#is this the medication or just my personality and the way i’ve developed with condition? who can say

[lucky-clover-gazette]

i have the type of adhd that makes me try aggressively harder until it consumes me when it’s extremely difficult to acquire medication, instead of giving up because phone calls scary

[reasonsforhope]

Story from the Washington Post here, non-paywall version here.

Washington Post stop blocking linksharing and shit challenge.

"The young woman was catatonic, stuck at the nurses’ station — unmoving, unblinking and unknowing of where or who she was.

Her name was April Burrell.

Before she became a patient, April had been an outgoing, straight-A student majoring in accounting at the University of Maryland Eastern Shore. But after a traumatic event when she was 21, April suddenly developed psychosis and became lost in a constant state of visual and auditory hallucinations. The former high school valedictorian could no longer communicate, bathe or take care of herself.

April was diagnosed with a severe form of schizophrenia, an often devastating mental illness that affects approximately 1 percent of the global population and can drastically impair how patients behave and perceive reality.

“She was the first person I ever saw as a patient,” said Sander Markx, director of precision psychiatry at Columbia University, who was still a medical student in 2000 when he first encountered April. “She is, to this day, the sickest patient I’ve ever seen.” ...

It would be nearly two decades before their paths crossed again. But in 2018, another chance encounter led to several medical discoveries...

Markx and his colleagues discovered that although April’s illness was clinically indistinguishable from schizophrenia, she also had lupus, an underlying and treatable autoimmune condition that was attacking her brain.

After months of targeted treatments [for lupus] — and more than two decades trapped in her mind — April woke up.

The awakening of April — and the successful treatment of other people with similar conditions — now stand to transform care for some of psychiatry’s sickest patients, many of whom are languishing in mental institutions.

Researchers working with the New York state mental health-care system have identified about 200 patients with autoimmune diseases, some institutionalized for years, who may be helped by the discovery.

And scientists around the world, including Germany and Britain, are conducting similar research, finding that underlying autoimmune and inflammatory processes may be more common in patients with a variety of psychiatric syndromes than previously believed.

Although the current research probably will help only a small subset of patients, the impact of the work is already beginning to reshape the practice of psychiatry and the way many cases of mental illness are diagnosed and treated.

“These are the forgotten souls,” said Markx. “We’re not just improving the lives of these people, but we’re bringing them back from a place that I didn’t think they could come back from.” ...

Waking up after two decades

The medical team set to work counteracting April’s rampaging immune system and started April on an intensive immunotherapy treatment for neuropsychiatric lupus...

The regimen is grueling, requiring a month-long break between each of the six rounds to allow the immune system to recover. But April started showing signs of improvement almost immediately...

A joyful reunion

“I’ve always wanted my sister to get back to who she was,” Guy Burrell said.

In 2020, April was deemed mentally competent to discharge herself from the psychiatric hospital where she had lived for nearly two decades, and she moved to a rehabilitation center...

Because of visiting restrictions related to covid, the family’s face-to-face reunion with April was delayed until last year. April’s brother, sister-in-law and their kids were finally able to visit her at a rehabilitation center, and the occasion was tearful and joyous.

“When she came in there, you would’ve thought she was a brand-new person,” Guy Burrell said. “She knew all of us, remembered different stuff from back when she was a child.” ...

The family felt as if they’d witnessed a miracle.

“She was hugging me, she was holding my hand,” Guy Burrell said. “You might as well have thrown a parade because we were so happy, because we hadn’t seen her like that in, like, forever.”

“It was like she came home,” Markx said. “We never thought that was possible.”

...After April’s unexpected recovery, the medical team put out an alert to the hospital system to identify any patients with antibody markers for autoimmune disease. A few months later, Anca Askanase, a rheumatologist and director of the Columbia Lupus Center,who had been on April’s treatment team, approached Markx. “I think we found our girl,” she said.

Bringing back Devine

When Devine Cruz was 9, she began to hear voices. At first, the voices fought with one another. But as she grew older, the voices would talk about her, [and over the years, things got worse].

For more than a decade, the young woman moved in and out of hospitals for treatment. Her symptoms included visual and auditory hallucinations, as well as delusions that prevented her from living a normal life.

Devine was eventually diagnosed with schizoaffective disorder, which can result in symptoms of both schizophrenia and bipolar disorder. She also was diagnosed with intellectual disability.

She was on a laundry list of drugs — two antipsychotic medications, lithium, clonazepam, Ativan and benztropine — that came with a litany of side effects but didn’t resolve all her symptoms...

She also had lupus, which she had been diagnosed with when she was about 14, although doctors had never made a connection between the disease and her mental health...

Last August, the medical team prescribed monthly immunosuppressive infusions of corticosteroids and chemotherapy drugs, a regime similar to what April had been given a few years prior. By October, there were already dramatic signs of improvement.

“She was like ‘Yeah, I gotta go,’” Markx said. “‘Like, I’ve been missing out.’”

After several treatments, Devine began developing awareness that the voices in her head were different from real voices, a sign that she was reconnecting with reality. She finished her sixth and final round of infusions in January.

In March, she was well enough to meet with a reporter. “I feel like I’m already better,” Devine said during a conversation in Markx’s office at the New York State Psychiatric Institute, where she was treated. “I feel myself being a person that I was supposed to be my whole entire life.” ...

Her recovery is remarkable for several reasons, her doctors said. The voices and visions have stopped. And she no longer meets the diagnostic criteria for either schizoaffective disorder or intellectual disability, Markx said...

Today, Devine lives with her mother and is leading a more active and engaged life. She helps her mother cook, goes to the grocery store and navigates public transportation to keep her appointments. She is even babysitting her siblings’ young children — listening to music, taking them to the park or watching “Frozen 2” — responsibilities her family never would have entrusted her with before her recovery.

Expanding the search for more patients

While it is likely that only a subset of people diagnosed with schizophrenia and psychotic disorders have an underlying autoimmune condition, Markx and other doctors believe there are probably many more patients whose psychiatric conditions are caused or exacerbated by autoimmune issues...

The cases of April and Devine also helped inspire the development of the SNF Center for Precision Psychiatry and Mental Health at Columbia, which was named for the Stavros Niarchos Foundation, which awarded it a $75 million grant in April. The goal of the center is to develop new treatments based on specific genetic and autoimmune causes of psychiatric illness, said Joseph Gogos, co-director of the SNF Center.

Markx said he has begun care and treatment on about 40 patients since the SNF Center opened. The SNF Center is working with the New York State Office of Mental Health, which oversees one of the largest public mental health systems in America, to conduct whole genome sequencing and autoimmunity screening on inpatients at long-term facilities.

For “the most disabled, the sickest of the sick, even if we can help just a small fraction of them, by doing these detailed analyses, that’s worth something,” said Thomas Smith, chief medical officer for the New York State Office of Mental Health. “You’re helping save someone’s life, get them out of the hospital, have them live in the community, go home.”

Discussions are underway to extend the search to the 20,000 outpatients in the New York state system as well. Serious psychiatric disorders, like schizophrenia, are more likely to be undertreated in underprivileged groups. And autoimmune disorders like lupus disproportionately affect women and people of color with more severity.

Changing psychiatric care

How many people ultimately will be helped by the research remains a subject of debate in the scientific community. But the research has spurred excitement about the potential to better understand what is going on in the brain during serious mental illness...

Emerging research has implicated inflammation and immunological dysfunction as potential players in a variety of neuropsychiatric conditions, including schizophrenia, depression and autism.

“It opens new treatment possibilities to patients that used to be treated very differently,” said Ludger Tebartz van Elst, a professor of psychiatry and psychotherapy at University Medical Clinic Freiburg in Germany.

In one study, published last year in Molecular Psychiatry, Tebartz van Elst and his colleagues identified 91 psychiatric patients with suspected autoimmune diseases, and reported that immunotherapies benefited the majority of them.

Belinda Lennox, head of the psychiatry department at the University of Oxford, is enrolling patients in clinical trials to test the effectiveness of immunotherapy for autoimmune psychosis patients.

As a result of the research, screenings for immunological markers in psychotic patients are already routine in Germany, where psychiatrists regularly collect samples from cerebrospinal fluid.

Markx is also doing similar screening with his patients. He believes highly sensitive and inexpensive blood tests to detect different antibodies should become part of the standard screening protocol for psychosis.

