes. But one of the things that I’m wondering, Rachel, is we’ve talked about the bias in diagnosis. Now let’s pretend that it’s the correct diagnosis. Let get out of our mind that it might be incorrect. It’s 100% the right diagnosis. What about treatment? Are minorities with schizophrenia getting the best treatment?

Rachel Star Withers: And that’s what’s crazy. We go back to if we have two people walk in. Same symptoms walking into the same doctor. They found that all racial minorities. OK. So not just a specific race. All of them are less likely to be offered cognitive behavioral therapy than a white person. They’re more, it’s almost like they’re more willing, like, OK, like you have a lot of different options here. And then with minorities, let’s not give them as many options. And I don’t think it’s always, you know, an outright discriminatory thing. But, yeah, across the board, they’ve found that out. They’ve noticed that black patients are far less likely to be offered family therapy. I can see that definitely being a bias. Thinking the family’s less stronger in African-Americans, the family’s less stronger in Hispanics. Yeah. I easily see that being a bias with different doctors.

Gabe Howard: And that, of course, is, one, it’s just outright offensive. But let’s move that aside for a moment. I know that I would not be living as well as I am now if I didn’t have strong family support. And, Rachel, you’ve talked too. Your mom was on an episode of Inside Schizophrenia and talked about how much you two partner and work together to help you lead the best life possible. There is a tremendous amount of research that people living with schizophrenia do better if they have a strong support system. And listen, I always take this opportunity to point out that everybody does better.

Rachel Star Withers: Yes.

Gabe Howard: You don’t have to have a mental illness. No one is an island. So now this is being taken away from somebody based solely on the color of their skin. That, to me, is a tremendous loss.

Rachel Star Withers: Yes, and with Asian people, as far as being a minority, they are actually less likely to receive copies of care plans. Like isn’t that random? They’re less likely at the end of it to be given, OK, here is what we talked about today. This is our plan going forward. That’s worrisome because when I’m in the doctor’s, I have to take notes because the minute I walk out, I don’t remember anything. So, if me and that doctor are coming up with a care plan and then they don’t even like, let me walk away with it. You know, that’s odd to me. I’ve never had that situation. Like that would never occur to me that the doctors wouldn’t be wanting me to do this plan.

Gabe Howard: Rachel, along those same lines, what about the role of medication, is that at least the same for everybody in the treatment of schizophrenia?

Rachel Star Withers: No. Minorities have been found that they are prescribed typical antipsychotics over atypical antipsychotics. So, the typical ones tend to be the older ones. OK. The kinds we’ve been using since the 40’s. And if you’ve ever taken those type, like I have, the side effects are intense. They’re just so much worse than the newer drugs. Whenever you talk about movement disorders, that unfortunately are a side effect of many antipsychotics, the majority come from typical antipsychotics. So, if you have tremors, shaking that’s been brought on as a side effect, it’s going to be more of those older ones. So here we have minorities, they’re less likely to be offered therapy. They are less likely to be given a set plan and they’re more likely to be given medication without that support system. That can be very hard to deal with.

Gabe Howard: I’m really just speechless because, you know, I became a mental health advocate because I believe that people weren’t getting access to the care that they needed. And listen, this was largely from my own experience, seeing mostly middle-class white people. I thought that middle class white people weren’t getting the right care. And I still stand by that. And you’re saying that there is worse care based on gender, religion, the color of your skin. That’s just altogether frightening. In general, from what I’m seeing, from my perspective, from my eyes, from my vantage point, which I understand is only mine, I think that we need to do way, way better. And everything that we’re reading shows that it’s worse based on nothing more than who you are, where you were born or the color of your skin. And that’s, it’s a lot to take in, Rachel. It’s a lot to take in.

Rachel Star Withers: And we’ll be right back after this message from our sponsor.

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Rachel Star Withers: And we’re back to talking about schizophrenia in minorities.

Gabe Howard: Rachel, I think this is a good spot to introduce our guest, Sakinah, the Muslim Hippie, Karen Michelle. Clearly, we can only understand and process the world from our own vantage point, with our own eyes. The same with Sakinah. She is an incredible mental health advocate. She has done so much. And I’m so glad we had the opportunity to speak with her. So, go ahead and roll the interview.

Rachel Star Withers: So, we’re talking with our guest for this episode, Sakinah. And she’s also known as The Muslim Hippie.

Sakinah: Yes.

Rachel Star Withers: So, tell us a little bit about your background.

Sakinah: So I grew up in the D.C. area. That actually is why I call myself a Muslim hippie. When I started with my journey with mental health slash mental illness, one of the first hospitals that I went to was in Takoma Park. And Takoma Park has a really eclectic history to it. And I like it because when I was growing up, I was really attached to some schools in that area. And I kind of felt like since I got better, or started getting better, there, I wanted to remind myself of what I liked about that part of D.C. and I like being a hippie. So, I just called myself a Muslim hippie and it just stuck. And then people were like, Oh, that’s cool. What do you mean by that? I know that people have a negative association with the name Karen. But my dad named me Karen. So that’s kind of why I also stick to my given name, because he really wanted me to have that name and he liked the meaning of it, which is pure. So, I go by Sakinah because that’s my Muslim name. But I stick with Karen, too. So that’s me in a nutshell.

Rachel Star Withers: And you are a mental health advocate, crisis counselor, speaker and a mentor.

Sakinah: Yes.

Rachel Star Withers: Can you tell us a little bit about your mental health journey?

Sakinah: I did not intend to be a mental health advocate at all. I just dealt with mental health in one way or another since high school. And I kind of stumbled into all of this. And then when I started talking about my journey, I started blogging just because I like writing. And a few of my friends from elementary school, they read my stuff and they’re like, oh, you’re a really good writer. And a friend of mine, she’s a professional writer. She encouraged me to talk about what I was going through. And initially what I noticed was depression. So, I started talking about my depression issues. And then when I got online, which was mostly Twitter, I developed a following. And then it was kind of like I was healing and writing and like learning how to blog and do all that stuff all at the same time. So, then I learned about advocacy work. So, I used my journey online to kind of teach people about mental health. And as I was learning and healing, I decided, okay, why don’t I do this full time? So, then I started going to classes and things like that. And then I told people, OK. This is what I’m doing intentionally. So, let’s learn about mental health together. And then once I started going to the doctor and stuff, I actually told people, well, I didn’t know things and like maybe you don’t know either. And so that’s kind of how I got started. And there are so many mistakes that I made or that other people made. And rather than use my blogs to just say this didn’t work and hurt me, I used it to teach people about what I thought they should know about mental health.

Rachel Star Withers: So, our episode today is about minorities, and we were discussing that what a minority is, of course, changes depending on where you’re at.

Sakinah: Right.

Rachel Star Withers: And it can be, you know, a lot of different factors. A big one, though, however, usually is race. Can you tell us what race you are? Do you feel comfortable talking about that?

Sakinah: I’m actually African-American. My dad is black. My mom is black. They’re both American. My dad is from D.C. and my mom is from Georgia. The funny thing is people don’t know where I’m from because I cover with this scarf, this hijab, because I’m Muslim. So, when they see me, they assume actually, because I look racially ambiguous, they will assume that I am other, like Somali or Ethiopian or, you know, something. And my dad, they usually think he’s Egyptian or Moroccan. So, it’s hard for me when I identify. I’m kind of, I get stuck because when I was working in a hospital, I was a CNA for a while. And they would say things like, oh, you don’t have an accent. And it was hard for me to understand what they meant by that. Because I didn’t know if they meant I don’t have a D.C. accent? Or I don’t have a Maryland accent? Or if they meant I don’t have an American accent? I didn’t know what they meant. And then I realized they meant that I don’t have an accent for someone who they thought was Ethiopian or whatever. So, I’m African-American.

Rachel Star Withers: You should have said, well, my mother’s from Georgia, not me.

Sakinah: Yes.

Rachel Star Withers: For like a Southern accent. And they’d be like, oh, okay.

Sakinah: Yes. And what’s funny is I’ll actually, yeah. Well, funny enough where I was working was in northeast D.C. and I ended up saying things like, no, my dad’s from, and then I would say the street where he was from. That’s how I found out, because they just kind of look like what? And then even when I take the scarf off, people will say things like, are you mixed Black and Spanish? Are you mixed Black and White? So, it’s still kind of a thing where people don’t know where I am. So that mixes the race and ethnicity. So, I’m like, I’m black African-American. You know, I try to get both in because let me explain and clarify. And I shouldn’t have to do that. When it comes to mental health and the conversations that we have, if I’m talking about being a Muslim with mental health issues, being a black person and African-American. It actually does matter because when I go to the hospital, it depends on how they look at me, how they’ll treat me. Like, if they think that I speak English but they don’t care that I’m black, they’ll be really nice. But if they think that I am a Muslim who doesn’t have a good handle on English, then they’re really rude. That’s something that I’ve had to do.

Rachel Star Withers: Very interesting. So, you can tell right away, like how they’re interpreting you?

Sakinah: Yeah. Because you can see, especially because my name. I have not changed my name legally. My name is Karen Kaiser. I mean, that’s easy. But also, no one is expecting someone black when they hear it. Karen Kaiser, because it doesn’t sound black at all. And then they see me and always, oh, OK. And sometimes they’ll say, how did you get that last name? And I used to be like really rude. I’d say, slavery and then like

Rachel Star Withers: Oh.

Sakinah: Somebody said please don’t say slavery, but. You know, that isn’t a nice thing to say. But I don’t know what people want me to say because I don’t really know my whole lineage yet.

Rachel Star Withers: And they’re implying something else also.

Sakinah: Well, exactly. Exactly. And the thing is, though, when I go to the hospital or to the doctor, it depends on if the doctor is black or African-American. It depends on their background and how educated they are. And if they have a prejudice, how they’re going to treat me. So what I’ve noticed is sometimes I prefer to use my name, Karen Kaiser. I don’t want to deal with, oh, where are you from? And I had doctors that I grew up with, they knew me. But then when I put my scarf on, they didn’t recognize me and they were really mean to me. And then they’re like, wait

Rachel Star Withers: Oh.

Sakinah: A minute, we recognize this name. We just didn’t. And they did. We didn’t notice that something. Oh, so you’re saying that you’re going to be prejudiced against this until you know who I am. Sometimes you can see it right away and sometimes they won’t say anything. But it’s in how they will. And one time I went to the hospital and I was really very sick. I almost died. And I asked someone for Sprite and she, on purpose, brought me back apple juice because she thought that I wouldn’t understand the difference. And there is a black guy there who is also attending to my care. And he said, you heard her ask for such and such. Why did you do that? So, it’ll be little things like that. I don’t know how to tell the person you’re doing this because you think that I’m from someplace else. And by that time, it won’t matter if I take my scarf off. And then when I go to inpatient, it’s the same thing. So, I can hear things that people will say and they’re thinking, I don’t hear because I have the scarf on. So actually, when I was in Dallas, I had been able to explain it to them. Because I was in the hospital and they were doing things like making me take my scarf.

Sakinah: They would say that I can’t wear a scarf in the room because I’m going to harm myself with the scarf. And then they have bedsheets in there. So, there are things that like they will have cultural hang ups that they don’t realize. And I don’t know how to explain it to them easily. So that’s one thing that I’d like to work on with my advocacy is being able to clearly share with people how I can see their prejudices. And I’m not that eloquent sometimes in my speech, because if I’m unwell, if I’m in psychosis, I don’t have time to educate you. One time I was at a hospital and they said, well, there’s our patient line, you can tell us what we’re doing wrong and I shouldn’t have to do that when I’m not feeling well. So, it’s something that I want to work on when I’m like now when I’m passionate but not feeling hurt or upset, because I think that in the long run, it helps people to see how they can better help someone like me.

Rachel Star Withers: As far as, we’re talking about on the small scale of things right away, people seeing you. What about the larger scale as far as like diagnoses? How do you feel race or religion might have played a difference?

Sakinah: Well, so what I have noticed, this is just a small bit of research that I’ve done. What I noticed and what I’ve heard is that African-Americans, so we tend to be more easily diagnosed with bipolar and schizophrenia and definitely more psychotic disorders, whether that’s that or not. So, let’s say that you see me in a trauma setting. So, you might just put a label of bipolar or schizophrenia, and that might not be what it is. That’s easier because you just assume all of us, if I’m loud and I’m yelling and I’m assuming they think that is what the data supports, that it’s easier to put us with that label. Just how they would say, like with young black boys, they’ll get the label of ADHD. When it comes to psychotic disorders, black people will get the label of a psychotic disorder, and without getting much research. A lot of diagnoses are missed because we just get one thing slapped on us and then nothing else is looked into. And I think that is really so sad because we could get help. And also, there is a rush to overmedicate. Even if it is a psychotic disorder, I might be on a really high dosage or something when I could be on a lower dose just because it’s almost like criminalization of symptoms. Whereas someone else may just do with a lower dose because they’re not looking at her as a criminal. So that’s on a larger scale where it just is with African-Americans. It’s more of just you have that psychotic label and then we’re just going to medicate. Almost like a prison type thing within the medication.

Rachel Star Withers: Just asking, because this is obviously in the news a lot and it is a major issue and problem is African-American people specifically, but people of color being I don’t want to say harassed, but unfortunately, yeah, harassed in a lot of like legal situations, kind of police tend to jump where they’ll stand and might talk to a white person who’s, like waving a gun for hours and talk them down,

Sakinah: Yes. Yeah.

Rachel Star Withers: And they’ll tend to see a black person doing something like lighting a cigarette, thinking it’s a gun and overreacting. Mental health wise, how does that make you feel? You know, you’ve talked about being inpatient some. Are you scared to get help sometimes? That maybe things could escalate?

Sakinah: Now, that’s an interesting topic and how that plays out is it depends on your presentation, gender and how you look. Because as a Muslim, let’s say I’m five one and I’m light skinned. I might be Muslim and I am African-American and I cover. But if I’m not seen as a threat, well then no, I’m not scared. But then they won’t help me because they don’t see me as someone that they need to pay attention to. So, they’re not interested in getting me the help that I need. And since I’m not a criminal, they don’t want to pay me any attention. So let’s say that someone calls the police because I’m exhibiting psychotic symptoms. They usually will say, OK, she’s African-American, she’s dangerous. But then if they come out and I’m not dangerous, then they just walk away. So, they don’t give me any help. Do you see what I mean? So it is that criminalization of African Americans with any type of psychiatric symptoms. It’s automatically we have to harm this person. Then if they aren’t a danger to us, then we’re not going to help them. In order for me to get impatient, I have to take myself. Because when it comes to someone calling for me, nobody wants to deal with me because it’s almost like they’re like, OK, there, there. You know, we’re not dealing with you. Now, if it were my son, who is a darker skinned male who is bigger, yeah, I’d be afraid for him because the minute they see him, they’re thinking, is he a threat? OK, we’ll shoot him. So we talk about the privilege of being light skinned. If you have pretty privilege, that kind of thing, because certain people, they’re not looking for you. So they’re not going to do anything.