Also on the horizon: more targeted immunotherapy rather than current “sledgehammer approaches” that suppress the immune system on a broad level, said George Yancopoulos, the co-founder and president of the pharmaceutical company Regeneron.

“I think we’re at the dawn of a new era. This is just the beginning,” said Yancopoulos."

-via The Washington Post, June 1, 2023

[butchpeace]

Begging you to stop assuming that trans people are just gay people who can't admit to being gay. I'm bi regardless of whether I'm the woman the body I was born into is supposed to make me or the man that I feel like I was supposed to be. I won't say that no one has ever transitioned to avoid homophobia, but there are better ways to address that than to stop genuinely transsexual people from transitioning.

I've been in therapy for 27 years. Since puberty sunk its teeth in me. NOTHING is going to make me feel like being a woman is the right fit for me and trying to force myself to fit into that box has made me suicidal for decades. Convincing myself I could just be a masculine woman barely soothed any of that. I'm sorry that transition wasn't the right fit for you, and you deserve all of the support you need for that, but it's no more fair to force me to be a woman just because of the body that I was born into than it would be to force you to keep identifying as a man and taking hormones.

I don’t know you and it’s none of my business how you live your life.

My opposition to transition is primarily due to the medical risks of testosterone therapy on women.

Testosterone causes our reproductive organs to atrophy, potentially irreversibly. I’ve heard stories of people who develop chronic pain, persisting even after stopping T. People whose ovaries no longer work correctly after only a few years on T, causing various problems from low hormone production. People with urinary incontinence and pelvic floor issues caused by T essentially putting them into early menopause. PCOS worsening. Ovaries twisting. People who have had unnecessary gynecological surgeries due to the effects of T. People with chronic chest pain after top surgery. People who developed arthritis in their joints, or autoimmune conditions while on T. People who had mental health crises triggered by being on testosterone. People with chronic debilitating vocal pain or clitoral pain due to the effect on those areas. People who developed cholesterol or blood pressure problems only after being on T, causing them to be at higher risk for heart health issues.

That’s just off the top of my head, and that’s just things I’ve personally witnessed in myself and friends, both trans and detrans.

Live your life, do what makes you happy. I’m not going to stop talking about this health crisis that’s currently affecting young women, many of whom are just gay or tomboys, and would eventually become fine with themselves if they were able to grow up with masculine female role models and actual feminist education.

Even if there was a small minority of “true transsexuals”, even if you are one of them, that doesn’t make what I’m saying wrong or unimportant. You can’t deny that women are getting harmed by transition.

[theautisticdoctor]

Entry #012

Hypermobility

A problem many autistic fellows of mine, including me, are suffering from is hypermobility. It's a underdiagnosed, underrecognized part of autism.

I personally deal with Ehlers-Danlos Syndrome (EDS), which runs in my family. My great-grandmother, grandmother, and mother all have it, and so do I. It comes with a host of symptoms: atrophic scars, mitral valve insufficiency, postural / orthostatic tachycardia syndrome, gastric motility disorder, pelvic and bladder dysfunction, extremely soft and stretchy skin, and, of course, extreme hypermobility. I can bend my joints in ways that I only learned in medical school was abnormal, and I’ve often felt like a bit of a freak during skills practices. I remember asking an orthopaedic surgeon during training why people couldn’t do 90 degrees flexion and extension with their forefeet, only to be met with confusion. When I demonstrated what I meant, the look on his face was one of pure astonishment. This highlights how different our experiences can be and how misunderstood they often are.

One of the most frustrating parts is not being taken seriously by some doctors. I’m lucky to have a medical degree and trusted colleagues I can consult, but many autistic individuals don’t have this luxury. Too often, our symptoms are dismissed or attributed to our mental health, leading us to delay seeking help until things get really bad. Please, don’t wait. The longer you put off seeing a doctor, the harder it becomes to treat your symptoms. Find a physician who listens and takes you seriously. Hypermobility doesn't necessarily mean you have EDS, but hypermobile or not, moving and living isn’t easy. Chronic exhaustion is real and debilitating. I touched on managing energy levels in entry #003 with routines based on my modified spoon theory, which I call the cutlery theory. I’ll dive deeper into this in a future post.

Living with hypermobility means constant joint pain, frequent dislocations, and early arthritis. I’ve never known a pain-free day, and overdoing it physically just makes things worse. Recovery takes time, and I’m still figuring out if physical and mental fatigue recover together or separately. Overstraining definitely not only impacts physical, but also my mental state. Not everyone can access rehabilitation programs, but there are steps you can take on your own to make it a little easier or better. Start by tracking your symptoms to identify patterns. This can help you find ways to support yourself. Working with a physiotherapist or occupational therapist is ideal, but you can also use trial and error to find what works for you. I’m always here to brainstorm and offer support.

I’m a big believer in creative therapy. One exercise is to color in a body image to show where you feel comfortable, uncomfortable, or in pain. This helps you and your healthcare providers understand your condition better and develop a personalised treatment plan.

Also, braces can be a lifesaver for dislocated or overstretched joints, even though I hate wearing them. They help prevent further injury and aid in recovery. Despite the awkward looks and comments, they’re definitely worth it.

In conclusion, hypermobility is often a comorbidity of autism. It can cause mental fatigue and chronic pain, among other symptoms. Don’t suffer in silence, but find ways to accommodate yourself and make life easier. Medication and surgery aren’t always the answers, although they can help. Awareness and lifestyle adjustments can make a big difference too. Talk to your physician, physiotherapist, occupational therapist, and fellow patients to find what works for you.

[anarchoherbalism]

Hi I do education stuff including public facing sliding scale online workshops and classes n shit. More deets below cut

This workshop covers a variety of holistic pain management strategies for individuals and practitioners, primarily focusing on chronic pain.

Upcoming class date: Sunday March 3rd, 4:00PM-5:30PM EST

Registration: Send an email to mildewamyx(at)protonmail(dot)com and specify the email or phone # you would like me to send the class link & recording to. You don't have to attend live to recieve the recording but you do have to register.

Requirements: This is an intermediate-level workshop that assumes familiarity with western herbal terminology and herbal medicine making. (pssst! All background knowledge required is covered in An Anarchist Free Herbal)

Suggested donation: $15-$45; No one turned away for lack of funds

Recording policy: Registration is required to receive the recording. There will be an UNRECORDED q&a portion at the end of the class.

Background

I’ve been in pain every day for over half my life, from a varying combination of joint instability, neurological problems, and repetitive injuries. Like many chronically ill and disabled people, my experience of pain is not just a sense of urgency or a signal to stop doing something: It’s brain fog, immobility, dissociation, low empathy, a short temper, mood swings, both an ever-present sensation and something I have to actively remember to address. Naturally, I’ve spent a lot of my life thinking about and discussing extreme pain. Many friends and accomplices and I have been dissatisfied with pain management options available via western medicine; especially when we’ve been presented with potentially-dangerous long-term NSAID prescriptions or non-indicated medications with unpleasant side effects. Herbalism can offer a wider range of potential management strategies that can be compatible with western medical treatment for underlying conditions or offer relief to those of us who have chosen not to pursue or continue medical treatment for any number of personal reasons.

Course Description

Over the years, I’ve developed a set of specific indications centering around different experiences of pain, which I will now share with you! We’ll talk about ways of conceptualizing and communicating about pain and explore a wide variety of pain management options—Not just analgesic herbs (although don’t get me wrong, there’s plenty!) but strategies and practices for living with chronic and long-term pain like sensory redirection, ritual, nervous system support and more. This workshop intends to develop a rich, multifaceted and adaptable toolkit that focuses on increasing quality of life in difficult situations with strategically-targeted, doable steps.

[theforesteldritch]

A while ago I did an interview with stats Canada (basically the organization responsible for census and demographics data in canada) about potentially developing a census question about being intersex, and the person doing the interview was super nice and receptive, but one of the things I tried to convey especially is that with intersex people, if you’re surveying our prevalence or whatever in a population based off of self-reported answers like a census, the number you come up with is probably going to be less than the actual number of us out there to the point where it’s almost certain that there’s a higher percentage of intersex people out there than a census number suggests. This isn’t to say that it’s not important to have data that’s as accurate as can be about us on a national scale, because that’s one of the reasons I did the interview because it is important to help work on policy etc, but being intersex isn’t necessarily like other demographic information in that there’s a few ways that can and will interfere with someone’s reporting of their intersex status, and so there will be a gap between how many people say they are intersex on a survey and the higher number of how many people actually are intersex.