Rachel Star Withers: Now, as you just mentioned, you’re also a mother of teenagers.

Sakinah: Yes, two teenagers and a 20 year old.

Rachel Star Withers: What do you tell them? Do you warn your kids as far about, hey, when you go to the doctor, you might want to be careful about this? Do you ever worry?

Sakinah: I do, but I’m careful how I warn them because I don’t want to put in them this idea. This inferiority complex, like, OK, you do this so you don’t get hurt because then that raises someone with this idea that it’s OK for me to victim blame. At the same time, I don’t give them the idea that they can do whatever they want. It’s this tightrope, this walk that I have to do that. OK. And when it comes to psychiatric symptoms, if you need help, you have to know how to reach out. And then it’s a difficult thing. But I want them to know how to talk to me. I just have to let them know how to advocate for themselves. And I think that’s the best way to do it. But I do let them know they can look at my social media pages if they need to understand mental health and if they need to ask for help. I really try not to let me enter into it because I want young people to look at the adults in their lives to know how to get help. And that’s kind of the way that I’m steering my advocacy work.

Rachel Star Withers: Earlier in the episode, me and Gabe, we discussed that we’re both white and I have never been in a situation where I did not feel comfortable due to my race as far as like a medical setting. I’ve never thought when the doctor came in, they’re going to treat me differently. I’ve never worried about that. The nurse practitioners and other ones have been more diverse. But like the psychiatrists that I’ve seen, the vast of the doctors have all been white males, with the exception of two, and I’ve seen a lot. So that exception is under five percent. You know, at the end of the day, I can’t understand. What would you tell other people like me and Gabe?

Sakinah: Well, what I would say is that. See someone like me has also had a bit of a privileged experience when it comes to clinicians. So, I had to have that explained to me. And I didn’t know that because I grew up in the DMV area that which is the D.C., Maryland, Virginia area. I have had, I’d say about 98% really good experiences because those doctors are so well, not just well educated. These are the specialists of the specialists. So all of the really good hospitals, there are such good hospitals. And I’m not in a rural area. So if I had bad experiences, I can name them on one hand. And even if my friends had bad experiences, we are the anomaly. What I would say is for African-Americans, each person’s experience is going to be different. And then it’s going to depend on their life circumstances. Unfortunately, it depends on appearance. It depends on how well educated they are about their situation. And it also depends on money.

Rachel Star Withers: Yes.

Sakinah: For me, every single time I went to get diagnosed, it all lined up to what I have today, which is so rare. I’ve never had a different diagnosis. With all the times I’ve been to different hospitals, that’s unusual. Usually people say, oh, well, first they thought this and they never thought something different. And they hadn’t. They had no reason to say that. So I think I had one doctor who did something that was so unusual that it was racially based. It was abusive. But I can be mad at that one doctor. It might have been as bad as I should’ve sued the hospital. But again, I would say that as a patient who’s African-American. Like, I can’t even speak for all African-American patients, you know, with mental illness

Sakinah: Because my situation would be different, too, because of being Muslim. After 9/11, the difference is a lot of Muslims have trouble with trusting mental health professionals because some people are afraid of things like surveillance or afraid of stigma. And I never thought of that because my mom raised me to be so open with I’m going to the doctor that I didn’t think about it until people had told me, like, you’re so clueless. And so that’s, again, a privilege that I didn’t have bad experiences. And what I would tell to you guys is Gabe was probably the first advocate who came to me and said, OK, I don’t know about what you do and your experience. So how do I learn? I’m going to be honest, that’s unusual to me. You guys have been so open with me. And that was really helpful. If I talk about race and I talk about ignorance it is because some people, they just never were open. And what I like about when I meet advocates like you is that you asked me to tell you about my experience. So that helps me to see how I can teach you. So, I think that if each person shares their experience with one another, then we all can learn.

Rachel Star Withers: Oh, I like that. What the world needs more of is people willing to learn.

Sakinah: Yeah, yeah, I think so.

Rachel Star Withers: As you know, with mental health, depression and suicide comes up a lot. A few years ago, I’d given a response, we’re talking about as far as suicide. Pretty much, my rule is if your friend or loved one or whoever is talking about suicide, don’t treat it as a joke. If you think they’re going to hurt themselves or others, you need to call the police. And I had a lot of backlash because a lot of people said because you’re white, you think that means they’re going to get help. And yeah, unfortunately, a lot of times if the person isn’t white, they’re not going to get help. It’s going to be a very different response. And I know there is no correct answer. There is no. Well, this is what.

Sakinah: Right.

Rachel Star Withers: What advice, though, would you give me as far as dealing with those situations?

Sakinah: What I would say is a lot of areas now are starting to adopt warm lines. And like, I won’t say, a crisis text line. But there is a difference between the 911 number and a crisis line. But things like, in my area, they have either 211 or 311, which is the county services. And if you call them, which is a non-emergency number, they should have a mobile crisis. Now the problem with mobile crisis is that sometimes they will send the police. So unfortunately, in that sense, there’s nothing you can do. But I think by state, I think people are having these numbers for mobile crisis. Or you can ask for an ambulance when you call the cops. You can say maybe it’s not an emergency or when you call crisis text line. I also take crisis text line calls. What we can do on crisis text line is you can call on behalf of someone else and say, I think this person might need help and they can call someone for them. It doesn’t have to be the police. So, one of the things I want people to think about is if it is a person of color, African-American or somebody else, find somebody different to call besides the police. And if you’re not sure who, then you can look it up, because for whatever reason, there’s just such a stigma against us when it comes to law enforcement or they don’t know how to de-escalate. I’ve seen and retweeted videos of white Americans, they can walk at the police with all kinds of machetes and everything, and the police will just stand there like, oh, it’s OK. And then me, I can have nothing, and like, I’m like, I’m compliant, I’m on the ground and they’ll shoot us. And I don’t know why that is. Rather than figure that out, I would try to help by just call a different number. But I think until you get African-Americans to deal positively with law enforcement and share our experiences and teach, I don’t think that it will change that we’re getting hurt.

Rachel Star Withers: And something you said earlier. So Gabe’s a pretty big, big guy. You’ve met him in real life. He’s like six something, huge towering guy.

Sakinah: Yeah.

Rachel Star Withers: And let’s say there’s a situation and I feel that, yeah, he needs help. I wouldn’t think twice about calling the police. It would never occur to me that, like, oh, they’ll make it worse. And he’s huge.

Sakinah: Ok.

Rachel Star Withers: So, you should think that, hey, if anyone. Yeah, I would be worried that they might shoot him because he’s such a big dude, but that never entered my mind.

Sakinah: Right.

Rachel Star Withers: But that’s almost like that privilege that people don’t realize. I wouldn’t have thought about race having any effect.

Sakinah: Right.

Rachel Star Withers: Yeah.

Sakinah: And the thing with privilege, regardless of the scenario, you almost don’t realize it until someone lets you know where you have it. One time I was tweeting about something, about maybe going to the E.R. or why would you wait to get a doctor? And whatever I tweeted about, someone said, you know, you think that because you have privilege. You know where I am, even if you’re in crisis, if you call the doctor, they won’t see you for about a month. And I said, oh. And they were letting me know that your privilege is such that. Like, if I call my doctor, they’ll call me right back. Sometimes I have my doctor’s cell phone number. So I was sorta like, oh, I can just go to the E.R. right then and get evaluated by a psychiatric social worker so they’ll let me know if I need to go to inpatient. Like, why would you wait? And a couple things I said. And they’re like, you are in the D.C. area. Of course you have. And I was talking about like I just go and I just did this. And you don’t even understand how much privilege you have. We can’t go even in an emergency. And then I said, oh, OK, I get it. And I think we all have privilege. Even if you don’t realize this. So, sometimes someone has to tell you, oh, you didn’t realize. That was easy for you. That’s why you think that. So, yes, the same type of thing. And I think even for me, the way that my stature is with if you see cops, most of them, it’s obvious they are bigger than me and they have more like they have authority over me.

Sakinah: But when someone calls for me, there are six of them. Six of them came out and I’m just sitting there and they keep saying like, well, that your friend said that you were suicidal. And I said, I’m not. I just asked them out of it and like, OK, you can leave. But her son, they talked to him in such a way, it was obvious they wanted to harm him, you know, and they’re making fun of him and like, have you taken your medicine? And they weren’t really trying to de-escalate the situation. They didn’t do any of that to me. So, the way that they treat people like us is so different. And they weren’t interested in getting him out. They were just trying to, like, let her know that she had messed up by not giving him his meds. So that’s the kind of thing where if you don’t see that happen, you won’t really know. That’s how they deal with it. There were actually only three of them, and there were six for me. You know, there’s no need to. Like, they’re trying to strong arm us and let us know. None of that makes any sense.

Rachel Star Withers: And that goes whether you’re in a city or rural area, like how many? Obviously, you always hear where not everyone’s bad, which is correct. But when you look at like, the responses. Yeah. If you’re in an area that the police have more of a budget, they’ll probably send more. And it could probably escalate quicker than if you’re from where I’m from. And I don’t know, like five cops for like half of South Carolina. You know, the idea that a whole bunch coming out wouldn’t happen and be like, well, where are you going to find them? But yeah, usually, like, things change.

Sakinah: See, I didn’t even think of that. Yeah.

Rachel Star Withers: Mm hmm.

Sakinah: Yeah, because for me, I’m like, why are these six cops in a room? And like, they’re all like just trying to stand in front of a window where if I fell out, I’m not even going to die. And then I’m like, what are you even doing? It was really, really odd. And then I kept telling them, look why are you all around the windows? We don’t want you to jump out. Of this window? Yes. None of that makes sense. OK. Yeah. Then they had an actual budget. And then finally they’re like, all right, let’s just go, we’re wasting our time. I told you that. Yes.

Rachel Star Withers: So we’ve hit on a lot of different things, and I’ve loved talking with you. What overall advice do you have for people whenever they’re in a minority situation dealing with mental health, whether it’s a crisis or just worried about getting general help?

Sakinah: Ok, I’ll say two things. If you are a minority and you are concerned about your mental health, don’t be afraid to ask. What you don’t know, that is what can hurt you. And it is not a shame on you to say, hey, I’m dealing with this issue. And you won’t know what it is wrong with you unless you ask a professional. You cannot assume. Everything isn’t depression. Everything isn’t anxiety. You need to know and you deserve to feel well. And I have a friend who always told me that. So you should check into it. You should reach out. But especially if you are black or African-American, you need to take care of yourself because you need, you have to be strong in today’s society. But if you’re dealing with someone who’s black or African-American, same thing. Don’t assume that they know what’s going on with them and don’t look at them and think, oh, that person’s angry all the time. Or that person is whatever. They may be dealing with trauma and they don’t know how to get help. So, if you say something, let’s say online, you say, oh, reach out or take care of your mental health. They won’t know how to do that unless they’ve been taught. So, don’t assume that like one size fits all. Or if you’re an advocate or even a doctor, that they’ll know how to do that. And then you might be thinking, well, I said it. They won’t know. And so for us, you really almost are going to have to go into those communities and teach people and just be kind of patient because some people have such a stigma. Like in black communities, we have such a stigma. And you may need someone who looks like them or who they will take that information from. So, it’s OK if he will kind of push back. They’re not pushing back against you. They’re just a little bit scared sometimes. Just like no assumptions. No assumptions.

Rachel Star Withers: And how can our audience learn more about you?

Sakinah: The best way to learn about me, I would say, is through my social media, Twitter and Facebook is where I’m most active. My Twitter handle is @TheMuslimHippie. You can find me on Facebook /Sakinah.Karen. And both of those have all information on any other projects that I’m working on. You’ll find those. I’m working on the second book about substance use disorders. I want to write a book about Muslims dealing with substance use and how being in a marginalized community, if you don’t take care of your substance use disorder, you can die quicker. That’s kind of what that project is, but it’s going to be positive. And it’s a story of hope because I’m always looking forward. So, Twitter and Facebook is where you can find me.

Rachel Star Withers: Thank you so much for coming on here and teaching us and our audience. And I kind of hope we will all just continue to learn from each other.

Sakinah: Thank you for having me.

Rachel Star Withers: Thank you so much. Loved speaking with you today.

Gabe Howard: Rachel, that was incredible. I’m so glad that we have the opportunity to interview people on this podcast, not just Sakinah, but all of our guests have just been so incredible. What do you think?

Rachel Star Withers: I learned so much from her. Especially when we talk about, like religious wear. For the most part, when I walk into a doctor’s office, they’re not going to know what religion I am. It’s pretty hard to judge me off that, whereas they know right away with her, you know, and you make assumptions off that, whether you mean to or not.

Gabe Howard: One of the major takeaways that I learned from Sakinah was it’s not intentional. I think this is just such an important point to bring up. This debate is always tabled with you are a malicious racist or you’re perfectly fine. There’s like willful racism or nothing to improve upon. And the reality is, it’s so much more complex than that. I’m not saying that there’s not willful racists. There absolutely are. I don’t think Sakinah is denying that either. Her point was that some of the major issues that people of color, that minorities, have aren’t that willful racism. It’s the unexplored biases. It’s the misunderstandings that go unchecked that lead to people like her not getting the best care. That was a real aha moment for me because it would just be so much cleaner if it was, oh, you’re a racist and you’re evil. Oh, you’re not a racist and you’re wonderful. Like that would be so much easier, but it’s not that way. So, I’m really glad that she pointed that out and I can see where that would be very impactful on her care.

Rachel Star Withers: And sometimes you don’t have access, you know, where you’re living at. So how I dress, let’s say I walk in and the doctor, I’ll go, you know, a week without showering because I’m so depressed and I’m, like, mentally out of it. So imagine if I show up to a very first doctor’s appointment and they’re thinking, oh, wow, this girl looks rough. They make these assumptions that, oh, she probably has no support care system. Oh, wow. We need to, you know, up her meds right away. People look at you and they make assumptions based on the way you dress. There’s so many things that can affect our health care. And it, it’s scary, Gabe. I’m not gonna lie. It’s scary, especially for people with schizophrenia. And there is no like, OK, well, here’s the answer, guys. Like there isn’t. We have no answer for how do you deal with subtle biases? Because unfortunately, every single thing is going to be different and so much of it people don’t even realize they’re doing.

Gabe Howard: Our listeners probably aren’t aware of this, but Rachel is a stuntwoman and she’s also a model and quite accomplished at both. And I am just, I am lucky to have Rachel as a friend. And I bought a new wardrobe recently that Rachel helped me with. So, one, I just wanted to publicly thank you, because now I look stellar.

Rachel Star Withers: True.

Gabe Howard: But people are like, Gabe, you’re really stepping up your game. And I said, yeah, I have a friend who’s a model, Rachel, and she gave me all kinds of hints and tips because this is her experience. And that’s like, oh, that’s awesome. I wish I had a model friend. And the reason I’m telling this story is because recently one of my friends realized that my schizophrenic friend Rachel and my model friend Rachel were the same person. It never occurred to her that my model friend Rachel could live with schizophrenia. She very much considered them separate. Now, my friend is a very good person. She’s a very nice person. She’s not, she doesn’t have a mean bone in her body. This was not malicious, but she was unable to connect the two and she was quite surprised when she found out. That, in my mind, is an excellent example of just an internal bias that you miss. And obviously, the stakes aren’t very high on that. Health care is a matter of life and death. And that’s why we’ve got to do better.

Rachel Star Withers: Absolutely. This episode is a very hard one for me to kind of wrap up. I’m very upbeat. You’ve noticed that, I’m sure, throughout the episodes. So, I always want to leave on an upbeat note. And this is hard because as we’ve said multiple times, me and Gabe, in a lot of ways are very privileged. And we’ve never been outright discriminated against. We’ve never kind of been held back from health care due to being a minority. And I don’t wanna give upbeat words for something that I know nothing about. During this episode, we’ve talked about all different stats and acknowledged that so much goes into the way people perceive us and we perceive other people, how we subconsciously even connect to people. How you’re like, oh, hey, this person’s like me and the opposite there and that’s across the board. That’s something that’s scary to me, that there are people out there and they almost never feel like they connect with a doctor. And I do wish I could be like, oh, well just go find another one. As Sakinah pointed out, especially when you’re not in a city, there may only be one doctor. Depending on your financial status, you might not be able to go to anybody else. You might have to stick with a free clinic or something like that. So, there are no good answers that blanket everything. We all have blind spots. Some of them are self-imposed. Others are put on us. I think we all just kind of have to realize that we have these blind spots and try to do better.

Gabe Howard: Rachel, I could not agree more.

Rachel Star Withers: Thank you so much for listening to this episode of Inside Schizophrenia, a Psych Central podcast. Please, like, share, subscribe. Send it to all of your friends, any of your friends who are dealing with schizophrenia, caretakers, your medical friends, or just some really cool people you know.

Gabe Howard: See you all next time.

Announcer: Inside Schizophrenia is presented by PsychCentral.com, America’s largest and longest operating independent mental health website. Your host, Rachel Star Withers, can be found online at RachelStarLive.com. Co-host Gabe Howard can be found online at gabehoward.com. For questions, or to provide feedback, please e-mail talkback@PsychCentral.com. The official website for Inside Schizophrenia is PsychCentral.com/IS. Thank you for listening, and please, share widely.

from https://ift.tt/32huJ3r Check out https://peterlegyel.wordpress.com/

[ashley-unicorn]

Inside Schizophrenia: Impact of Schizophrenia in Minority Communities

Rates of psychosis are more strongly influenced by ethnicity and socioeconomic status than any other mental health condition. In this episode of Inside Schizophrenia host Rachel Star Withers, a diagnosed schizophrenic, and co-host Gabe Howard discuss the impact of schizophrenia in minority communities. Guest Sakinah “The Muslim Hippie��� joins to share her experiences in mental health care.

Highlights of “Impact of Schizophrenia in Minority Communities

[01:00] The realization

[02:08] Sociology definition of the word minority

[04:30] The stats of mental health and minorities

[09:00] Diagnosing differences

[12:00] Is the medical community racially bias?

[14:00] Two people, same symptoms but different diagnosis

[15:40] The privilege of not having to worry

[16:30] Two people, same diagnosis but different treatment

[21:50] Guest Interview with Sakinah “The Muslim Hippie” Karen Michelle

[32:00] Police intervention in the minority mental health community

[39:35] What to do for someone who is suicidal

[51:00] So what is the answer?

About Our Guest

Sakinah “The Muslim Hippie” – Karen Michelle

Mental Health Advocate, Crisis Counselor, Speaker

Sakinah (Karen) Kaiser, also known as The Muslim Hippie lives in Baltimore, MD where she is currently a writer and mental health advocate. She hopes to go back to a school for a degree in social work with a concentration in substance use disorders.

www.Twitter.com/TheMuslimHippie

www.Facebook.com/Sakinah.Karen

    Computer Generated Transcript of “Impact of Schizophrenia in Minority Communities” Episode

Editor’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.

Announcer: Welcome to Inside Schizophrenia, a look in to better understanding and living well with schizophrenia. Hosted by renowned advocate and influencer Rachel Star Withers and featuring Gabe Howard.

Sponsor: Listeners, could a change in your schizophrenia treatment plan make a difference?  There are options out there you might not know about. Visit OnceMonthlyDifference.com to find out more about once monthly injections for adults with schizophrenia.

Rachel Star Withers: Welcome to Inside Schizophrenia, a Psych Central podcast. I’m Rachel Star Withers here with my co-host Gabe Howard. Today’s episode, we’re going to be discussing schizophrenia and how it relates to minorities and also the treatment that minorities receive.

Gabe Howard: I think this is a very timely episode because I really believed before all this started that everybody received the same level of care and that things like gender or race or nationality or religion really didn’t play a role in it. I just thought this was just basic science. So, I was surprised to learn during the research that, yeah, things like gender, race, nationality, religion play a huge role in the treatment options that are offered, that are available. It was stunning to learn.

Rachel Star Withers: And I think with me, when we’re looking at the idea of minorities, you always immediately think discrimination, but so much is things that might just be like these subtle biases that we don’t even realize that we’re doing, whether it’s other people or even to ourselves. In the U.S., whenever I hear minority, most of us usually think it has to do with race. But of course, we have religion differences, gender, sexual orientation, age, lifestyles. So, this episode, we’re going to be looking all across that and explore kind of how those differences affect other stuff around us.

Gabe Howard: Rachel, let’s establish some guidelines so we don’t get off track. So, this episode is called Schizophrenia and Minorities. What is the exact definition that we’re using for this show?

Rachel Star Withers: So, Gabe, I had to look it up because I wasn’t 100% sure. Like I said, I, in the U.S., here, we kind of just think race. But

Gabe Howard: That’s all we think.

Rachel Star Withers: Yeah. Yeah.

Gabe Howard: We don’t kind of think, that’s what we think 100% of the time.

Rachel Star Withers: According to sociology, a minority group refers to a category or people who experience relative disadvantage as compared to members of the dominant social group.

Gabe Howard: So, Rachel, in sociology terms, a minority is not just a few of something, but also it puts you in a disadvantaged class because of it. Now, wouldn’t somebody living with schizophrenia then fall under this definition?

Rachel Star Withers: Yes, and disabilities also can put you into a minority group. So, we’re talking about mental health. We’re talking about physical anything that sets you apart that might hinder you compared to everybody else.

Gabe Howard: And then even in this subset of people living with schizophrenia, there’s a minority group of people inside the minority group. This is where it gets complicated. The general principle that we’re trying to establish here is that, let’s just call it out, white people with schizophrenia often have better access and get better care than African-Americans with schizophrenia. It’s the exact same illness, even in some cases the exact same socioeconomic class. Different outcomes based on race.

Rachel Star Withers: Yes. And here in the U.S., that’s very correct. But you also look that across different countries, different areas, that changes depending on what the dominant race may be.

Gabe Howard: And the reason that we’re pushing this so far into the ground is because it’s not so easy to say that, oh, well, if you’re a minority and you have schizophrenia, people don’t care about you. It’s just racism. It’s not that simple. It’s these cultural and societal biases that we’re completely unaware of. And hopefully this show will shed some light on that because it really is unfair what is happening. And we’d like to think that in some small way Inside Schizophrenia can help maybe educate people on that. Let’s talk about what we found out, because we found out a lot of just straight up facts. This isn’t Rachel and Gabe’s opinion. We’re going to hit you with some straight up Internet knowledge.

Rachel Star Withers: And you’re also probably wondering why does all of this matter? OK. Rates of psychosis are more strongly influenced by ethnicity and socio-economic status than any other mental health conditions. So not just schizophrenia, psychosis, which can, of course, extend into other mental disorders. I found that very interesting. If you were to ask me, Rachel, what do you think your ethnicity and, you know, economically where you fall, what that would affect the most mental health? I would assume depression. That’s what I would assume. Like, well, if you’re poorer, you’re probably going to be more depressed. So, the fact that it’s tied to psychosis really is eye opening. It’s just not what I, at least, would expect.

Gabe Howard: Now, we found an interesting study while we did this because, again, we just don’t want our flapping gums, because let’s be honest here, a couple of white people talking about minority mental health has its own challenges and issues. We just happened to be the hosts. Later on in the episode, we’re going to talk to Karen who bills herself as the Muslim Hippie. She is a very cool mental health advocate, and she taught us all kinds of things. That’s coming up later in the episode. But back to the study and it was done in the United Kingdom.  You know, I want to do a little aside here, the reason we’re using a study from the United Kingdom is because in America, we’re not actually doing a lot of studies on how these biases are impacting the minority community, and that’s very telling in and of itself. It sort of appears, from my perspective, that we don’t care.

Rachel Star Withers: I did find some studies and I was like, yes, finally. OK. And then I went to read through them and the words were very dated, for instance, describing race. And I was like, oh, and I’d have to like, oh, OK. I see. This was done in the 60’s. A lot has changed. But I immediately, like once I realized that, I’d have to start checking the dates and there are very few concrete studies, I would say, that have been done in the past few years, especially with minorities and schizophrenia. It was easier to find for like mental health in general. But definitely the schizophrenia community, almost, almost nothing.

Gabe Howard: Rachel, I think it’s important to remind our audience that there is no definitive test for schizophrenia. Schizophrenia is diagnosed observationally. A professional observes the patient and comes up with a diagnosis that way. And in the United States, black people are four times more likely to be diagnosed with schizophrenia than white people and Hispanic people more than three times. Now, that doesn’t sound right to me. Again, I am not a researcher. But schizophrenia doesn’t. It doesn’t discriminate against race or gender or religion. So, the fact that it’s four times and three times more likely to be diagnosed, shows me that there’s a flaw in the way that we diagnose. What did you find?

Rachel Star Withers: So in the U.K., they found that rates for psychotic disorders, again, not just schizophrenia, but psychosis in general, were five times higher in the minority group of people of black Caribbean heritage. Very, very specific. Black Caribbean, five times higher. That’s a lot. And I feel that if I were one those researchers, I’d be like, wow, there clearly is a genetic link. Right? But there’s actually no pattern found if you go to Caribbean countries that suggests this. So, it’s just found when the Caribbean black people there in the U.K. are a minority. That’s interesting, Gabe. It definitely makes you look at, you know, kind of that nature versus nurture situation.

Gabe Howard: Well, that’s certainly one possibility. Or it could be the trauma of living. There’s so many tangents that we could go off on here if we believed that there was no bias, that this is just the way that it was, then nature versus nurture could be an argument, like you said. But I don’t think that’s it. I don’t think that there is any nurture that causes schizophrenia. And the research holds up that you’re born with schizophrenia. So now we’re talking about diagnosis prevalence rates, not actual schizophrenia prevalence rates. And I think the disturbing thing is that there is a debate. Anybody listening to this should have grave concerns if they’re a member of the minority class. Are you feeling that you’re getting the best care when there’s all of this debate on how it’s diagnosed? It would be disturbing to me if I were an African-American living with schizophrenia. And I find out that it’s diagnosed four times more than in my white counterparts because I’m thinking that’s a lot of margin for error. Am I taking medications that I don’t need? Am I receiving treatments that I don’t need? Was I misdiagnosed? Now, Rachel, please, I imagine that it is very difficult living with schizophrenia, and I imagine that it would be even worse if there was a doubt. If there was an asterisk, if you were wondering to yourself, am I actually schizophrenic or am I a victim of a flawed system? I know that you’re a white woman, but what are your thoughts on that?

Rachel Star Withers: That can be really scary. You know, it takes so long to get a diagnosis and you kind of start to doubt yourself. It isn’t just America or the UK. They’ve done international studies and immigrant communities usually are assigned psychotic disorders way more frequently than the natives of that country who have the racial majority. This is like, OK, well, in America, it’s because they’re dealing with this. No, it’s across the world that if you’re different, they’re more willing to label you with a psychotic disorder.

Gabe Howard: Rachel, let’s do a little segue and talk about the individual patient doctor relationship. Let’s forget about all of the research, the bias and all of that. Let’s just talk about what many people with schizophrenia see for themselves, which is themselves sitting in front of a doctor. Do you think a lack of diversity among mental health professionals can lead to unequal health care?

Rachel Star Withers: Absolutely. For the most part, Gabe, I think me and you are very privileged. Most of the doctors I’ve been to have been white. So, all of the psychiatrists, specifically, have been white males. I’ve never walked in and thought, you know, I’ve never, I’ve never felt out of my element or, like, worried. That’s just, it hasn’t entered my mind. I’ve never looked at the person and thought, oh, you know, they don’t understand me. And that’s kind of interesting. And I was playing in my head being like, let’s say that I’ve never went to a white doctor. But let’s say they were always a different race than me. Would I second guess them? Would I be less willing to trust them almost if they were a different race?

Gabe Howard: It’s interesting because various studies have shown that people of color report more dissatisfaction with their care. And it was interesting when you were saying that all of your providers have been Caucasian, they’ve been white. I am shocked at this. And I didn’t even think about it before this very moment. One hundred percent of my doctors, mental health and physical health, have been white. And I don’t know how that has impacted my care. I don’t know how that has impacted my comfort level because they’ve always been white. A hundred percent of the time. It’s making me uncomfortable to think about. It’s stirring up feelings in me. And again, I’m a white male. Nobody should feel bad for me. But I’m thinking if I’m having this much trouble thinking about it in the abstract. This is a hypothetical. Gabe, how would you feel if all of your doctors were of a different race? And my brain is twisting. I can only imagine how it must feel if all of your doctors were of a different race in practice, not just in theory. But that then makes me ask, do you think that these are terrible psychiatrists, that just we’re intentionally providing bad care? By we I mean, the global we. Bad care to members of the minority class? I mean, is this deliberate? Are we filled with racism and hate? Like, it’s gotta be deeper than that. I don’t want to believe that the entire medical community is just filled with this. This. I don’t know. I just. Obviously, that makes me uncomfortable, too. I don’t want to believe that these are bad people because it does mean that Gabe and Rachel are getting care from bad people, too.

Rachel Star Withers: Of course, outright discrimination, that absolutely exists. But a lot of times it’s not that outright, it’s just more subtleness. And when you look at someone, you right away, you make all these kind of assumptions about them. When you hear someone, you make a lot of assumptions about them.

Gabe Howard: I’m always, of course, fascinated by people that say, well, I don’t see differences, I only see a fellow person in front of me and always think, well, if I went missing, what would you say? Would you say, oh, I’m looking for a tall white redhead? Well, but that means you noticed that I was tall, you noticed that I was white and you noticed that I had red hair. I mean, you certainly know how to identify me in a crowd. Like when you see me over there, you aren’t looking into a group of one hundred people and you’re like, well, I have no idea who is who. I don’t see anything. It’s just disingenuous to say that we don’t notice these things. And I’m wondering if all of this leads to creating criteria for diagnoses that while beneficial to the majority, are not beneficial to the minority.