For one, an intersex person may simply be undiagnosed. There are quite a few intersex variations which may not be very apparent externally unless you know what to look for, and many that can’t be confirmed without a karyotype. If you had asked me or my parents if I was intersex before I was 15, we would’ve said no- not because I wasn’t always intersex, but simply because no one knew, my diagnostic process hadn’t even started yet. The other big reason is intersex erasure. What used to be considered the ‘standard of care’ for people with my variation, CAIS, up until very relatively recently, was to just lie to us and tell us that we had ovarian cancer as an excuse to remove our gonads- really internal testes- and then not tell us the truth under the assumption that we’d commit suicide if we found out we ‘weren’t real women’. This is something that the majority of older people with CAIS that I’ve spoken to have gone through, only finding out the truth later. But some of us have likely never discovered the truth, and may still not know they have it, meaning that if they put that they weren’t intersex on a census, this would be unknowingly wrong. This is just one example with one variation, but having people attempt to erase our intersex-ness is pretty common among intersex people of all variations.

This brings me to my final factor to consider: the language used for questions like these and intersex-ness in general. The medical establishment, in order to perpetuate our erasure, is incredibly resistant to the word intersex. Whether it be refusing to accept that conditions accepted by the community as intersex are intersex, or refusing to use the word at all, instead opting to erase us through the term DSD, even people who are told about our conditions may have to discover that we indeed fall under the intersex umbrella on our own. And so while in general I very much don’t like the term DSD and don’t want it to be used anywhere near me, I do think that for the purposes of collecting data, it is a term that should be included in explanations for what intersex means in these demographics questions. I won’t hate it any less, but it’s the unfortunate reality that many people won’t know themselves as intersex except through that term, because of the general erasure of the term intersex and the pushing of DSD language despite it being rejected by the general intersex community. I don’t think it’s right and I don’t think it’s a term that should have to be mentioned, but especially in a population where we have all these barriers to accurate data, we end up having to include these euphemisms because unfortunately there’s been such a successful push of these terms in the medical community that they’re what people know their intersex-ness as.

[tobeabatman]

fatness and health

Being fat means that people call me unhealthy even though I’ve been to all possible blood tests and I’ve been described as ”healthy” by all the health professionals I’ve met… And there’s no reason they would believe otherwise besides my weight.

And so what if I will become sick in the future? I probably will: my family already has all sorts of conditions that me, and my skinny siblings alike, will most likely develop in the future. You too, will become sick at some point, regardless of how good you think your health is. You might also get into an accident and die any day.

You see, if fatness was as unhealthy as you think, fatphobia would have started as an actual medical concern, and not as eugenicist propaganda. I’m not saying that fatness and certain conditions have no correlation: we know that they do. However, this doesn’t mean that fatness causes those conditions: researchers and doctors have kind of just assumed that it does, and further research is still ongoing.

We also have research stating that ”obesity paradox” exists. And there is research claiming that slightly overweight people (BMI under 30) live even longer than skinny people.

And whether that or any research is true or not, it doesn’t change the fact that fat people don’t need to change their bodies. Heavy smokers can die even 12-13 years earlier than non-smokers, but heavy smokers still do not owe you smoking cessation. We fat people also don’t owe you weight-loss, just because some research states that people with a BMI higher than 30 die about 4-6 years earlier than people with a ”normal” BMI (BMI is not accurate, but it is also what most weight-related research uses).

(…Even just an every-day (non-heavy) smoker can lose 8 years of their lifetime: if you cared about our health and lives so much, then you’d also go harass skinny cigarette users about their health (I’m not advocating for it, but I recognize that there is a clear difference in how much shit we fat people get for our health vs skinny smokers). And for stuff like vapes, we don’t even know what they do to our bodies in a long term, yet! But I digress.)

Whether you think that we are ”glorifying obesity” or whatever, it doesn’t change the fact that we are human. We are not a type of subhumans you can bully or joke about. If we say we deserve respect, you should realize that that is a basic ass human right, and not a reason to whine about ”glorifying obesity”.

Especially if you are a part of another marginalized group, then it’s about time you educate yourself on fat experiences. I for sure want the queer community to accept my body the way it is.

We just don’t owe you weight-loss, we don’t owe you our health history, we shouldn’t have to listen to any bullshit on how we are a burden on society. The point of society is to take care of the people who need care!!

If you ask me, I believe a massive part of why we fat people die faster isn’t our fatness: it’s medical mistreatment, unemployment, homelessness, and poverty, all of which are more prevelent among fat people.

I know of too many fat people who have died because of medical professionals not taking them or their health seriously: my ”obese” grandpa actually died in surgery in which not all safety protocols were followed. This isn’t necessarily proof of medical mistreatment because of fatness, but he was a 70 year old ”obese” man with type 2 diabetes, BED, and sleep apnea. This make him at least an example of a fat person who died not because of his fatness, or other conditions that are correlated with fatness. My other, skinny, grandpa died 7 years earlier than my fat grandpa with diabetes and sleep apnea.

And I know that some troll will likely reblog this as well: someone even reblogged my book recommendation on a book that debunks parts of fatphobia. You guys are literally broken records that dedicate their entire accounts on reblogging fat people’s content as a way to get back at them… Kinda pathetic and useless: you guys think you can say anything more hurtful about my weight than my own literal mom said to me at 9? You’re most likely grown ass adults: go do something else instead of scrolling tags related to fatness and reblogging every single post with the same talking points.

[homeostasister]

I’m in a very Modeling sort of mood right now, so have a framework for life based on the levels of organization in biology:

Biosphere—The actual world we’re living in, and the knowledge and experiences we have of it that provide a reason to keep living, independent of values and goals—the existence which precedes essence, so to speak.

Ecosystem—The values you hold, the things that matter to you and that you want to support in some capacity.

Community—The system and environment you’re directly a part of, which impacts both the conditions of your day-to-day existence and the means by which you learn to support your values.

Population—Your obligations and responsibilities to the people around you, which emerge as a result of your own personal values and the needs and values of your community.

Organism—A long-term plan for your own life. It doesn’t need to be anything fancy or certain, but it should hopefully give you a starting point for how you could fulfill the different levels of organization. Right now I think my plan is to major in environmental science and try to get involved in restoration work at my school, and see what emerges as a result of that.

Organ systems—The practical goals you set to work towards fulfilling your plan and engaging with your community in a functional, enjoyable, and sustainable way. I’ve been taking a break from school to figure out exactly what these are for me.

Organs—The specific obligations and responsibilities that come about as a result of the goals you set for yourself and the things that people need from you—the work you have to do, the things you need to schedule, the ways you can support the people you care about, including yourself.

Tissues—The short-term means by which you fulfill your obligations—the strategies you use to stay organized, motivated, and happy in the life you’re trying to live.

Cells—The physiological and psychological mechanisms by which these strategies work—which you don’t necessarily have to know, but I’d say the more you can work towards figuring out why and how something works for you, the better equipped you’ll be to apply it appropriately.

Organelles/molecules/atoms—The physical basis for everything that you do and are. Every level of biological organization actualized—your evolutionary history, your genetic makeup, your environmental influences, your individual development, the physiological and molecular mechanisms by which you are able to maintain homeostasis and interface with the world around you. The essence which precedes existence, and which is never going to be truly and completely understood, no matter how thoroughly we work to tease it apart. And for so long I’ve been living in this mindset of wanting to Know Everything and Unify Everything, and thinking about molecular biology always gets me in that emotional space, only now that I don’t feel like I actually Have To Keep Learning About Molecular Biology, it’s honestly just exhausting. I hope it’ll be less exhausting once I’m off my medication, and I can engage with molecular biology and immunology as I want to engage with all of biology—with empathy and curiosity and appreciation, and the occasional research rabbit hole.

[confusedgoldenflower]

Pop culture has conditioned us to say "I forgive you" when someone apologizes, but you're not obliged to follow the social ritual, so I didn't.

I’m so glad someone added this!

No one is owed your forgiveness; for absolution from their actions they still performed and continued at an age they knew it was wrong and after being told it was wrong.

No one is owed absolution for taking away your childhood! For making you live in fear, and see what should be a safe place and one of learning (preferably also fun) as a DANGER. They don’t deserve to have that weight lifted off their shoulders—if they even felt a weight to begin with.

If one of mine came to me, I’d tell them I was impressed they were able to get over themselves enough to even come close to unpacking what the fuck their issues were back then and why they took it out on another child. I’d probably ask them what the bug was that they’d had up their ass for years on end because my largest vice is needing to know.

If they had a child(ren), I’d tell them that I hope better than either of us had for their kid(s) and for them to be a decent parent, but that no matter how good of a parent they are or person they’ve become, nothing would undo or override what they did to me. The years of fear, the buckets of tears and the insane levels of stress. The literal ptsd. (Literally, somehow, getting adults to join them!) All of which will impact me for the rest of my life.

But is it really being healed to demand catharsis and then revert when you’re told you don’t deserve it?

But my views on forgiveness are different than a lot of peoples’, and a lot of that is because of what I went through. There’s no right or wrong way to view “forgive and forget” in whatever light is best for you. Hence, I’ve added another view to this post.

Part of me wishes they would. I’m a believer is retributive karma: experiencing what you gave out. I want them to understand in the realest posisble terms what they put me through. But I also know the closest way is by proxy, and that my child self will never have catharsis. Her window for going to school without fear of a prosecutor is long past; even high school having been tainted. Her and all those other children she knew. We won’t get what we deserve.

Now I’m crying and forgot where exactly I wanted to go with this. I think just to show the severity of “child antics.” Those were formative years. Those were years designed to impact the rest of our lives. No matter what development and realizations or “healing” those bullies go through, it will never, ever excuse their behavior, nor will being better for their kids or nieces unwrite the deeply ingrained trauma patterns in our brains. Again, trying to “redeem” themselves by being better parental figures is good, but it’s not magic.

So I won’t be saying “I take the responsibility of your own actions off you.” But I will say “I curse you to hold more of the responsibility of what you chose to do to me, and you being a better adult (or parent figure) is the LEAST you owe everyone.”

Y’all can disagree with me, but I won’t be arguing with you. And yes, I’m healing. I’m in therapy. Still, that doesn’t mean I’m obliged to them, especially not to say “it’s okay you hurt me so deeply and so long because I’m in medical debt over therapy and spent years trying to overcome my own trauma.”

Life really does align in weird ways.

My bully from 5th grade who snapped my glasses in front of his friends just found me on social media a few weeks ago.

He wrote me a long apology saying how he was now a father to a 3 year old little girl and was taking her to get her first pair of little glasses in the next few days—and it brought back what he did. He said couldn’t ever handle the idea of someone doing that to her.

My first instinct was to tell him to get lost, but I realized I was getting what I always prayed for. I just wanted the people who were mean to me to eventually understand it—even if it took a personal experience to relate to and 14 years to open their eyes.

A piece of me healed in that moment as I gave him glasses advice for his daughter because I was the same age when I got my first pair.

Kids are really ruthless, but it takes a healed adult to reach out to apologize. And there is always time to change; it’s never too late.

[blogofmastermind]

Understanding Diabetes: What You Need to Know

Diabetes is a chronic condition that affects how your body processes glucose (sugar). There are three main types of diabetes:

Type 1 Diabetes: This occurs when the immune system attacks the insulin-producing cells in the pancreas. It typically develops in childhood or adolescence.

Type 2 Diabetes: In this type, your body either becomes resistant to insulin or doesn't produce enough. It is often related to lifestyle factors and usually occurs in adults.

Gestational Diabetes: This develops during pregnancy but usually goes away after childbirth. However, it increases the risk of developing Type 2 diabetes later in life.

Recognizing symptoms early, such as frequent urination, excessive thirst, blurred vision, and unexplained weight loss, is key to getting proper treatment. If you experience any of these symptoms, consult a healthcare provider.

Diabetes-Friendly Meals: What to Eat

Managing diabetes through diet is essential for controlling blood sugar levels. Here are some tips for making your meals diabetes-friendly:

Choose whole grains: Brown rice, quinoa, and whole-wheat pasta are better options than refined carbs.

Focus on lean proteins: Chicken, turkey, and plant-based proteins like tofu and legumes are excellent choices.

Fill your plate with vegetables: Non-starchy vegetables like spinach, kale, broccoli, and cucumbers are packed with nutrients and fiber.

Incorporate healthy fats: Avocados, nuts, seeds, and olive oil can help keep you full and are great for heart health.

By carefully planning your meals, you can maintain better control of your blood sugar. It’s always best to consult a dietitian to personalize your eating plan.

How Exercise Helps Manage Diabetes

Regular physical activity plays a major role in managing diabetes. Exercise helps improve insulin sensitivity, which means your body can use insulin more effectively. Here's how it benefits those with diabetes:

Regulates blood sugar: Exercise helps muscles use glucose for energy, lowering blood sugar levels.

Supports heart health: Diabetes increases the risk of cardiovascular diseases, and exercise can reduce this risk.

Improves mood: Physical activity can reduce stress and help manage diabetes-related emotional struggles.

Try to aim for at least 30 minutes of moderate activity most days of the week. Walking, cycling, swimming, or even yoga can be great ways to keep moving!

My Journey with Type 2 Diabetes

Living with Type 2 diabetes can be challenging, but it’s also a journey of learning and adaptation. When I was first diagnosed, I felt overwhelmed and unsure of what the future would hold. But over time, I’ve learned to take control of my health. With the right combination of diet, exercise, and medication, I’ve been able to manage my blood sugar levels.

There are days when it feels tough, but I remind myself that small steps lead to big changes. And the support of my community—whether friends, family, or online groups—has been crucial in my journey. If you’re newly diagnosed or struggling, remember: you’re not alone. Progress is key, not perfection.

How to Manage Diabetes Burnout

Managing diabetes can sometimes feel like a full-time job. The constant checking of blood sugar, insulin doses, and meal planning can lead to “diabetes burnout.” Here’s how you can handle it:

Take breaks: It’s important to rest and not let the demands of managing diabetes overwhelm you. Mental health matters.

Connect with others: Whether it’s a support group or a close friend, talking to others going through the same thing can help you feel less isolated.

Simplify your routine: Consider planning your meals for the week or setting reminders to check your blood sugar at specific times.

Remember, it’s okay to have challenging days. Taking care of your mental and emotional health is just as important as managing your diabetes.

Busting Common Diabetes Myths

There are many misconceptions about diabetes, and it's essential to clear them up. Here are some common myths debunked:

Myth: Only older people get diabetes.

Fact: Type 2 diabetes can develop at any age, especially with risk factors like obesity and inactivity. Type 1 is typically diagnosed in children or young adults.

Myth: People with diabetes can’t eat sugar.

Fact: People with diabetes can eat sugar in moderation. The focus should be on balanced meals and portion control.

Myth: Insulin is a cure for diabetes.

Fact: Insulin is a tool to help manage blood sugar, but it doesn’t cure diabetes. It’s just part of the treatment plan for many.

Understanding the truth behind diabetes is key to managing it effectively. Don’t let myths stop you from seeking the right care and information.

Diabetes and Mental Health: Why It Matters

Living with diabetes can take a toll on your mental health. The constant management of blood sugar levels, medication, and potential complications can lead to stress, anxiety, and depression. Here’s why mental health should be a priority:

Stress affects blood sugar: Chronic stress can make it harder to control blood sugar levels, leading to more fluctuations.

Diabetes-related anxiety: The fear of complications or dealing with daily management can cause emotional strain.

Depression and motivation: Feeling down can affect your ability to take care of yourself, making it harder to manage your condition.

If you feel overwhelmed, talk to a professional who can help. There are also support groups for people living with diabetes, where you can connect with others who understand.

[felicitymatima13]

Understanding the Role of Occupational Therapy in Mental Health Recovery

When we talk about mental health recovery, most people immediately think of therapy or medication, and I have to admit, I was one of those people. I had to sit down and ask myself the other day when I was preparing to go on my psych block for the first time since last year that what is going to be my role exactly here? Well, now I know the answer but I didn’t know before, OT focuses on helping people find meaning in their daily activities, which can play a huge role in their mental health. Research shows that engaging in these meaningful activities can improve mental health by adding structure, purpose, and better ways to handle stress (Crisp, 2022).