Rachel Star Withers: Rutgers found that African-Americans with severe depression are actually more likely to be misdiagnosed with schizophrenia. So, you have two people who are coming in to the doctor saying the exact same thing. I’m having, let’s say, visual hallucinations. I’m having audio hallucinations, these different delusions. And they’re quicker to say the African-American person is a schizophrenic.

Gabe Howard: And you can see how devastating that could be, getting the incorrect diagnosis means that you’re getting the incorrect care. It means that you are not presented with options that are most beneficial to you. So therefore, you don’t have the opportunity to lead your best life. This is terrible. It’s terrible to consider. And speaking as a man who lives with bipolar disorder, I can only imagine that if in addition to managing bipolar disorder, which is devastatingly awful, I also had to wonder if I actually had bipolar disorder. Have you ever doubted your schizophrenia diagnosis, Rachel?

Rachel Star Withers: I haven’t doubted it in the past, you know, let’s say 10 years. In the very beginning, when I was first getting diagnosed, my early twenties? Yes. Mainly because the doctors kept, they were giving me different diagnoses. So, I was going, wait, which one of you should I believe? You know, one saying one thing, one saying another. However, I’ve never once thought it had to do anything with me. The psychologist was saying one thing. The psychiatrist was saying something else. I never said, oh, it’s probably because I’m a woman. That’s why this one thinks that. Oh, it might be because I’m white that one. That never occurred to me. I really just thought, you know, they’re different types of doctors. That’s why they maybe have different opinions. Never occurred to me that I in any way influence that. I was putting a lot of trust just in the doctors. And that goes back to what we’re saying earlier. That could very well be a privilege that I have, that it wouldn’t occur to me that I can’t trust this person.

Gabe Howard: I think it is an incredible privilege that you and I have. It’s wonderful not to have to wonder, because it just takes something off the table. There is a lot to manage with a severe and persistent mental illness. Schizophrenia is a scary illness. And also having to wonder if you are getting the best care based on the available research, based on your race or religion, socioeconomic status, etc. I just cannot imagine and I want to be very, very clear that there’s only so much understanding that Rachel and I can have, because it’s just not possible to walk a mile in these shoes. But one of the things that I’m wondering, Rachel, is we’ve talked about the bias in diagnosis. Now let’s pretend that it’s the correct diagnosis. Let get out of our mind that it might be incorrect. It’s 100% the right diagnosis. What about treatment? Are minorities with schizophrenia getting the best treatment?

Rachel Star Withers: And that’s what’s crazy. We go back to if we have two people walk in. Same symptoms walking into the same doctor. They found that all racial minorities. OK. So not just a specific race. All of them are less likely to be offered cognitive behavioral therapy than a white person. They’re more, it’s almost like they’re more willing, like, OK, like you have a lot of different options here. And then with minorities, let’s not give them as many options. And I don’t think it’s always, you know, an outright discriminatory thing. But, yeah, across the board, they’ve found that out. They’ve noticed that black patients are far less likely to be offered family therapy. I can see that definitely being a bias. Thinking the family’s less stronger in African-Americans, the family’s less stronger in Hispanics. Yeah. I easily see that being a bias with different doctors.

Gabe Howard: And that, of course, is, one, it’s just outright offensive. But let’s move that aside for a moment. I know that I would not be living as well as I am now if I didn’t have strong family support. And, Rachel, you’ve talked too. Your mom was on an episode of Inside Schizophrenia and talked about how much you two partner and work together to help you lead the best life possible. There is a tremendous amount of research that people living with schizophrenia do better if they have a strong support system. And listen, I always take this opportunity to point out that everybody does better.

Rachel Star Withers: Yes.

Gabe Howard: You don’t have to have a mental illness. No one is an island. So now this is being taken away from somebody based solely on the color of their skin. That, to me, is a tremendous loss.

Rachel Star Withers: Yes, and with Asian people, as far as being a minority, they are actually less likely to receive copies of care plans. Like isn’t that random? They’re less likely at the end of it to be given, OK, here is what we talked about today. This is our plan going forward. That’s worrisome because when I’m in the doctor’s, I have to take notes because the minute I walk out, I don’t remember anything. So, if me and that doctor are coming up with a care plan and then they don’t even like, let me walk away with it. You know, that’s odd to me. I’ve never had that situation. Like that would never occur to me that the doctors wouldn’t be wanting me to do this plan.

Gabe Howard: Rachel, along those same lines, what about the role of medication, is that at least the same for everybody in the treatment of schizophrenia?

Rachel Star Withers: No. Minorities have been found that they are prescribed typical antipsychotics over atypical antipsychotics. So, the typical ones tend to be the older ones. OK. The kinds we’ve been using since the 40’s. And if you’ve ever taken those type, like I have, the side effects are intense. They’re just so much worse than the newer drugs. Whenever you talk about movement disorders, that unfortunately are a side effect of many antipsychotics, the majority come from typical antipsychotics. So, if you have tremors, shaking that’s been brought on as a side effect, it’s going to be more of those older ones. So here we have minorities, they’re less likely to be offered therapy. They are less likely to be given a set plan and they’re more likely to be given medication without that support system. That can be very hard to deal with.

Gabe Howard: I’m really just speechless because, you know, I became a mental health advocate because I believe that people weren’t getting access to the care that they needed. And listen, this was largely from my own experience, seeing mostly middle-class white people. I thought that middle class white people weren’t getting the right care. And I still stand by that. And you’re saying that there is worse care based on gender, religion, the color of your skin. That’s just altogether frightening. In general, from what I’m seeing, from my perspective, from my eyes, from my vantage point, which I understand is only mine, I think that we need to do way, way better. And everything that we’re reading shows that it’s worse based on nothing more than who you are, where you were born or the color of your skin. And that’s, it’s a lot to take in, Rachel. It’s a lot to take in.

Rachel Star Withers: And we’ll be right back after this message from our sponsor.

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Rachel Star Withers: And we’re back to talking about schizophrenia in minorities.

Gabe Howard: Rachel, I think this is a good spot to introduce our guest, Sakinah, the Muslim Hippie, Karen Michelle. Clearly, we can only understand and process the world from our own vantage point, with our own eyes. The same with Sakinah. She is an incredible mental health advocate. She has done so much. And I’m so glad we had the opportunity to speak with her. So, go ahead and roll the interview.

Rachel Star Withers: So, we’re talking with our guest for this episode, Sakinah. And she’s also known as The Muslim Hippie.

Sakinah: Yes.

Rachel Star Withers: So, tell us a little bit about your background.

Sakinah: So I grew up in the D.C. area. That actually is why I call myself a Muslim hippie. When I started with my journey with mental health slash mental illness, one of the first hospitals that I went to was in Takoma Park. And Takoma Park has a really eclectic history to it. And I like it because when I was growing up, I was really attached to some schools in that area. And I kind of felt like since I got better, or started getting better, there, I wanted to remind myself of what I liked about that part of D.C. and I like being a hippie. So, I just called myself a Muslim hippie and it just stuck. And then people were like, Oh, that’s cool. What do you mean by that? I know that people have a negative association with the name Karen. But my dad named me Karen. So that’s kind of why I also stick to my given name, because he really wanted me to have that name and he liked the meaning of it, which is pure. So, I go by Sakinah because that’s my Muslim name. But I stick with Karen, too. So that’s me in a nutshell.

Rachel Star Withers: And you are a mental health advocate, crisis counselor, speaker and a mentor.

Sakinah: Yes.

Rachel Star Withers: Can you tell us a little bit about your mental health journey?

Sakinah: I did not intend to be a mental health advocate at all. I just dealt with mental health in one way or another since high school. And I kind of stumbled into all of this. And then when I started talking about my journey, I started blogging just because I like writing. And a few of my friends from elementary school, they read my stuff and they’re like, oh, you’re a really good writer. And a friend of mine, she’s a professional writer. She encouraged me to talk about what I was going through. And initially what I noticed was depression. So, I started talking about my depression issues. And then when I got online, which was mostly Twitter, I developed a following. And then it was kind of like I was healing and writing and like learning how to blog and do all that stuff all at the same time. So, then I learned about advocacy work. So, I used my journey online to kind of teach people about mental health. And as I was learning and healing, I decided, okay, why don’t I do this full time? So, then I started going to classes and things like that. And then I told people, OK. This is what I’m doing intentionally. So, let’s learn about mental health together. And then once I started going to the doctor and stuff, I actually told people, well, I didn’t know things and like maybe you don’t know either. And so that’s kind of how I got started. And there are so many mistakes that I made or that other people made. And rather than use my blogs to just say this didn’t work and hurt me, I used it to teach people about what I thought they should know about mental health.

Rachel Star Withers: So, our episode today is about minorities, and we were discussing that what a minority is, of course, changes depending on where you’re at.

Sakinah: Right.

Rachel Star Withers: And it can be, you know, a lot of different factors. A big one, though, however, usually is race. Can you tell us what race you are? Do you feel comfortable talking about that?

Sakinah: I’m actually African-American. My dad is black. My mom is black. They’re both American. My dad is from D.C. and my mom is from Georgia. The funny thing is people don’t know where I’m from because I cover with this scarf, this hijab, because I’m Muslim. So, when they see me, they assume actually, because I look racially ambiguous, they will assume that I am other, like Somali or Ethiopian or, you know, something. And my dad, they usually think he’s Egyptian or Moroccan. So, it’s hard for me when I identify. I’m kind of, I get stuck because when I was working in a hospital, I was a CNA for a while. And they would say things like, oh, you don’t have an accent. And it was hard for me to understand what they meant by that. Because I didn’t know if they meant I don’t have a D.C. accent? Or I don’t have a Maryland accent? Or if they meant I don’t have an American accent? I didn’t know what they meant. And then I realized they meant that I don’t have an accent for someone who they thought was Ethiopian or whatever. So, I’m African-American.

Rachel Star Withers: You should have said, well, my mother’s from Georgia, not me.

Sakinah: Yes.

Rachel Star Withers: For like a Southern accent. And they’d be like, oh, okay.

Sakinah: Yes. And what’s funny is I’ll actually, yeah. Well, funny enough where I was working was in northeast D.C. and I ended up saying things like, no, my dad’s from, and then I would say the street where he was from. That’s how I found out, because they just kind of look like what? And then even when I take the scarf off, people will say things like, are you mixed Black and Spanish? Are you mixed Black and White? So, it’s still kind of a thing where people don’t know where I am. So that mixes the race and ethnicity. So, I’m like, I’m black African-American. You know, I try to get both in because let me explain and clarify. And I shouldn’t have to do that. When it comes to mental health and the conversations that we have, if I’m talking about being a Muslim with mental health issues, being a black person and African-American. It actually does matter because when I go to the hospital, it depends on how they look at me, how they’ll treat me. Like, if they think that I speak English but they don’t care that I’m black, they’ll be really nice. But if they think that I am a Muslim who doesn’t have a good handle on English, then they’re really rude. That’s something that I’ve had to do.

Rachel Star Withers: Very interesting. So, you can tell right away, like how they’re interpreting you?

Sakinah: Yeah. Because you can see, especially because my name. I have not changed my name legally. My name is Karen Kaiser. I mean, that’s easy. But also, no one is expecting someone black when they hear it. Karen Kaiser, because it doesn’t sound black at all. And then they see me and always, oh, OK. And sometimes they’ll say, how did you get that last name? And I used to be like really rude. I’d say, slavery and then like

Rachel Star Withers: Oh.

Sakinah: Somebody said please don’t say slavery, but. You know, that isn’t a nice thing to say. But I don’t know what people want me to say because I don’t really know my whole lineage yet.

Rachel Star Withers: And they’re implying something else also.

Sakinah: Well, exactly. Exactly. And the thing is, though, when I go to the hospital or to the doctor, it depends on if the doctor is black or African-American. It depends on their background and how educated they are. And if they have a prejudice, how they’re going to treat me. So what I’ve noticed is sometimes I prefer to use my name, Karen Kaiser. I don’t want to deal with, oh, where are you from? And I had doctors that I grew up with, they knew me. But then when I put my scarf on, they didn’t recognize me and they were really mean to me. And then they’re like, wait

Rachel Star Withers: Oh.

Sakinah: A minute, we recognize this name. We just didn’t. And they did. We didn’t notice that something. Oh, so you’re saying that you’re going to be prejudiced against this until you know who I am. Sometimes you can see it right away and sometimes they won’t say anything. But it’s in how they will. And one time I went to the hospital and I was really very sick. I almost died. And I asked someone for Sprite and she, on purpose, brought me back apple juice because she thought that I wouldn’t understand the difference. And there is a black guy there who is also attending to my care. And he said, you heard her ask for such and such. Why did you do that? So, it’ll be little things like that. I don’t know how to tell the person you’re doing this because you think that I’m from someplace else. And by that time, it won’t matter if I take my scarf off. And then when I go to inpatient, it’s the same thing. So, I can hear things that people will say and they’re thinking, I don’t hear because I have the scarf on. So actually, when I was in Dallas, I had been able to explain it to them. Because I was in the hospital and they were doing things like making me take my scarf.

Sakinah: They would say that I can’t wear a scarf in the room because I’m going to harm myself with the scarf. And then they have bedsheets in there. So, there are things that like they will have cultural hang ups that they don’t realize. And I don’t know how to explain it to them easily. So that’s one thing that I’d like to work on with my advocacy is being able to clearly share with people how I can see their prejudices. And I’m not that eloquent sometimes in my speech, because if I’m unwell, if I’m in psychosis, I don’t have time to educate you. One time I was at a hospital and they said, well, there’s our patient line, you can tell us what we’re doing wrong and I shouldn’t have to do that when I’m not feeling well. So, it’s something that I want to work on when I’m like now when I’m passionate but not feeling hurt or upset, because I think that in the long run, it helps people to see how they can better help someone like me.

Rachel Star Withers: As far as, we’re talking about on the small scale of things right away, people seeing you. What about the larger scale as far as like diagnoses? How do you feel race or religion might have played a difference?

Sakinah: Well, so what I have noticed, this is just a small bit of research that I’ve done. What I noticed and what I’ve heard is that African-Americans, so we tend to be more easily diagnosed with bipolar and schizophrenia and definitely more psychotic disorders, whether that’s that or not. So, let’s say that you see me in a trauma setting. So, you might just put a label of bipolar or schizophrenia, and that might not be what it is. That’s easier because you just assume all of us, if I’m loud and I’m yelling and I’m assuming they think that is what the data supports, that it’s easier to put us with that label. Just how they would say, like with young black boys, they’ll get the label of ADHD. When it comes to psychotic disorders, black people will get the label of a psychotic disorder, and without getting much research. A lot of diagnoses are missed because we just get one thing slapped on us and then nothing else is looked into. And I think that is really so sad because we could get help. And also, there is a rush to overmedicate. Even if it is a psychotic disorder, I might be on a really high dosage or something when I could be on a lower dose just because it’s almost like criminalization of symptoms. Whereas someone else may just do with a lower dose because they’re not looking at her as a criminal. So that’s on a larger scale where it just is with African-Americans. It’s more of just you have that psychotic label and then we’re just going to medicate. Almost like a prison type thing within the medication.