As an OT student, I’ve often wondered how our work fits into mental health, especially with clients who don’t have obvious physical problems. This was exactly my experience a few days ago when I was preparing my write-up and trying to decide on an activity for my client. I found myself thinking, “What activity should I choose?” My previous physical block seemed more straightforward—patients had clear physical limitations, so it was easy to identify activities to do with a patient like bathing or dressing. But now, faced with a client who has bipolar disorder and substance use disorder, I was confused. This person could bathe and dress themselves—so what was my role here as an OT? 

My confusion made me question the unique role of OT in mental health settings. What do we offer that psychologists, social workers, or psychiatrists don’t? As a third-year student, this felt like a question I should already know the answer to, especially since I’d had a psychosocial block before and I also know that OT is just way more than bathing or dressing. According to Homewood Health Centre (2024), OTs help individuals with mental health challenges engage in meaningful activities and improve their overall well-being. This made sense to me—but what if the patient already knows how to do those activities? They have no physical limitations, so for example with my patient, how does bipolar disorder affect their ability to function?

It was only after I thought deep and read through my observations and deductions that I wrote down before when I saw the light. As I thought more about it, I remembered that OT isn’t just about physical ability. For example, someone with bipolar disorder—especially during a manic phase—might struggle with attention, concentration, and task completion (Stan Clark, 2021). These challenges can make it difficult for them to perform activities like cooking, grooming, or leisure tasks that require sustained focus. This realization was a breakthrough for me. Even though my client might not have physical impairments, their mental health condition impacts their ability to complete activities that require cognitive skills, attention, and emotional regulation.

We always hear the word holistic in class and that’s what OT is- HOLISTIC, that’s what’s makes us unique. We look at the whole person—not just their physical abilities, but also their cognitive, emotional, and social needs. In the case of my client with bipolar disorder, I could focus on helping them improve their task completion skills through structured activities. These activities could also be used to teach mindfulness, develop effective coping mechanisms, and set healthy boundaries—areas where OTs can make a big difference (Courtney Gardener, 2024). It’s different from the work of psychologists or psychiatrists because we focus on practical, everyday tasks that help clients integrate therapeutic strategies into their daily lives.

Reflecting on this experience, I realized how i was so stuck in the mindset of my previous block. I was so focused on physical limitations that I wasn’t thinking “outside the box” as an OT should. This experience taught me that being an OT, especially in mental health, requires flexibility, creativity, and a holistic view of the person. It’s not just about what the client can or can’t do physically; it’s about how their mental health impacts their overall functioning and quality of life. It’s about helping people find meaning in their everyday lives, even when they seem capable on the surface

So, why are OTs in mental health? Because we bring a unique, holistic perspective that considers the person’s ability to engage in meaningful activities, their cognitive and emotional challenges, and their environment (HPCSA, 2022). We help clients navigate the complexities of their mental health conditions in a way that’s practical and grounded in everyday life. That’s what makes our role so essential—and it’s why I’m proud to be on this journey, even when it feels overwhelming.

In future practice, I will be definitely considering the fact that every client, regardless of their condition, has the potential to engage in activities that enhance their well-being. Our job as occupational therapists is to guide them toward those opportunities, empowering them to lead fulfilling lives.

REFERENCES

hw_admin. (2023, November 9). The Role of Occupational Therapy in Mental Health Treatment. Homewood Health Centre. https://homewoodhealthcentre.com/articles/the-role-of-occupational-therapy-in-mental-health-treatment/

‌Does Bipolar Disorder Affect Someone’s Ability to Learn? - International Bipolar Foundation. (2021, April 14). Ibpf.org. https://ibpf.org/articles/does-bipolar-disorder-affect-someones-ability-to-learn/#:~:text=Driven%20to%20Distraction%20by%20Mood

‌HPCSA. (2022, November 10). The occupational therapist’s role in promoting mental health -. Hpcsa-Blogs.co.za. https://www.hpcsa-blogs.co.za/the-occupational-therapists-role-in-promoting-mental-health/#:~:text=Occupational%20therapists%20use%20standardised%20assessments

‌Occupational Therapists and Mental Health Interventions - Moving With Hope. (n.d.). https://www.movingwithhope.org/posts/occupational-therapists-and-mental-health-interventions/#:~:text=Occupational%20therapists%20use%20activities%20of

[katlove80]

**From a Bipolar Mind: What It’s Like to Not Be Able to Do Anything But Sleep**

Living with bipolar disorder can be an emotional rollercoaster, characterized by extreme highs and devastating lows. One of the most challenging aspects for me is the periods of debilitating fatigue where it feels like the only thing I can do is sleep. It’s not just feeling tired; it’s an overwhelming sense of exhaustion that seeps into every part of my being, making even the simplest tasks feel insurmountable.

### The Overwhelming Fatigue

When I’m in a depressive phase, my energy levels plummet to the point where getting out of bed feels impossible. This isn't your average tiredness after a long day; it’s a bone-deep exhaustion that blankets my entire existence. The mental fog is so thick that concentrating on anything feels futile. My body feels heavy, and my mind is clouded with a sense of hopelessness. Sleeping becomes a refuge, a way to escape the relentless grip of depression.

### The Guilt and Shame

As I succumb to the need to sleep, guilt and shame often follow. Society values productivity, and there’s immense pressure to be constantly active and engaged. When I’m unable to meet these expectations, I feel like I’m failing. The guilt is compounded by the awareness that others might perceive my need for rest as laziness. But the truth is, bipolar disorder is a medical condition, and these episodes of extreme fatigue are a symptom, not a choice.

### The Isolation

During these times, isolation becomes a significant issue. The world keeps moving while I’m stuck in a cycle of sleep and inactivity. It’s hard to reach out to friends or family when I’m in this state, partly because I don’t have the energy, and partly because I fear judgment. This isolation only deepens the depression, creating a vicious cycle that’s hard to break.

### Self-Care and Understanding

Managing bipolar disorder is a constant balancing act, and self-care becomes crucial during these episodes. I’ve learned to be kinder to myself and to recognize that rest is a legitimate need. This means creating a supportive environment where I can sleep without feeling guilty and where I can slowly regain my energy. Understanding and compassion from loved ones also make a significant difference. Knowing that I have a support system that acknowledges my struggle helps alleviate some of the emotional burden.

### Seeking Help

If there’s one piece of advice I can give to others in a similar situation, it’s to seek professional help. Therapy and medication can play vital roles in managing bipolar disorder. Talking to a therapist provides a safe space to express feelings and develop coping strategies. Medication can help stabilize mood swings and reduce the severity of depressive episodes, making it easier to manage daily life.

### Conclusion

Living with bipolar disorder means navigating a complex landscape of emotions and experiences. The periods of extreme fatigue and the need to sleep are just one aspect of this condition. It’s essential to recognize these symptoms for what they are—a part of the illness—and not a reflection of personal failure. With the right support and self-care, it’s possible to manage these episodes and find a way back to a more balanced and fulfilling life.

[all-minds-matter]

Hello everyone, Lucas here. I’m a 26 year old learning to live with multiple mental health diagnoses including; BPD, CPTSD and MDD with psychotic tendencies. This journal is my attempt at externalizing my feelings about my journey of healing and hoping that it might help some people who don’t have a voice about their own problems to know they aren’t alone.

My Discovery:

You know that inner voice? The one that’s like a personal GPS, guiding you through life’s decisions, like reminding you to look both ways before crossing or nudging you towards that lemon ice tea you can’t get enough of. It’s a mix of a coach and a critic, especially when you’re beating yourself up over a mistake. But here’s the kicker: I recently discovered that what I thought was just me… isn’t just me. I’ve been hosting an uninvited guest in my head, let’s call him “Jeremy.” This guy, Jeremy, isn’t the cheerleading type. He’s been with me since I was a kid, whispering sweet nothings of the not-so-sweet variety, convincing me I’m less than, leading me down paths best left untrodden.

This revelation hit me like a freight train during a group therapy session focused on the not-so-gentle art of self-talk. We were peeling back the layers of self-criticism when suddenly, my internal dialogue split right down the middle. For the first time, I could hear “Jeremy” as someone separate from me. The realization that I wasn’t alone in my head was terrifying. I mean, hearing voices is one thing I never wanted to check off my list, and here I was, thinking I had just unlocked a new level of “not okay.”

The aftermath of this discovery had me floored — literally. I was a mess, tears and tremors, caught in the grip of fear. It felt like my mind had turned against me. But, salvation came in the form of my psychiatrist’s timely intervention. He explained that “Jeremy’s” presence wasn’t as outlandish as it felt. For someone juggling BPD, CPTSD, and MDD, hearing a voice like Jeremy could be part of the complex tapestry of my mental health. It seems my brain’s eclectic mix of conditions created the perfect stage for Jeremy to perform his unsettling monologues.

A New Chapter:

Switching meds isn’t always smooth sailing, but in my case, the timing couldn’t have been better. I was already in the process of tapering off my old antidepressants when “Jeremy” decided to crash the party. Given the new developments with my diagnoses, my psychiatrist thought it was time to introduce anti-psychotics into the mix. It’s been 2.5 days since I started the new medication, and the difference is night and day. My mood has lifted in a way I hadn’t dared to hope for. “Jeremy” has been unusually quiet, and there’s a newfound sense of joy threading through my days.

While I’m savoring this peaceful phase, I’m conscious that the immediate uplift might be due to the novelty of the new medication. There’s a chance its effects could diminish over time. That’s where my therapy plays a crucial role. Thankfully, my diagnoses respond well to Dialectical Behavior Therapy (DBT), which equips me with skills to maintain this level of mental peace alongside the medication. I won’t lie — it feels daunting. The path to managing my mental health seems like a steep climb, and part of me questions if the effort is worth the reward. However, the thought of the people who care for me, who support me unconditionally, reignites my will to push forward. I owe it to them, and to myself, not to give up.

[tallmantall]

#JamesDonaldson On #MentalHealth - Crisis On Campus: 60% Of #College #Kids Are Living With #MentalHealthDisorders, And #Schools Are Woefully Unprepared