Rachel Star Withers: Just asking, because this is obviously in the news a lot and it is a major issue and problem is African-American people specifically, but people of color being I don’t want to say harassed, but unfortunately, yeah, harassed in a lot of like legal situations, kind of police tend to jump where they’ll stand and might talk to a white person who’s, like waving a gun for hours and talk them down,

Sakinah: Yes. Yeah.

Rachel Star Withers: And they’ll tend to see a black person doing something like lighting a cigarette, thinking it’s a gun and overreacting. Mental health wise, how does that make you feel? You know, you’ve talked about being inpatient some. Are you scared to get help sometimes? That maybe things could escalate?

Sakinah: Now, that’s an interesting topic and how that plays out is it depends on your presentation, gender and how you look. Because as a Muslim, let’s say I’m five one and I’m light skinned. I might be Muslim and I am African-American and I cover. But if I’m not seen as a threat, well then no, I’m not scared. But then they won’t help me because they don’t see me as someone that they need to pay attention to. So, they’re not interested in getting me the help that I need. And since I’m not a criminal, they don’t want to pay me any attention. So let’s say that someone calls the police because I’m exhibiting psychotic symptoms. They usually will say, OK, she’s African-American, she’s dangerous. But then if they come out and I’m not dangerous, then they just walk away. So, they don’t give me any help. Do you see what I mean? So it is that criminalization of African Americans with any type of psychiatric symptoms. It’s automatically we have to harm this person. Then if they aren’t a danger to us, then we’re not going to help them. In order for me to get impatient, I have to take myself. Because when it comes to someone calling for me, nobody wants to deal with me because it’s almost like they’re like, OK, there, there. You know, we’re not dealing with you. Now, if it were my son, who is a darker skinned male who is bigger, yeah, I’d be afraid for him because the minute they see him, they’re thinking, is he a threat? OK, we’ll shoot him. So we talk about the privilege of being light skinned. If you have pretty privilege, that kind of thing, because certain people, they’re not looking for you. So they’re not going to do anything.

Rachel Star Withers: Now, as you just mentioned, you’re also a mother of teenagers.

Sakinah: Yes, two teenagers and a 20 year old.

Rachel Star Withers: What do you tell them? Do you warn your kids as far about, hey, when you go to the doctor, you might want to be careful about this? Do you ever worry?

Sakinah: I do, but I’m careful how I warn them because I don’t want to put in them this idea. This inferiority complex, like, OK, you do this so you don’t get hurt because then that raises someone with this idea that it’s OK for me to victim blame. At the same time, I don’t give them the idea that they can do whatever they want. It’s this tightrope, this walk that I have to do that. OK. And when it comes to psychiatric symptoms, if you need help, you have to know how to reach out. And then it’s a difficult thing. But I want them to know how to talk to me. I just have to let them know how to advocate for themselves. And I think that’s the best way to do it. But I do let them know they can look at my social media pages if they need to understand mental health and if they need to ask for help. I really try not to let me enter into it because I want young people to look at the adults in their lives to know how to get help. And that’s kind of the way that I’m steering my advocacy work.

Rachel Star Withers: Earlier in the episode, me and Gabe, we discussed that we’re both white and I have never been in a situation where I did not feel comfortable due to my race as far as like a medical setting. I’ve never thought when the doctor came in, they’re going to treat me differently. I’ve never worried about that. The nurse practitioners and other ones have been more diverse. But like the psychiatrists that I’ve seen, the vast of the doctors have all been white males, with the exception of two, and I’ve seen a lot. So that exception is under five percent. You know, at the end of the day, I can’t understand. What would you tell other people like me and Gabe?

Sakinah: Well, what I would say is that. See someone like me has also had a bit of a privileged experience when it comes to clinicians. So, I had to have that explained to me. And I didn’t know that because I grew up in the DMV area that which is the D.C., Maryland, Virginia area. I have had, I’d say about 98% really good experiences because those doctors are so well, not just well educated. These are the specialists of the specialists. So all of the really good hospitals, there are such good hospitals. And I’m not in a rural area. So if I had bad experiences, I can name them on one hand. And even if my friends had bad experiences, we are the anomaly. What I would say is for African-Americans, each person’s experience is going to be different. And then it’s going to depend on their life circumstances. Unfortunately, it depends on appearance. It depends on how well educated they are about their situation. And it also depends on money.

Rachel Star Withers: Yes.

Sakinah: For me, every single time I went to get diagnosed, it all lined up to what I have today, which is so rare. I’ve never had a different diagnosis. With all the times I’ve been to different hospitals, that’s unusual. Usually people say, oh, well, first they thought this and they never thought something different. And they hadn’t. They had no reason to say that. So I think I had one doctor who did something that was so unusual that it was racially based. It was abusive. But I can be mad at that one doctor. It might have been as bad as I should’ve sued the hospital. But again, I would say that as a patient who’s African-American. Like, I can’t even speak for all African-American patients, you know, with mental illness

Sakinah: Because my situation would be different, too, because of being Muslim. After 9/11, the difference is a lot of Muslims have trouble with trusting mental health professionals because some people are afraid of things like surveillance or afraid of stigma. And I never thought of that because my mom raised me to be so open with I’m going to the doctor that I didn’t think about it until people had told me, like, you’re so clueless. And so that’s, again, a privilege that I didn’t have bad experiences. And what I would tell to you guys is Gabe was probably the first advocate who came to me and said, OK, I don’t know about what you do and your experience. So how do I learn? I’m going to be honest, that’s unusual to me. You guys have been so open with me. And that was really helpful. If I talk about race and I talk about ignorance it is because some people, they just never were open. And what I like about when I meet advocates like you is that you asked me to tell you about my experience. So that helps me to see how I can teach you. So, I think that if each person shares their experience with one another, then we all can learn.

Rachel Star Withers: Oh, I like that. What the world needs more of is people willing to learn.

Sakinah: Yeah, yeah, I think so.

Rachel Star Withers: As you know, with mental health, depression and suicide comes up a lot. A few years ago, I’d given a response, we’re talking about as far as suicide. Pretty much, my rule is if your friend or loved one or whoever is talking about suicide, don’t treat it as a joke. If you think they’re going to hurt themselves or others, you need to call the police. And I had a lot of backlash because a lot of people said because you’re white, you think that means they’re going to get help. And yeah, unfortunately, a lot of times if the person isn’t white, they’re not going to get help. It’s going to be a very different response. And I know there is no correct answer. There is no. Well, this is what.

Sakinah: Right.

Rachel Star Withers: What advice, though, would you give me as far as dealing with those situations?

Sakinah: What I would say is a lot of areas now are starting to adopt warm lines. And like, I won’t say, a crisis text line. But there is a difference between the 911 number and a crisis line. But things like, in my area, they have either 211 or 311, which is the county services. And if you call them, which is a non-emergency number, they should have a mobile crisis. Now the problem with mobile crisis is that sometimes they will send the police. So unfortunately, in that sense, there’s nothing you can do. But I think by state, I think people are having these numbers for mobile crisis. Or you can ask for an ambulance when you call the cops. You can say maybe it’s not an emergency or when you call crisis text line. I also take crisis text line calls. What we can do on crisis text line is you can call on behalf of someone else and say, I think this person might need help and they can call someone for them. It doesn’t have to be the police. So, one of the things I want people to think about is if it is a person of color, African-American or somebody else, find somebody different to call besides the police. And if you’re not sure who, then you can look it up, because for whatever reason, there’s just such a stigma against us when it comes to law enforcement or they don’t know how to de-escalate. I’ve seen and retweeted videos of white Americans, they can walk at the police with all kinds of machetes and everything, and the police will just stand there like, oh, it’s OK. And then me, I can have nothing, and like, I’m like, I’m compliant, I’m on the ground and they’ll shoot us. And I don’t know why that is. Rather than figure that out, I would try to help by just call a different number. But I think until you get African-Americans to deal positively with law enforcement and share our experiences and teach, I don’t think that it will change that we’re getting hurt.

Rachel Star Withers: And something you said earlier. So Gabe’s a pretty big, big guy. You’ve met him in real life. He’s like six something, huge towering guy.

Sakinah: Yeah.

Rachel Star Withers: And let’s say there’s a situation and I feel that, yeah, he needs help. I wouldn’t think twice about calling the police. It would never occur to me that, like, oh, they’ll make it worse. And he’s huge.

Sakinah: Ok.

Rachel Star Withers: So, you should think that, hey, if anyone. Yeah, I would be worried that they might shoot him because he’s such a big dude, but that never entered my mind.

Sakinah: Right.

Rachel Star Withers: But that’s almost like that privilege that people don’t realize. I wouldn’t have thought about race having any effect.

Sakinah: Right.

Rachel Star Withers: Yeah.

Sakinah: And the thing with privilege, regardless of the scenario, you almost don’t realize it until someone lets you know where you have it. One time I was tweeting about something, about maybe going to the E.R. or why would you wait to get a doctor? And whatever I tweeted about, someone said, you know, you think that because you have privilege. You know where I am, even if you’re in crisis, if you call the doctor, they won’t see you for about a month. And I said, oh. And they were letting me know that your privilege is such that. Like, if I call my doctor, they’ll call me right back. Sometimes I have my doctor’s cell phone number. So I was sorta like, oh, I can just go to the E.R. right then and get evaluated by a psychiatric social worker so they’ll let me know if I need to go to inpatient. Like, why would you wait? And a couple things I said. And they’re like, you are in the D.C. area. Of course you have. And I was talking about like I just go and I just did this. And you don’t even understand how much privilege you have. We can’t go even in an emergency. And then I said, oh, OK, I get it. And I think we all have privilege. Even if you don’t realize this. So, sometimes someone has to tell you, oh, you didn’t realize. That was easy for you. That’s why you think that. So, yes, the same type of thing. And I think even for me, the way that my stature is with if you see cops, most of them, it’s obvious they are bigger than me and they have more like they have authority over me.

Sakinah: But when someone calls for me, there are six of them. Six of them came out and I’m just sitting there and they keep saying like, well, that your friend said that you were suicidal. And I said, I’m not. I just asked them out of it and like, OK, you can leave. But her son, they talked to him in such a way, it was obvious they wanted to harm him, you know, and they’re making fun of him and like, have you taken your medicine? And they weren’t really trying to de-escalate the situation. They didn’t do any of that to me. So, the way that they treat people like us is so different. And they weren’t interested in getting him out. They were just trying to, like, let her know that she had messed up by not giving him his meds. So that’s the kind of thing where if you don’t see that happen, you won’t really know. That’s how they deal with it. There were actually only three of them, and there were six for me. You know, there’s no need to. Like, they’re trying to strong arm us and let us know. None of that makes any sense.

Rachel Star Withers: And that goes whether you’re in a city or rural area, like how many? Obviously, you always hear where not everyone’s bad, which is correct. But when you look at like, the responses. Yeah. If you’re in an area that the police have more of a budget, they’ll probably send more. And it could probably escalate quicker than if you’re from where I’m from. And I don’t know, like five cops for like half of South Carolina. You know, the idea that a whole bunch coming out wouldn’t happen and be like, well, where are you going to find them? But yeah, usually, like, things change.

Sakinah: See, I didn’t even think of that. Yeah.

Rachel Star Withers: Mm hmm.

Sakinah: Yeah, because for me, I’m like, why are these six cops in a room? And like, they’re all like just trying to stand in front of a window where if I fell out, I’m not even going to die. And then I’m like, what are you even doing? It was really, really odd. And then I kept telling them, look why are you all around the windows? We don’t want you to jump out. Of this window? Yes. None of that makes sense. OK. Yeah. Then they had an actual budget. And then finally they’re like, all right, let’s just go, we’re wasting our time. I told you that. Yes.

Rachel Star Withers: So we’ve hit on a lot of different things, and I’ve loved talking with you. What overall advice do you have for people whenever they’re in a minority situation dealing with mental health, whether it’s a crisis or just worried about getting general help?

Sakinah: Ok, I’ll say two things. If you are a minority and you are concerned about your mental health, don’t be afraid to ask. What you don’t know, that is what can hurt you. And it is not a shame on you to say, hey, I’m dealing with this issue. And you won’t know what it is wrong with you unless you ask a professional. You cannot assume. Everything isn’t depression. Everything isn’t anxiety. You need to know and you deserve to feel well. And I have a friend who always told me that. So you should check into it. You should reach out. But especially if you are black or African-American, you need to take care of yourself because you need, you have to be strong in today’s society. But if you’re dealing with someone who’s black or African-American, same thing. Don’t assume that they know what’s going on with them and don’t look at them and think, oh, that person’s angry all the time. Or that person is whatever. They may be dealing with trauma and they don’t know how to get help. So, if you say something, let’s say online, you say, oh, reach out or take care of your mental health. They won’t know how to do that unless they’ve been taught. So, don’t assume that like one size fits all. Or if you’re an advocate or even a doctor, that they’ll know how to do that. And then you might be thinking, well, I said it. They won’t know. And so for us, you really almost are going to have to go into those communities and teach people and just be kind of patient because some people have such a stigma. Like in black communities, we have such a stigma. And you may need someone who looks like them or who they will take that information from. So, it’s OK if he will kind of push back. They’re not pushing back against you. They’re just a little bit scared sometimes. Just like no assumptions. No assumptions.

Rachel Star Withers: And how can our audience learn more about you?

Sakinah: The best way to learn about me, I would say, is through my social media, Twitter and Facebook is where I’m most active. My Twitter handle is @TheMuslimHippie. You can find me on Facebook /Sakinah.Karen. And both of those have all information on any other projects that I’m working on. You’ll find those. I’m working on the second book about substance use disorders. I want to write a book about Muslims dealing with substance use and how being in a marginalized community, if you don’t take care of your substance use disorder, you can die quicker. That’s kind of what that project is, but it’s going to be positive. And it’s a story of hope because I’m always looking forward. So, Twitter and Facebook is where you can find me.

Rachel Star Withers: Thank you so much for coming on here and teaching us and our audience. And I kind of hope we will all just continue to learn from each other.

Sakinah: Thank you for having me.

Rachel Star Withers: Thank you so much. Loved speaking with you today.

Gabe Howard: Rachel, that was incredible. I’m so glad that we have the opportunity to interview people on this podcast, not just Sakinah, but all of our guests have just been so incredible. What do you think?

Rachel Star Withers: I learned so much from her. Especially when we talk about, like religious wear. For the most part, when I walk into a doctor’s office, they’re not going to know what religion I am. It’s pretty hard to judge me off that, whereas they know right away with her, you know, and you make assumptions off that, whether you mean to or not.

Gabe Howard: One of the major takeaways that I learned from Sakinah was it’s not intentional. I think this is just such an important point to bring up. This debate is always tabled with you are a malicious racist or you’re perfectly fine. There’s like willful racism or nothing to improve upon. And the reality is, it’s so much more complex than that. I’m not saying that there’s not willful racists. There absolutely are. I don’t think Sakinah is denying that either. Her point was that some of the major issues that people of color, that minorities, have aren’t that willful racism. It’s the unexplored biases. It’s the misunderstandings that go unchecked that lead to people like her not getting the best care. That was a real aha moment for me because it would just be so much cleaner if it was, oh, you’re a racist and you’re evil. Oh, you’re not a racist and you’re wonderful. Like that would be so much easier, but it’s not that way. So, I’m really glad that she pointed that out and I can see where that would be very impactful on her care.

Rachel Star Withers: And sometimes you don’t have access, you know, where you’re living at. So how I dress, let’s say I walk in and the doctor, I’ll go, you know, a week without showering because I’m so depressed and I’m, like, mentally out of it. So imagine if I show up to a very first doctor’s appointment and they’re thinking, oh, wow, this girl looks rough. They make these assumptions that, oh, she probably has no support care system. Oh, wow. We need to, you know, up her meds right away. People look at you and they make assumptions based on the way you dress. There’s so many things that can affect our health care. And it, it’s scary, Gabe. I’m not gonna lie. It’s scary, especially for people with schizophrenia. And there is no like, OK, well, here’s the answer, guys. Like there isn’t. We have no answer for how do you deal with subtle biases? Because unfortunately, every single thing is going to be different and so much of it people don’t even realize they’re doing.

Gabe Howard: Our listeners probably aren’t aware of this, but Rachel is a stuntwoman and she’s also a model and quite accomplished at both. And I am just, I am lucky to have Rachel as a friend. And I bought a new wardrobe recently that Rachel helped me with. So, one, I just wanted to publicly thank you, because now I look stellar.

Rachel Star Withers: True.

Gabe Howard: But people are like, Gabe, you’re really stepping up your game. And I said, yeah, I have a friend who’s a model, Rachel, and she gave me all kinds of hints and tips because this is her experience. And that’s like, oh, that’s awesome. I wish I had a model friend. And the reason I’m telling this story is because recently one of my friends realized that my schizophrenic friend Rachel and my model friend Rachel were the same person. It never occurred to her that my model friend Rachel could live with schizophrenia. She very much considered them separate. Now, my friend is a very good person. She’s a very nice person. She’s not, she doesn’t have a mean bone in her body. This was not malicious, but she was unable to connect the two and she was quite surprised when she found out. That, in my mind, is an excellent example of just an internal bias that you miss. And obviously, the stakes aren’t very high on that. Health care is a matter of life and death. And that’s why we’ve got to do better.

Rachel Star Withers: Absolutely. This episode is a very hard one for me to kind of wrap up. I’m very upbeat. You’ve noticed that, I’m sure, throughout the episodes. So, I always want to leave on an upbeat note. And this is hard because as we’ve said multiple times, me and Gabe, in a lot of ways are very privileged. And we’ve never been outright discriminated against. We’ve never kind of been held back from health care due to being a minority. And I don’t wanna give upbeat words for something that I know nothing about. During this episode, we’ve talked about all different stats and acknowledged that so much goes into the way people perceive us and we perceive other people, how we subconsciously even connect to people. How you’re like, oh, hey, this person’s like me and the opposite there and that’s across the board. That’s something that’s scary to me, that there are people out there and they almost never feel like they connect with a doctor. And I do wish I could be like, oh, well just go find another one. As Sakinah pointed out, especially when you’re not in a city, there may only be one doctor. Depending on your financial status, you might not be able to go to anybody else. You might have to stick with a free clinic or something like that. So, there are no good answers that blanket everything. We all have blind spots. Some of them are self-imposed. Others are put on us. I think we all just kind of have to realize that we have these blind spots and try to do better.

Gabe Howard: Rachel, I could not agree more.

Rachel Star Withers: Thank you so much for listening to this episode of Inside Schizophrenia, a Psych Central podcast. Please, like, share, subscribe. Send it to all of your friends, any of your friends who are dealing with schizophrenia, caretakers, your medical friends, or just some really cool people you know.

Gabe Howard: See you all next time.

Announcer: Inside Schizophrenia is presented by PsychCentral.com, America’s largest and longest operating independent mental health website. Your host, Rachel Star Withers, can be found online at RachelStarLive.com. Co-host Gabe Howard can be found online at gabehoward.com. For questions, or to provide feedback, please e-mail talkback@PsychCentral.com. The official website for Inside Schizophrenia is PsychCentral.com/IS. Thank you for listening, and please, share widely.

from https://ift.tt/32huJ3r Check out https://daniejadkins.wordpress.com/

[pitz182]

Microdosing Marijuana at 9 Years Sober

Microdosing. All the cool kids in Silicon Valley are doing it, and anyone who got sober before 2015 has been left out of the fun. At least, anyone with an all-or-nothing recovery plan, which is most people, but definitely not yours truly. Anecdotally, it looks like it’s better to have Silicon Valley hooked on low doses of LSD and psilocybin than abusing Adderall, but more empirical data on the therapeutic benefits of this trend is needed. Though I’m not going near psychedelics without a doctor’s note, I have dabbled in some microdosing on weed, and I still consider myself 100% sober.Alcohol was my problem. It was a gnarly problem. I put the kibosh on that problem in 2009 and haven’t looked back.Google piqued my interest in microdosing on weed by feeding me a headline that claimed one puff of it could blast away depression. I double-clicked. Since I deal with bipolar disorder and have benefited from using CBD (the non-psychoactive component in marijuana), the article seemed relevant.According to the study, one drag of low-THC and high-CBD dose of weed can knock out depression immediately, unlike traditional antidepressants that often take a few weeks to kick in. But, there’s a catch: Continual use of THC could worsen depression, so this had to be an every-now-and-again smoke. I stored that information in my brain for future reference, noting that if I ever experienced an intense depression that didn’t abate I could give it a try since I’m fortunate enough to live in Los Angeles (pot shops on nearly every major street).About two months after I read about the study, I got stuck in a morass of negativity and self-deprecation and self-doubt for about a week. Everything was out of alignment, and no matter how much meditation I did, I just couldn’t snap out of it. Sure, I have bipolar II, but because I take meds, 90% of the time the symptoms are manageable. Still, there are those days when stress or neurochemistry or hormones or a bad fight with a boyfriend can throw me off.Sometimes I find relief in jogging or dancing, calling my therapist or going to a meeting, but there are times where I don’t have the energy or ability to do the very things I know will help (Depression 101). Since I’ve dealt with the condition for so long, I know when I’m dealing with a chemical imbalance and when I’m dealing with a psychological imbalance.This time it felt like both.I was curious to see how the weed would work, especially since I’d heard so much about the benefits of microdosing on psychedelics from friends. Because the CBD succeeded in quieting my anxiety and smoothing out my thoughts, I figured why not try something with a bit of THC.Anyone who smokes pot can tell you that it triggers euphoria, thereby alleviating depression; you don’t need a study to tell you that. But I’ve never been a huge fan of weed, for several reasons.For starters, my sister smoked way too much of it when she was 18, and she wound up with a permanent case of acute paranoid schizophrenia right after a three-month-long binge. Her doctor said the weed probably triggered a dormant case of the illness inherited from my schizophrenic grandfather, one that would have emerged with or without the pot, it was just a matter of time. So, that instilled in me a well-warranted dose of fear.After staying far away from weed until my early 20s, I started smoking it every now and then, but not very often, and I certainly never purchased any or had it around. You’re probably wondering why I’d even risk smoking pot at all given my sister’s condition. Well, the doc also pointed out that she displayed many early signs of the disorder from childhood, and that my emotional and expressive--albeit mood-disordered--personality was opposite of what you’d typically see in a child predisposed for schizophrenia.I also had passed adolescence by the time I started smoking, and the science says adolescents are the ones most at risk. Strength and frequency also play a huge role, and my sister admitted that she holed herself up in her dorm room smoking bowl after bowl after bowl all day long for months until she literally couldn’t think anymore. I had no intention of smoking more than a hit or two off a blunt.My highs were a total mixed bag: Sometimes they relaxed me, sometimes they brought on unstoppable fits of giggles; one time I had waking dreams about dancing tortilla chips, and a few times I found myself in the midst of very uncomfortable paranoia. The one and only time I smoked way more than two hits, I wound up with full-blown psychosis that ruined an entire Halloween for multiple people. Even when smoking did bring on an enjoyable high, I still had to endure those moments of not remembering the last word I spoke, which I found, and still find, utterly horrifying. Plus my head felt like it weighed 100 pounds and my face felt like it was going to burn off.Pot just didn’t provide an alluring buzz. I never developed a craving for or addiction to it.If the weed I smoked had had even a small percentage of CBD, those episodes of paranoia would likely have not occurred since CBD actually curbs the anxiety-inducing effects of THC. In fact, in a bizarre twist of irony, studies have shown CBD effectively treats schizophrenia.Sadly, whoever bred weed in the 90s and early 2000s grew strains that had little or no CBD because it decreases the psychoactive effect. (Remember chronic?) Now, CBD is making a comeback among health-conscious, microdosing millennials who are sensible enough to want a more balanced high. This is good news for a paranoid Gen Xer.Now, you can walk into the local dispensary and see a smorgasbord of pot goodies that include CBD, from all-CBD vanilla bean cookies to 1:1 taffies to 100% CBD oil cartridges. There are salves and gums and pre-rolls and mints and a white CBD dust that looks just like cocaine, and all of them are labeled with the milligrams and the percentages of THC and CBD. This is heaven for someone like me who might want to try some pot without getting paranoid or stoned.I have to say, I love budtenders. Mitch, who manned the shop by my house, was extremely sympathetic to my terror of coming down with pot-induced paranoia. He emphasized that dosing, strain, and CBD content made a world of difference when trying to avoid it and pointed me in the direction of 1:1 taffies. Each taffy had 5 mg of CBD and THC, which sounds low, but it’s no microdose for someone like me. According to Mitch, 5 mg of CBD and THC can lead to a strong high for someone with zero pot tolerance, and I wasn’t looking to get stoned — I just wanted that mild euphoria, for the bell jar to lift.I ended up buying the taffies and slicing them into thirds, which Mitch suggested. In the end, I was ingesting about 1.5 mg of THC and 1.5 mg of CBD, which a lot of doctors would consider an ineffective dose, but not for me! My brain is super sensitive. After two hours, I ended up feeling a very small effect, but of course it grew.Ultimately, the high — if you’d call it that — was a powerful feeling of ease and positivity. My thoughts quieted, and yes, a mild euphoria fell over me. It was, without a doubt, a nice buzz, but a buzz no more intense than a glass of wine sipped slowly and on a reasonably full stomach. Despite this buzz, I had no craving for more pot. I was so pleased to not be paranoid or forgetting my thoughts as they spilled out of my head, the last thing I wanted was more. More might have induced those adverse effects. (Oh, the benefits of legalization!)I am not ashamed of that pot buzz nor do I think it nulls my sobriety in any way. My sobriety is just that — my sobriety, and it’s not some stringent moral code that demands I never feel any psychoactive pleasure whatsoever just because I used to drink myself into rages, sobs, and blackouts. If the pot buzz was harmless and actually beneficial for my mental health, why not embrace it? One of the main reasons I got off the booze is because how seriously destabilizing it is for my mood given my bipolar diagnosis. When I drank too much, it sent me crashing down into suicidal depressions.Normal drinkers get a slight buzz — if not a big buzz — from their drinks, and they’ll admit it. It’s a social lubricant and a relaxant that well-adjusted and healthy folks leverage all the time to take the edge off and have fun. When they manage to leverage these positive aspects of alcohol without destroying their lives, we tip our hats to them.Being out of AA for nearly three years no doubt helped me take the microdosing plunge with zero guilt.Now, if I wanted to gorge myself on those taffies after this experience, that would be problematic, at least for me. Someone else might not care if they engage that behavior, but I’m not in the mood to pick up any new addictions.I’m still very wary of using weed on the regular given my familial history of schizophrenia, though at this age my chances of developing the illness are low. Some studies have shown that heavy and regular use can fry your short-term memory, and I’m not down for that either: I need all the synapses I can get as I push 40. So, I don’t plan on using it very often.After having the weed, the positive mood lasted for a few days without ingesting any more taffies. I basically just returned to baseline. I didn’t eat any for weeks after that episode. Since then, I’ve probably had two or three, each time cutting them in thirds or halves. After a while, the package just sat there in the fridge, and eventually I ended up tossing them when I moved out of the apartment.So, now I have no taffies, and I could frankly care less. If I feel like one might help me in the future, I’ll take it. If I go out to the desert, maybe I’ll take some for recreational use. Either way, I know my limitations, and I know I don’t want to do it often. Because I don’t experience a craving, I doubt this will be a problem. I experienced a craving for alcohol from Day One. From the very beginning, I needed more.“Marijuana maintenance,” or smoking pot in recovery, is generally frowned upon by your standard AA member. Historically referred to (incorrectly) as “the gateway drug,” 12-step philosophy looks at it in the same way, cautioning that if you start smoking it in recovery it will open up the floodgates toward drinking again.The problem with this thinking is that it doesn’t take into account the vast differences that exist between all of us, be they physiological or psychological, or, hell, even spiritual. After reading much about recovery, from Lance Dodes to Marc Lewis to Gabrielle Glaser to Bill Wilson and all the stories in the rest of the Big Book, I feel that it's unconscionable to argue that we are not unique, as so many people do in 12-step programs. We are highly unique, and observing this and tailoring treatment plans for each individual will increase success at recovery. One-size-fits-all recovery modalities are, according to my research, quite dangerous.Imagine if a woman with breast cancer walked into a doctor’s office and the doctor said, “Well, there’s no reason to take any additional imaging because all breast cancer patients are the same. You’re not unique. Mastectomy it is!”Even in the dark ages medicine was probably more sophisticated than this. So why are we in the dark ages when it comes to addiction treatment? If our bodies are this unique, then so are our minds. The field of psychiatry also takes our differences into account, with medication and other treatment prescribed according to individual circumstances.I am not encouraging anyone to microdose, but I am trying to encourage the sober community to keep an open mind about new psychotherapeutic treatments and to accept the fact that some people can stay away from their drug of choice while indulging in a substance that wasn’t and isn’t problematic. Studies have shown that marijuana can benefit our mental health; let’s continue to study this promising medicine instead of closing ourselves off to it out of fear.Microdosing on anything while in recovery is a very nuanced topic, and drawing blanket conclusions won’t do anyone a bit of good. But in order to make room for these conversations, we have to be open and accepting. We have to be willing to say, “Okay, she can take a little THC every now and then and enjoy it. I know it’s not a good idea for me since I smoked too much pot in the past, so I won’t do it.” We all need to be in touch with our own limits and accept them while not imposing them on others; otherwise, we resort to reductive fear-mongering that has no basis in reality.