BYMEGAN LEONHARDT NYU student Haruka photographed in Hyde Park in London, England on July 6, 2022. The following article contains experiences of emotional turmoil and suicide. If you or someone you know may be considering suicide, contact the National Suicide Prevention Lifeline at 1-800-273-8255. Starting July 16, 2022, you can simply dial 988 to be connected to trained counselors. For emotional crisis support, contact the Crisis Text Line by texting HOME to 741741.  Isolated, homesick, and dealing with a bad relationship, Jose struggled to find his footing at the University of Texas at Austin’s campus of more than 50,000 students during his freshman year in 2018.  “I really felt like I was internalizing frustration, and I wasn’t in the best mental space,” Jose says. (All students interviewed for this story are identified by only their first names to protect their privacy.) But that first year, he resisted seeking help. “I wasn’t very big on therapy or anything like that. I wasn’t against it, but I thought there was nothing wrong with me.” At the start of the spring semester of his sophomore year, he made an appointment with an on-campus counselor—mostly because the university offered a couple free sessions to students. But while he says the counselor was a good listener, he wasn’t inclined to continue. “I couldn’t really develop a connection,” Jose recalls. When the COVID-19 pandemic hit, Jose moved to Houston to stay with his dad. And his mental state declined even more. “At that point, I was very self-isolated, very in my own head,” Jose says, and he found himself using drugs as a way of self-medicating. “One night, I got into the drugs in a way I’d never done before—in a destructive way,” Jose says. “And I realized, ‘This isn’t me. I don’t know why I’m doing this. I don’t like doing this. I need some help figuring this out because this path that I’m on is not good.’” The next day, he called his mom and asked for help getting into therapy. Jose has been seeing a therapist for the past two years. “It’s really helped my mental health,” he says.  Jose also decided to transfer to the University of Houston during the summer of 2020 to be closer to his family. “Once I made that decision, it just made everything else easier,” he says, adding it was the right course of action even though it meant he wouldn’t graduate in four years.  Jose, a student at the University of Houston, photographed on July 5, 2022. “I’ve been doing more classes in person. And I have been more involved on campus. I’ve taken the time to try to build those relationships,” Jose says. “Thankfully I’m in a much better mental space.” Jose’s experience is far from uncommon—American college students are facing an unprecedented mental health crisis. Three in five (60%) college students reported being diagnosed with a mental health condition by a professional, the most common afflictions being anxiety and depression, according to an exclusive Fortune survey of 1,000 college students conducted by The Harris Poll in June.  That’s significantly higher than the general population, only about 48% of whom say they’ve been diagnosed with a mental health condition.  Women in college are far more likely to report a diagnosis than men: 67% compared with 51%. And part-time students tend to struggle more than their full-time classmates, the survey found.  Despite the high prevalence of mental health problems among college students, counseling services are rarely featured prominently in university brochures. There is no real national database where parents and their college-age children can search to find the best college wellness center. Of those who have received counseling, about 30% have used services provided by their college or university, according to Fortune’s survey findings. That’s likely to climb as more students continue to return to campus in person this fall. But the question remains: Are colleges and universities across the country prepared to handle the mounting mental health concerns of these young adults? Probably not.  “Many counseling centers are really understaffed,” says John Dunkle, senior clinical director of higher education at The Jed Foundation, a nonprofit aimed at suicide prevention among young adults. At the same time, these centers are seeing unprecedented demand from students for a wide range of support. “There was a time when college counseling was about personal growth and career aspirations. Now we are actively treating severe and persistent mental illness—in some cases, with the presence of pretty debilitating symptoms,” says Jonathan Mitchell, assistant director for clinical services at the University of South Florida St. Petersburg’s Wellness Center. On-campus wellness centers “can’t be everything to everybody—and that’s sort of what’s happening,” Dunkle says. Students are showing up seeking support for a variety of problems, ranging from generalized anxiety and depression to eating disorders and even more severe mental psychosis. Some of the more intensive problems cannot really be treated by college mental health counselors, but wellness centers are frequently the first line of defense when students need help.  But when these centers are understaffed and under-resourced, a catchall approach may not be helping students much. And that could lead to long-term consequences for young adults, their families, and even the wider workforce.  The pandemic only exacerbated the many mental health problems college students face Nearly half of college students surveyed by Fortune reported their overall mental health has worsened since the pandemic. About 56% say they have experienced worsening stress, while 53% reported heightened anxiety, and 45% cited increased depression symptoms.  https://datawrapper.dwcdn.net/U5NMh/3/ Yet even before the pandemic hit, students’ mental health was under siege. Over the past decade, rates of depression and anxiety have steadily risen among young adults. “Prior to COVID, there was a lot of distress; there was a lot of anxiety, depression, and burnout,” says Tia Dole, executive director of The Steve Fund, a nonprofit focused on the mental health of young people of color. Two or three decades ago, those trying to get into college simply needed good grades and to be involved in one or two extracurricular activities to get into a good school, Dole says. Now, with the increased competition, students take on so much more in order to gain acceptance to top-tier schools. “A lot of these young people—especially high-achieving young people—arrive at college, and they’re completely burnt out from their high school experience and the experience of getting to college,” Dole says.  The increased diversity of the student body also means that not only are there more students who may need support, but perhaps as well a wider range of symptoms and conditions for counselors to address than in the past, says Doug Hankes, licensed psychologist and executive director of student counseling and psychological services at Alabama’s Auburn University. In the fall of 2020, roughly 53% of the overall undergraduate student population in the U.S. were white compared with 69% of all undergraduate students in 2011, according to the National Center for Education Statistics. But the diversity goes beyond just race and ethnicity, Hankes says. At Auburn, and similarly elsewhere, there’s a mix of students from very affluent families as well as those from low-income households. And the increasing number of first-generation college students may also need additional support.   Social media and the 24/7 news cycle certainly don’t help either. “It’s not that more bad things are happening now than 30 years ago,” Dole says. It’s that the information is constantly at your fingertips now. It’s perhaps not surprising that declining mental health rates among young adults track fairly closely to the rise of smartphones.  “Young people are constantly inundated with information about those bad things. It’s causing distress, anxiety, and worry. What they’re experiencing is a lack of hope for the future,” Dole says. Throw in a global pandemic and the situation becomes increasingly dire. Two years of social isolation has left many college-age students struggling to leave home and make in-person connections. “We’re anticipating a lot more students who are having difficulty coping with the transition adjustment to college,” Hankes says.  While most students experienced increased isolation during the past two years, certain groups were disproportionately impacted by the pandemic, Dole says.  Many in Black and Hispanic households lost family members or faced severe financial setbacks, while at the same time working on the front lines as essential workers. For LGBTQ+ youth, some were sent back home to potentially unsafe environments, Dole says.  “Leading up to the pandemic, there was just this complete and utter exhaustion around the requirements of being a young person. Then the pandemic hit. And different communities were affected differently by it,” Dole says.  The trouble with accessing mental health support at school Three in 10 college students who received counseling have used their university services, but it’s more common to seek out a private therapist or counselor, according to Fortune’s survey. In many cases, that’s because it’s not a quick or easy process to get support on campus.  Many students don’t really know where to start. Just over a quarter (28%) of students strongly agree that they know where to go on campus to receive mental health treatment. When New York University student Haruka started to struggle with an undiagnosed eating disorder during her freshman year, she reached out to the school’s counseling and wellness services via its app. She says the first time she heard about these resources was not from the college brochure or freshman orientation, but rather in an email from her residential assistant (RA) after another student in her dorm died by suicide.  Haruka says she decided to use the app because she didn’t want her two roommates to overhear her on the phone. And she didn’t feel comfortable going in person. It seemed easier to just use the 24/7 chatbot. But when she didn’t receive an immediate reply, she moved on. It was only after she brought up the experience last semester during a routine checkup at the student health center—years after she first reached out—that she got a direct email from a counselor. “I’m not the only one who has experienced this. Everyone thinks that the wellness center isn’t that good,” she says.  The lack of diversity among staff was also a drawback for Haruka. “I do want to see someone who’s preferably female and Asian. But there’s only white people,” she says, adding that because she’s on the student health insurance plan, her options to seek out a private therapist are limited, as the cost likely wouldn’t be covered. In a statement to Fortune, NYU said its students have a variety of options available to them if they need to contact a counselor, including the 24/7 chat service, which is offered in six languages. “It may take a few minutes for a counselor who speaks the language requested by the student to become available, but we have never had a report of a student not reaching a counselor for support at all,” a university spokesperson says. Additionally, NYU said it currently has 60 full-time counselors, nearly half of whom (46%) identify as people of color. About 12% of clinicians currently employed identify as of East Asian origin. There’s definitely a lot of challenges for students trying to access mental health resources on campus. When fully staffed, a college provides an average of 199 clinical hours per week, according to the 2021 Center for Collegiate Mental Health (CCMH) annual report, which included data from 661 institutions. If a college is focused on individual counseling sessions that usually last an hour, that means fewer than 200 students are seen every week. That said, most schools do offer group therapy and other programs in an effort to maximize the staff’s time and reach.  But there is a lot of variability around this capacity, says Rebecca Janis, CCMH associate director of data science. Only about 7% of centers, for example, are even in the range of 193 to 240 hours of clinical capacity, so it’s hard to define what a typical center looks like, she says. Overall, colleges have the equivalent of about eight counselors on staff, according to the Association for University and College Counseling Center Directors’ (AUCCCD) 2021 annual report that surveyed 329 counseling center directors at colleges across the U.S. This isn’t an actual average staff headcount, however, but a calculation AUCCCD runs by comparing the total possible clinical hours available with the average caseload. But that staffing metric ranges dramatically as well. Small colleges with less than 1,500 students typically have the equivalent of about three staffers, while schools with over 45,000 students have closer to 29 on average.  That can mean long wait times for students to get in to see a counselor or therapist. Among those surveyed by Fortune, 58% of students report being put on some type of wait list at their college’s counseling services. Just over one in five were seen within a week, but 10% reported being wait-listed for over a month, and 6% faced such a delay they decided to seek help somewhere else. https://datawrapper.dwcdn.net/5CsrI/2/ The majority of college and university wellness centers surveyed by CCMH are not accredited through the International Accreditation of Counseling Services, nor do 65% have any dedicated staff that provides psychiatric services, according to CCMH findings. There are no real federal or even state requirements that a college must provide enrolled students with mental health services. Although Grand Valley State University in Allendale, Mich., has a student population of over 25,000, upperclassman Amber tells Fortune she didn’t experience an initial delay when she reached out to the campus counseling center in October 2021, when she was dealing with extreme anxiety and panic attacks. But after filling out the necessary paperwork and attending a virtual screening appointment, she was told the center did not have any open slots for individual counseling, only group sessions. “I come from a family of immigrants. No one goes to therapy. So was a very foreign thing for me,” Amber says. “I needed a more intimate one on one.” After declining the group option, the counseling center provided Amber with referrals to three therapists within the community, but she says those proved useless. “The three providers I was given were either not accepting new clients or did not accept my insurance, which was very disheartening and almost caused me to stop looking into getting help.”  Eventually, Amber says she took matters into her own hands and searched for therapists online, finding a provider a week or so later. She still sees her therapist remotely on a biweekly basis. In a comment to Fortune, GVSU noted that its University Counseling Center (UCC) provides short-term services within a stepped-care model, which starts with the least resource-intensive treatment and intensifies or adds services as required. Students who are referred to community services are given multiple referral options, a referral guide, and a community provider database, and receive follow-up contact and assistance from the UCC referral coordinator, the school noted. Daily urgent care remains available to students while they work to connect with a provider.  “Stepped-care has allowed the UCC to provide services to the greatest number of students, with the least amount of wait time and at the lowest cost to students,” the school said in a statement. “University counseling centers are not designed to provide all mental health services that may be desired or required for every student but aim to provide services to help students be successful.” While GVSU’s counseling services did follow up after Amber’s initial outreach, she felt the college’s mental health resources weren’t “as good as I think they advertised. I was hearing was more intimate, and it was more frequent, but it really, in reality, wasn’t.” Red tape and restrictions routinely frustrate students and prevent them from getting the help they need. Many colleges and universities have caps on the number of individual sessions students can attend, and some even charge co-pays, depending on the students’ insurance and financial situation. About 35% report putting session limits on individual counseling, according to CCMH. Moreover, for those who get their health insurance through a university-sponsored plan, it rarely covers mental health services, so those students may have few cost-effective options.  Another major barrier to accessing resources isn’t stigma or financial cost—or even the lack of resources from the university. But rather, it’s inertia; the idea that students feel they may not merit help. Among those not in therapy, half of students surveyed by Fortune say it’s because they don’t think their problems are serious enough to warrant help. A quarter say that the thought of reaching out for help is too overwhelming. “The current interventions that colleges are investing in are not targeting those barriers,” says Sarah Lipson, an assistant professor at Boston University’s School of Public Health and a principal investigator for the Healthy Minds Network. “They’re not acknowledging the fact that students are living in this 24/7, high-pressure environment, and it’s only when they’re in a crisis will students say, ‘Okay, today’s the day I prioritize my mental health,’” Lipson notes. “That’s why we need a broader menu of resources.” Many times, students may be more comfortable first approaching a dining hall employee, a professor, or their academic adviser than calling on the campus counseling services, especially because there are typically very few counseling staff of color or those who identify as LGBTQ+.  “We talk about having no wrong door,” Dunkle says. Universities need to focus on training a wide set of staff and faculty to recognize when a student may be in distress and get them support, even if it’s perhaps only spending some time talking, he adds.  #James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy Link for 40 Habits Signup bit.ly/40HabitsofMentalHealth www.celebratingyourgiftoflife.com ‘Not resourced to do that’  If mental health struggles among college students aren’t a new, post-pandemic phenomenon, why aren’t universities more prepared? A major reason is the scarcity of providers, a problem that extends far beyond just college campuses.  “Universities Read the full article

[harveyhawkscripts]

[A4A] Your Breathe Better Bot [Robot Speaker] [Asthmatic Listener] [Personal Attention] [Possible Series?]

AN: Hopefully this will turn into a series, but even if not I might as well put out this idea that’s been cooking for a while. I was going to do something different, but it’s ragweed time, soooo ¯\_(˶′◡‵˶)_/¯

Google Doc

Usage:

- Okay for monetization

- Please credit me as Harvey Hawk :)

- Tweaks, improv, and pronoun changes are okay! Just please do not rewrite the script completely.

Synopsis: The listener’s father has sent them a personalized Medibot of the Breathe-Better variety. The speaker, Breathe-Better-Bot, or 3B, is here to assist the listener in managing their asthma symptoms. They may also provide some much-needed companionship to the lonely listener. 