[alexdmorgan30]

Microdosing Marijuana at 9 Years Sober

Microdosing. All the cool kids in Silicon Valley are doing it, and anyone who got sober before 2015 has been left out of the fun. At least, anyone with an all-or-nothing recovery plan, which is most people, but definitely not yours truly. Anecdotally, it looks like it’s better to have Silicon Valley hooked on low doses of LSD and psilocybin than abusing Adderall, but more empirical data on the therapeutic benefits of this trend is needed. Though I’m not going near psychedelics without a doctor’s note, I have dabbled in some microdosing on weed, and I still consider myself 100% sober.Alcohol was my problem. It was a gnarly problem. I put the kibosh on that problem in 2009 and haven’t looked back.Google piqued my interest in microdosing on weed by feeding me a headline that claimed one puff of it could blast away depression. I double-clicked. Since I deal with bipolar disorder and have benefited from using CBD (the non-psychoactive component in marijuana), the article seemed relevant.According to the study, one drag of low-THC and high-CBD dose of weed can knock out depression immediately, unlike traditional antidepressants that often take a few weeks to kick in. But, there’s a catch: Continual use of THC could worsen depression, so this had to be an every-now-and-again smoke. I stored that information in my brain for future reference, noting that if I ever experienced an intense depression that didn’t abate I could give it a try since I’m fortunate enough to live in Los Angeles (pot shops on nearly every major street).About two months after I read about the study, I got stuck in a morass of negativity and self-deprecation and self-doubt for about a week. Everything was out of alignment, and no matter how much meditation I did, I just couldn’t snap out of it. Sure, I have bipolar II, but because I take meds, 90% of the time the symptoms are manageable. Still, there are those days when stress or neurochemistry or hormones or a bad fight with a boyfriend can throw me off.Sometimes I find relief in jogging or dancing, calling my therapist or going to a meeting, but there are times where I don’t have the energy or ability to do the very things I know will help (Depression 101). Since I’ve dealt with the condition for so long, I know when I’m dealing with a chemical imbalance and when I’m dealing with a psychological imbalance.This time it felt like both.I was curious to see how the weed would work, especially since I’d heard so much about the benefits of microdosing on psychedelics from friends. Because the CBD succeeded in quieting my anxiety and smoothing out my thoughts, I figured why not try something with a bit of THC.Anyone who smokes pot can tell you that it triggers euphoria, thereby alleviating depression; you don’t need a study to tell you that. But I’ve never been a huge fan of weed, for several reasons.For starters, my sister smoked way too much of it when she was 18, and she wound up with a permanent case of acute paranoid schizophrenia right after a three-month-long binge. Her doctor said the weed probably triggered a dormant case of the illness inherited from my schizophrenic grandfather, one that would have emerged with or without the pot, it was just a matter of time. So, that instilled in me a well-warranted dose of fear.After staying far away from weed until my early 20s, I started smoking it every now and then, but not very often, and I certainly never purchased any or had it around. You’re probably wondering why I’d even risk smoking pot at all given my sister’s condition. Well, the doc also pointed out that she displayed many early signs of the disorder from childhood, and that my emotional and expressive--albeit mood-disordered--personality was opposite of what you’d typically see in a child predisposed for schizophrenia.I also had passed adolescence by the time I started smoking, and the science says adolescents are the ones most at risk. Strength and frequency also play a huge role, and my sister admitted that she holed herself up in her dorm room smoking bowl after bowl after bowl all day long for months until she literally couldn’t think anymore. I had no intention of smoking more than a hit or two off a blunt.My highs were a total mixed bag: Sometimes they relaxed me, sometimes they brought on unstoppable fits of giggles; one time I had waking dreams about dancing tortilla chips, and a few times I found myself in the midst of very uncomfortable paranoia. The one and only time I smoked way more than two hits, I wound up with full-blown psychosis that ruined an entire Halloween for multiple people. Even when smoking did bring on an enjoyable high, I still had to endure those moments of not remembering the last word I spoke, which I found, and still find, utterly horrifying. Plus my head felt like it weighed 100 pounds and my face felt like it was going to burn off.Pot just didn’t provide an alluring buzz. I never developed a craving for or addiction to it.If the weed I smoked had had even a small percentage of CBD, those episodes of paranoia would likely have not occurred since CBD actually curbs the anxiety-inducing effects of THC. In fact, in a bizarre twist of irony, studies have shown CBD effectively treats schizophrenia.Sadly, whoever bred weed in the 90s and early 2000s grew strains that had little or no CBD because it decreases the psychoactive effect. (Remember chronic?) Now, CBD is making a comeback among health-conscious, microdosing millennials who are sensible enough to want a more balanced high. This is good news for a paranoid Gen Xer.Now, you can walk into the local dispensary and see a smorgasbord of pot goodies that include CBD, from all-CBD vanilla bean cookies to 1:1 taffies to 100% CBD oil cartridges. There are salves and gums and pre-rolls and mints and a white CBD dust that looks just like cocaine, and all of them are labeled with the milligrams and the percentages of THC and CBD. This is heaven for someone like me who might want to try some pot without getting paranoid or stoned.I have to say, I love budtenders. Mitch, who manned the shop by my house, was extremely sympathetic to my terror of coming down with pot-induced paranoia. He emphasized that dosing, strain, and CBD content made a world of difference when trying to avoid it and pointed me in the direction of 1:1 taffies. Each taffy had 5 mg of CBD and THC, which sounds low, but it’s no microdose for someone like me. According to Mitch, 5 mg of CBD and THC can lead to a strong high for someone with zero pot tolerance, and I wasn’t looking to get stoned — I just wanted that mild euphoria, for the bell jar to lift.I ended up buying the taffies and slicing them into thirds, which Mitch suggested. In the end, I was ingesting about 1.5 mg of THC and 1.5 mg of CBD, which a lot of doctors would consider an ineffective dose, but not for me! My brain is super sensitive. After two hours, I ended up feeling a very small effect, but of course it grew.Ultimately, the high — if you’d call it that — was a powerful feeling of ease and positivity. My thoughts quieted, and yes, a mild euphoria fell over me. It was, without a doubt, a nice buzz, but a buzz no more intense than a glass of wine sipped slowly and on a reasonably full stomach. Despite this buzz, I had no craving for more pot. I was so pleased to not be paranoid or forgetting my thoughts as they spilled out of my head, the last thing I wanted was more. More might have induced those adverse effects. (Oh, the benefits of legalization!)I am not ashamed of that pot buzz nor do I think it nulls my sobriety in any way. My sobriety is just that — my sobriety, and it’s not some stringent moral code that demands I never feel any psychoactive pleasure whatsoever just because I used to drink myself into rages, sobs, and blackouts. If the pot buzz was harmless and actually beneficial for my mental health, why not embrace it? One of the main reasons I got off the booze is because how seriously destabilizing it is for my mood given my bipolar diagnosis. When I drank too much, it sent me crashing down into suicidal depressions.Normal drinkers get a slight buzz — if not a big buzz — from their drinks, and they’ll admit it. It’s a social lubricant and a relaxant that well-adjusted and healthy folks leverage all the time to take the edge off and have fun. When they manage to leverage these positive aspects of alcohol without destroying their lives, we tip our hats to them.Being out of AA for nearly three years no doubt helped me take the microdosing plunge with zero guilt.Now, if I wanted to gorge myself on those taffies after this experience, that would be problematic, at least for me. Someone else might not care if they engage that behavior, but I’m not in the mood to pick up any new addictions.I’m still very wary of using weed on the regular given my familial history of schizophrenia, though at this age my chances of developing the illness are low. Some studies have shown that heavy and regular use can fry your short-term memory, and I’m not down for that either: I need all the synapses I can get as I push 40. So, I don’t plan on using it very often.After having the weed, the positive mood lasted for a few days without ingesting any more taffies. I basically just returned to baseline. I didn’t eat any for weeks after that episode. Since then, I’ve probably had two or three, each time cutting them in thirds or halves. After a while, the package just sat there in the fridge, and eventually I ended up tossing them when I moved out of the apartment.So, now I have no taffies, and I could frankly care less. If I feel like one might help me in the future, I’ll take it. If I go out to the desert, maybe I’ll take some for recreational use. Either way, I know my limitations, and I know I don’t want to do it often. Because I don’t experience a craving, I doubt this will be a problem. I experienced a craving for alcohol from Day One. From the very beginning, I needed more.“Marijuana maintenance,” or smoking pot in recovery, is generally frowned upon by your standard AA member. Historically referred to (incorrectly) as “the gateway drug,” 12-step philosophy looks at it in the same way, cautioning that if you start smoking it in recovery it will open up the floodgates toward drinking again.The problem with this thinking is that it doesn’t take into account the vast differences that exist between all of us, be they physiological or psychological, or, hell, even spiritual. After reading much about recovery, from Lance Dodes to Marc Lewis to Gabrielle Glaser to Bill Wilson and all the stories in the rest of the Big Book, I feel that it's unconscionable to argue that we are not unique, as so many people do in 12-step programs. We are highly unique, and observing this and tailoring treatment plans for each individual will increase success at recovery. One-size-fits-all recovery modalities are, according to my research, quite dangerous.Imagine if a woman with breast cancer walked into a doctor’s office and the doctor said, “Well, there’s no reason to take any additional imaging because all breast cancer patients are the same. You’re not unique. Mastectomy it is!”Even in the dark ages medicine was probably more sophisticated than this. So why are we in the dark ages when it comes to addiction treatment? If our bodies are this unique, then so are our minds. The field of psychiatry also takes our differences into account, with medication and other treatment prescribed according to individual circumstances.I am not encouraging anyone to microdose, but I am trying to encourage the sober community to keep an open mind about new psychotherapeutic treatments and to accept the fact that some people can stay away from their drug of choice while indulging in a substance that wasn’t and isn’t problematic. Studies have shown that marijuana can benefit our mental health; let’s continue to study this promising medicine instead of closing ourselves off to it out of fear.Microdosing on anything while in recovery is a very nuanced topic, and drawing blanket conclusions won’t do anyone a bit of good. But in order to make room for these conversations, we have to be open and accepting. We have to be willing to say, “Okay, she can take a little THC every now and then and enjoy it. I know it’s not a good idea for me since I smoked too much pot in the past, so I won’t do it.” We all need to be in touch with our own limits and accept them while not imposing them on others; otherwise, we resort to reductive fear-mongering that has no basis in reality.

from RSSMix.com Mix ID 8241841 http://bit.ly/2AF1Qjc

[emlydunstan]

Microdosing Marijuana at 9 Years Sober

Microdosing. All the cool kids in Silicon Valley are doing it, and anyone who got sober before 2015 has been left out of the fun. At least, anyone with an all-or-nothing recovery plan, which is most people, but definitely not yours truly. Anecdotally, it looks like it’s better to have Silicon Valley hooked on low doses of LSD and psilocybin than abusing Adderall, but more empirical data on the therapeutic benefits of this trend is needed. Though I’m not going near psychedelics without a doctor’s note, I have dabbled in some microdosing on weed, and I still consider myself 100% sober.Alcohol was my problem. It was a gnarly problem. I put the kibosh on that problem in 2009 and haven’t looked back.Google piqued my interest in microdosing on weed by feeding me a headline that claimed one puff of it could blast away depression. I double-clicked. Since I deal with bipolar disorder and have benefited from using CBD (the non-psychoactive component in marijuana), the article seemed relevant.According to the study, one drag of low-THC and high-CBD dose of weed can knock out depression immediately, unlike traditional antidepressants that often take a few weeks to kick in. But, there’s a catch: Continual use of THC could worsen depression, so this had to be an every-now-and-again smoke. I stored that information in my brain for future reference, noting that if I ever experienced an intense depression that didn’t abate I could give it a try since I’m fortunate enough to live in Los Angeles (pot shops on nearly every major street).About two months after I read about the study, I got stuck in a morass of negativity and self-deprecation and self-doubt for about a week. Everything was out of alignment, and no matter how much meditation I did, I just couldn’t snap out of it. Sure, I have bipolar II, but because I take meds, 90% of the time the symptoms are manageable. Still, there are those days when stress or neurochemistry or hormones or a bad fight with a boyfriend can throw me off.Sometimes I find relief in jogging or dancing, calling my therapist or going to a meeting, but there are times where I don’t have the energy or ability to do the very things I know will help (Depression 101). Since I’ve dealt with the condition for so long, I know when I’m dealing with a chemical imbalance and when I’m dealing with a psychological imbalance.This time it felt like both.I was curious to see how the weed would work, especially since I’d heard so much about the benefits of microdosing on psychedelics from friends. Because the CBD succeeded in quieting my anxiety and smoothing out my thoughts, I figured why not try something with a bit of THC.Anyone who smokes pot can tell you that it triggers euphoria, thereby alleviating depression; you don’t need a study to tell you that. But I’ve never been a huge fan of weed, for several reasons.For starters, my sister smoked way too much of it when she was 18, and she wound up with a permanent case of acute paranoid schizophrenia right after a three-month-long binge. Her doctor said the weed probably triggered a dormant case of the illness inherited from my schizophrenic grandfather, one that would have emerged with or without the pot, it was just a matter of time. So, that instilled in me a well-warranted dose of fear.After staying far away from weed until my early 20s, I started smoking it every now and then, but not very often, and I certainly never purchased any or had it around. You’re probably wondering why I’d even risk smoking pot at all given my sister’s condition. Well, the doc also pointed out that she displayed many early signs of the disorder from childhood, and that my emotional and expressive--albeit mood-disordered--personality was opposite of what you’d typically see in a child predisposed for schizophrenia.I also had passed adolescence by the time I started smoking, and the science says adolescents are the ones most at risk. Strength and frequency also play a huge role, and my sister admitted that she holed herself up in her dorm room smoking bowl after bowl after bowl all day long for months until she literally couldn’t think anymore. I had no intention of smoking more than a hit or two off a blunt.My highs were a total mixed bag: Sometimes they relaxed me, sometimes they brought on unstoppable fits of giggles; one time I had waking dreams about dancing tortilla chips, and a few times I found myself in the midst of very uncomfortable paranoia. The one and only time I smoked way more than two hits, I wound up with full-blown psychosis that ruined an entire Halloween for multiple people. Even when smoking did bring on an enjoyable high, I still had to endure those moments of not remembering the last word I spoke, which I found, and still find, utterly horrifying. Plus my head felt like it weighed 100 pounds and my face felt like it was going to burn off.Pot just didn’t provide an alluring buzz. I never developed a craving for or addiction to it.If the weed I smoked had had even a small percentage of CBD, those episodes of paranoia would likely have not occurred since CBD actually curbs the anxiety-inducing effects of THC. In fact, in a bizarre twist of irony, studies have shown CBD effectively treats schizophrenia.Sadly, whoever bred weed in the 90s and early 2000s grew strains that had little or no CBD because it decreases the psychoactive effect. (Remember chronic?) Now, CBD is making a comeback among health-conscious, microdosing millennials who are sensible enough to want a more balanced high. This is good news for a paranoid Gen Xer.Now, you can walk into the local dispensary and see a smorgasbord of pot goodies that include CBD, from all-CBD vanilla bean cookies to 1:1 taffies to 100% CBD oil cartridges. There are salves and gums and pre-rolls and mints and a white CBD dust that looks just like cocaine, and all of them are labeled with the milligrams and the percentages of THC and CBD. This is heaven for someone like me who might want to try some pot without getting paranoid or stoned.I have to say, I love budtenders. Mitch, who manned the shop by my house, was extremely sympathetic to my terror of coming down with pot-induced paranoia. He emphasized that dosing, strain, and CBD content made a world of difference when trying to avoid it and pointed me in the direction of 1:1 taffies. Each taffy had 5 mg of CBD and THC, which sounds low, but it’s no microdose for someone like me. According to Mitch, 5 mg of CBD and THC can lead to a strong high for someone with zero pot tolerance, and I wasn’t looking to get stoned — I just wanted that mild euphoria, for the bell jar to lift.I ended up buying the taffies and slicing them into thirds, which Mitch suggested. In the end, I was ingesting about 1.5 mg of THC and 1.5 mg of CBD, which a lot of doctors would consider an ineffective dose, but not for me! My brain is super sensitive. After two hours, I ended up feeling a very small effect, but of course it grew.Ultimately, the high — if you’d call it that — was a powerful feeling of ease and positivity. My thoughts quieted, and yes, a mild euphoria fell over me. It was, without a doubt, a nice buzz, but a buzz no more intense than a glass of wine sipped slowly and on a reasonably full stomach. Despite this buzz, I had no craving for more pot. I was so pleased to not be paranoid or forgetting my thoughts as they spilled out of my head, the last thing I wanted was more. More might have induced those adverse effects. (Oh, the benefits of legalization!)I am not ashamed of that pot buzz nor do I think it nulls my sobriety in any way. My sobriety is just that — my sobriety, and it’s not some stringent moral code that demands I never feel any psychoactive pleasure whatsoever just because I used to drink myself into rages, sobs, and blackouts. If the pot buzz was harmless and actually beneficial for my mental health, why not embrace it? One of the main reasons I got off the booze is because how seriously destabilizing it is for my mood given my bipolar diagnosis. When I drank too much, it sent me crashing down into suicidal depressions.Normal drinkers get a slight buzz — if not a big buzz — from their drinks, and they’ll admit it. It’s a social lubricant and a relaxant that well-adjusted and healthy folks leverage all the time to take the edge off and have fun. When they manage to leverage these positive aspects of alcohol without destroying their lives, we tip our hats to them.Being out of AA for nearly three years no doubt helped me take the microdosing plunge with zero guilt.Now, if I wanted to gorge myself on those taffies after this experience, that would be problematic, at least for me. Someone else might not care if they engage that behavior, but I’m not in the mood to pick up any new addictions.I’m still very wary of using weed on the regular given my familial history of schizophrenia, though at this age my chances of developing the illness are low. Some studies have shown that heavy and regular use can fry your short-term memory, and I’m not down for that either: I need all the synapses I can get as I push 40. So, I don’t plan on using it very often.After having the weed, the positive mood lasted for a few days without ingesting any more taffies. I basically just returned to baseline. I didn’t eat any for weeks after that episode. Since then, I’ve probably had two or three, each time cutting them in thirds or halves. After a while, the package just sat there in the fridge, and eventually I ended up tossing them when I moved out of the apartment.So, now I have no taffies, and I could frankly care less. If I feel like one might help me in the future, I’ll take it. If I go out to the desert, maybe I’ll take some for recreational use. Either way, I know my limitations, and I know I don’t want to do it often. Because I don’t experience a craving, I doubt this will be a problem. I experienced a craving for alcohol from Day One. From the very beginning, I needed more.“Marijuana maintenance,” or smoking pot in recovery, is generally frowned upon by your standard AA member. Historically referred to (incorrectly) as “the gateway drug,” 12-step philosophy looks at it in the same way, cautioning that if you start smoking it in recovery it will open up the floodgates toward drinking again.The problem with this thinking is that it doesn’t take into account the vast differences that exist between all of us, be they physiological or psychological, or, hell, even spiritual. After reading much about recovery, from Lance Dodes to Marc Lewis to Gabrielle Glaser to Bill Wilson and all the stories in the rest of the Big Book, I feel that it's unconscionable to argue that we are not unique, as so many people do in 12-step programs. We are highly unique, and observing this and tailoring treatment plans for each individual will increase success at recovery. One-size-fits-all recovery modalities are, according to my research, quite dangerous.Imagine if a woman with breast cancer walked into a doctor’s office and the doctor said, “Well, there’s no reason to take any additional imaging because all breast cancer patients are the same. You’re not unique. Mastectomy it is!”Even in the dark ages medicine was probably more sophisticated than this. So why are we in the dark ages when it comes to addiction treatment? If our bodies are this unique, then so are our minds. The field of psychiatry also takes our differences into account, with medication and other treatment prescribed according to individual circumstances.I am not encouraging anyone to microdose, but I am trying to encourage the sober community to keep an open mind about new psychotherapeutic treatments and to accept the fact that some people can stay away from their drug of choice while indulging in a substance that wasn’t and isn’t problematic. Studies have shown that marijuana can benefit our mental health; let’s continue to study this promising medicine instead of closing ourselves off to it out of fear.Microdosing on anything while in recovery is a very nuanced topic, and drawing blanket conclusions won’t do anyone a bit of good. But in order to make room for these conversations, we have to be open and accepting. We have to be willing to say, “Okay, she can take a little THC every now and then and enjoy it. I know it’s not a good idea for me since I smoked too much pot in the past, so I won’t do it.” We all need to be in touch with our own limits and accept them while not imposing them on others; otherwise, we resort to reductive fear-mongering that has no basis in reality.

from RSSMix.com Mix ID 8241841 https://www.thefix.com/microdosing-marijuana-9-years-sober

[vileart]

Three Shows and a Dramaturgy: Tim Marriot @ Edfringe

A Warning From History – Mengele 

As the Labour Party argues over the definition of anti-Semitism* and the Israeli government approves a Jewish Nation State**, divisions deepen and boundaries blur.

All across Europe and the USA extremist views advance and the Far Right begins to creep into government.

Against this contemporary background, Smokescreen Productions offers a warning from history at the Edinburgh Festival Fringe.

Mengele takes us back to a beach in Brazil in 1979 when a drowning man is washed up on a beach where he meets a mysterious woman.

The play imagines the notorious doctor of Auschwitz confronted by the woman he assumes has saved him. 

Mengele Trailer from Smokescreen Visuals Ltd on Vimeo.

Shell Shock Tackles Major Mental Health Issue Related Deaths of Veterans

Fringe Encore Winner and Best Solo Show, Adelaide Fringe 18 The Ministry of Defence has just admitted that it “does not hold information on the causes of death for all UK Armed Forces veterans”*.

This includes the growing numbers among our estimated 2.6 million former service men and women who take their own lives.

The multiple award-winning play Shell Shock,which is coming to the Edinburgh Festival Fringe on 11 August as part of the Army@TheFringe programme, tackles the mental health challenges faced by some veterans trying to return to civilian life. 

All Change – Ivor’s Not Going Quietly

Ivor waits, his train of thought broken by his fragmented and decaying memory. 

His daughter Lily packs a bag, preparing him for a “home”. But Ivor’s not going quietly. As fast as Lily packs, he unpacks...

Performed by sitcom veteran Tim Marriott  with Stefanie Rossi as Lily, it’s a tale for our times, addressing the issues of failing memory and caring for an aging parent – something growing numbers of us can expect to face in years to come.

First of all, how do you define mental health? What does the term mean to you - do you have a social model of sanity, for example, or is it concerned with neural atypical conditions?

We are all happy to discuss our physical health… I wear a Fitbit tracker and will happily bore anyone to death about how many steps I have taken today, this week, this month… but there is a stigma around mental health that, in order to be truly healthy, we should address. Mental health therefore means to me exactly that – a healthy, balanced, exercised and fit mental state… or not. 

I don’t think of mental health in terms of expected social norms, or psychosis, but more in terms of how I react to stress and pressure on a daily basis. There are neuroses, injuries, degenerative conditions, physical and mental traumas and imbalances covered by the very general term ‘mental health’, but on a day to day, the phrase makes me think of emotional and intellectual well being.

What areas of mental health are you looking at in the performance?

I am doing three shows at EdFringe that

can be seen to deal with different aspects of 

mental health. Two established shows and one new one. ‘ Mengele’ exposes the mind of a narcissistic sociopath, ‘Shell Shock’ charts the descent through toxic masculinity into Post Traumatic Stress Disorder. The new show, ‘All Change’ is a deeply personal family story about living with dementia interpreted through a domestic and comedic setting.

In what ways do you hope that your play can help the audience to move forward in their understanding and actions towards a greater sense of mental good health?

In ‘All Change’, we use humour to bring the audience into the world of Ivor and his daughter Lily as she attempts to prepare him for life in a ‘home’. Her gentle handling of this irascible character says much about how we can respond to the condition and ease the confusion of the sufferer. Though the play also contains other complexities in that Lily has her own issues that she struggles to share with her father as his mind slips away. The play is not didactic, that is not our style, but hopes to at least provoke a conversation or two.

And given the high pressure nature of the Fringe, do you have any ideas about positive self-care during August in Edinburgh.

Performing three plays during the fringe will be a challenge and the level of involvement in each one, the emotional and physical demands of each role will make us vulnerable to anxiety and stress. Audience reaction and reviews can feel very personal and you can’t win ‘em all, so we need to be prepared to take the rough with the smooth.  As a reviewer myself, I try and take account of

this when offering a written response as I know what negative criticism can feel like and how destructive it can be to one’s mental health.  I will try and make myself and my company as resilient as possible by keeping physically fit, eating and sleeping well, keeping regular hours and avoiding too many late nights and alcohol!

Josef Mengele, known in the camp as “The Angel of Death”, escaped justice after WW2 and escaped to South America. 

The woman challenges him to attempt to justify the unjustifiable and in so doing exposes the rhetoric of a sociopathic narcissist, echoing arguments we hear again today.

Created following advice from the Holocaust Educational Trust and endorsed by the Amud Aish Museum of New York, Mengele seeks to engage, educate and provoke conversations about the issues of today as much as of the past. 

A short run at Edinburgh last year was followed by an award to take the play to New York as a Fringe Encore winner, then on to a sell out season at Adelaide Fringe 2018. 

Inspired by the novel Right to Die, the play is written by Philip Wharam and Tim Marriott, who also performs it with Stefanie Rossi and Emma Wingrove.

Mengele, the play, is inspired by and written to acknowledge the chilling truth expressed by Auschwitz survivor Lydia Tischler who said: “all of us have the capacity to be sadistic and horrible to other people. The potential for destructiveness is in all of us.”Marriott says:“It is vital for us to understand such men as Mengele, to learn from history, to stop others like them from rising again.”

Adapted from Gulf War veteran Neil Blower Watkins’ autobiographical novel of the same name Shell Shocktells the story of long-serving soldier Tommy Atkins’ attempts to return to Civvy Street and his undiagnosed PTSD (post traumatic stress disorder). 

The effects of PTSD amongst generations of ex-military and first responders in a social media driven society where we are constantly under pressure to live “happy and fulfilled” lives are huge. 

Shell Shockwas adapted for the stage and is performed by BBC comedy veteran Tim Marriott (The Brittas Empire) and was created in association with military and mental health charities as a stigma reduction project for the military community and beyond. Earlier this year it was named Best Solo Show at the Adelaide Fringe.

The play is ultimately positive, offering hope and support, and is followed by informal interactive feedback sessions, or “Fire Circles”, where others are encouraged to share their own stories.

Marriott said:“PTSD can be a huge challenge for veterans. All too often the symptoms are repressed, unrecognised and often go untreated, especially in a culture defined by masculine grit. For generations we have taught our young men tobe embarrassed about their emotions and hide them, or avoid communicating them – unless in anger. This is now recognised as Toxic Masculinity.”

As Tommy shares his observations on the absurdities of the everyday with the audience, so the cracks in his military grit become apparent. As he represses his reactions to flashbacks, he rails at the world in increasing outrage. Nothing is safe. From post office queues to Ikea, computer games to ‘phone zombies, all feel the force of his frustration. 

Listings Details

·       Venue: Army @ The Fringe in association with Summerhall, Hepburn House Army Reserve Centre, East Claremont Street (Venue 210)

·       Time: 17:30

·       Duration: 60 mins

·       Dates: 11, 12, 14-19, 21-25 August. Previews 10 August. 

·       Tickets: £9 to £12

·       Bookings: https://festival18.summerhall.co.uk/book-tickets/

·       Advisory: Contains strong language

Marriott said:“Hundreds of thousands of families across the UK are affected by dementia every year. It has an immense impact on the lives of everyone it touches and as time ticks on its something that any of us might eventually suffer. But whilst the personal tragedy of dementia is at the heart of All Change, it’s very much a play filled with humanity, warmth and humour.”

All Changebegan life as a devised project, inspired by the work of St Wilfrid’s Hospice, workshopped with drama students and scripted by Toby H Marriott, on an emerging writers course at the Bristol Old Vic Theatre. Based on personal experience, the play was then developed into a compact professional production, researched and developed in Bristol and at Brighton Fringe and now premiering at Edinburgh.

Alzheimer’s Society fact file

·     There are 850,000 people with dementia in the UK, with numbers set to rise to over one million by 2025. This will soar to two million by 2051.

·     Some 225,000 will develop dementia this year, that’s one every three minutes.

·     One in six people over the age of 80 have dementia.

·     Some 70% of people in care homes have dementia or severe memory problems.

There are over 40,000 people under 65 with dementia in the UK.

See https://www.alzheimers.org.uk

- Ends -

Listings Details

·       Venue: Assembly George Square Theatre, The Box, EH8 9JZ (Venue 8)

·       Time: 12:20  

·       Duration: 50 mins

·       Dates: 9,11, 13, 15, 17, 19, 21, 23, 25, 27, 27 August. Previews 9 August 

·       Tickets: Previews £10 (£9); 11-27 August £12 (£11) 

·        Marriottis best known for seven series of BBC TV's leisure centre sit-com The Brittas Empire, appearing in every episode as deputy manager, Gavin. Other TV credits include Allo Allo, Doctors, The Bill, An Actor's Life for Me, The Main Event, Luv and film credits include the forthcoming features The Real Thing, Love Type D and Revelation. He recently returned to the stage after an 18-year career break teaching English and drama. He is also appearing in two other Fringe 2018 productions, Shell Shockand All Change.

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