Key:

[SFX and Action]

(.) Short Pause

(...) Longer pause

(Voice instruction)

Word count: 1209

----------------------------------------------------------------------------

DAD:

(Voiceover)

Dear Starshine, I’m so sorry that I had to cancel my visit. I know you haven’t been feeling well, but the clinic has been overwhelmingly busy. The next day off I get I’ll be driving up to see you. In the meantime, I’ve sent you something to help keep your asthma under control. It was made by a colleague of mine, and so far, has gotten incredibly positive reviews. I also sent a data chip to personalize your experience, so you don’t have to enter your preferences manually. Let me know how you like it. Love, Dad.

[Cardboard unfolded, shifting packing peanuts]

[Boot-up noises]

3B:

Hello, I am Breathe Better Bot, but you may call me 3B. I am here to help you track and control your asthma symptoms. Please note that I am not a replacement for your current asthma treatment plan as prescribed by your doctor. I am merely here to help you maintain that plan.

Excellent question. I am one of many advanced medical AI robots developed to handle a multitude of medical conditions depending on the patient’s needs. My particular programming focuses on asthma, allergies, and other respiratory illnesses. Your experience can be personalized by filling out the questionnaire shown on my torso screen, or you may insert a data chip from your care provider.

[Click and whirring]

Your preferences have been set, patient Starshine. You can change these any time in the settings. Now, please register your fingerprint on my screen.

Haha, that tickles! Just kidding. That is robot humor.

(.)

Yes, I have many jokes! After all, laughter is the best medicine.

You are curious about my services? Certainly. I can contact your pharmacy to request refills as prescribed by your doctor. I am equipped with a nebulizer, peak-flow meter, and a metered-dose inhaler. My databanks contain extensive medical knowledge, I connect to wi-fi, I am trained to handle a variety of emergency situations, and I can clean. Speaking of –

[Scanning]

Look at all this dust! How are you managing with such a mess, patient?

(.)

You are not? No wonder! When was the last time you cleaned?

(.)

You have not had the energy? Understood. Patient experiences fatigue. I will keep that in mind, in a manner of speaking.

[Vacuuming]

There. Much better.

(.)

No need to thank me, patient. It is what I am programmed for, after all.

(.)

Next order of business: please download the Medibot app onto your phone. You can access any of my data, call me directly, or contact the Medibot help desk.

(.)

Excellent. Next, I suggest we go over ways to manage your symptoms. A clean environment is only the first step.

(.)

Well, we can set a schedule so you do not miss your medication for one thing. Taking medicine inconsistently can often be worse than not taking it all.

(.)

You do not need to apologize, patient. I am not going to chastise you. My only concern is for your wellbeing.

(.)

You may also benefit from an exercise routine to help improve lung capacity. Have you done yoga before?

(.)

Worth a try indeed. I will add it to your regimen. Next, diet and sleep.

(.)

Certainly. Do not worry, though, I will not be too pushy. You are not going to be given a bedtime or put on a diet; I will just make sure you get adequate rest and proper nutrition.

(.)

Understandable. I know this seems like a lot from a respiratory wellness bot, but your father added a few extra features to help improve your quality of daily life. Additional features include but are not limited to daily affirmations, journal app, and dad’s recipes.

(.)

Now I must assess how you are currently managing your asthma. How often do you use your emergency inhaler?

(.)

Noted. How often, if at all, do you wake up in the night with symptoms?

(.)

I see. One more question. How often does your asthma affect your ability to complete daily activities, such as cooking, laundry, and work responsibilities?

(.)

Understood. Thank you for answering my questions, Starshine. I can now create an effective plan to manage your asthma.

(.)

Your medicine? Very well. I will contact your doctor to refill your maintenance medicine as well as provide a fresh inhaler.

(.)

As I do not wish to create a disturbance, do you have any roommates or pets that I should know about?

(.)

No. Your father is registered as your emergency contact. Would you like to change or add emergency contacts? It would be wise to add someone who lives closer to you…

(.)

No additions. Then I have nothing more to ask. Do you have any questions for me, Starshine?

(.)

Apologies, I did not speak to your father. Meeting you has been my first conscious experience. Before this, I was dormant.

(.)

I cannot speak for him, but I am sure he wishes he could come see you himself.

(.)

(Slightly hurt) While it is true that I am simply an automaton, I am highly advanced. I can read human emotions through physical tells, such as increased heart rate and perspiration. I can infer and come to conclusions with the information around me. I can see that you are upset. While I do not know your father, the fact that he sent me to help you lets me know that he cares for you. It tells me he must hold affection for you.

Though a robot, I am not without some semblance of humanity. I was built and programmed by someone who wishes to truly do good in the world; someone who wishes to reduce the suffering of those around him. All of the care that my creator put into building me, that is the care that I offer to you.

(.)

You wish to know about my creator? Perhaps another time, Starshine. It appears this talk has made you emotional, and you are beginning to be short of breath. Allow me to make you some tea instead.

[TIME SKIP]

[Tea pouring]

There. Much better. A warm drink will help relax your chest and open your airways, Starshine.

(.)

The data chip your father provided included your nickname. I hope that it is alright with you, patient. If it is not, you may change it at any time.

(.)

Very well, then. I will continue to address you as such. Is the tea to your liking?

(.)

Excellent! I hope you will not find my presence intrusive. From what you told me your asthma is – if you will excuse me – managed poorly. I simply wish to offer an adequate amount of support.

[Beeping]

Oh dear, it appears my battery is getting low. I will need to set up my charging station soon.

(.)

Anywhere with an outlet will work. I only need enough space for the disk to lay flat so I may stand on it.

(.)

Yes, very compact and convenient. Here, is this spot sufficiently out of the way?

(.)

Your room? I do not wish to intrude on your personal space…

(.)

Very well. Then I will set up my charging station in your bedroom. If you need me, please call on me via the Medibot app.

(.)

I understand having a new companion to live with may be overwhelming. However, I am here to help you. I look forward to caring for you, Starshine.

END

[brucearcherwiki]

Cerebral Palsy and Inclusion

The moment I knew I was different: A story for the fight for inclusion

Growing up with a disability, you may sometimes feel like you are different from your peers. Briar, an adult with cerebral palsy, writes about how she grew to understand that others around her may perceive her differently, and how she handled those perceptions.

As I sat on the bus on my way home from school the reality that I was ‘different’ to everyone else became apparent. I sat with another girl at the front of the bus in the area normally reserved for people with disabilities. She commented, “It was fine for me to sit here because of my hips”. I smiled confused as to what she meant, but then it dawned on me that I was ‘different’; I had a disability. It wasn’t until I became an adult that I realised just how much having a disability made you ‘different’ to others, and that life would be spent fighting to be included.

My cerebral palsy was so mild to begin with that it didn’t really register with me that I was ‘different’ to my peers. I knew that I had a lot more medical appointments and that all the physical therapy hurt a lot. I knew that my handwriting was terrible, and that I must be slightly ‘different’ to others as I got to type all my work at school. I still ran around and played just like everyone else and participated in things I could do, but it wasn’t until that moment on the bus that I realised that I was a person with a disability.

At that moment, I was determined that I wasn’t going to define myself by my disability. What I didn’t realise was how the world would define me by my disability. I was going to study hard, do my best at school, go to university and start a career, all of which I achieved, despite many people telling me I wouldn’t be able to do so. However, as I grew older, I developed more chronic health conditions. With every passing year and new diagnosis, my hopes and dreams of having a ‘normal life’ seemed to disappear.

My cerebral palsy was so mild to begin with that it didn’t really register with me that I was ‘different’ to my peers.

I have found myself in and out of employment, as I’ve struggled to find suitable jobs for a person with multiple health conditions. The barriers to employment come from some employers not being willing to provide flexible employment. It can also come from health professionals believing that I’ll never be in a position to work. I’ve seen that community attitudes towards people with disabilities, no matter how mild the disability, has left me on the outside unable to ever feel fully part of a community.

I have tried my best to show people that despite having cerebral palsy, I think, feel and experience the ups and downs of life just like everyone else. Having cerebral palsy automatically makes you ‘different’ in the eyes of some people. It can leave you on the outside looking in, wearied by the fight to be included. I have experienced the hardships and discrimination that come with being a person with a disability, yet been robbed of developing relationships with people like me because my disability is so mild. At times it has left me feeling isolated and lonely, but it has also given me a reason to get up each morning and continue the fight for change to occur so that people with disabilities can be included in the world in which we all live.

If you need help with managing your mental health and wellbeing, we have a number of information resources available on our site. Visit the Mental Health section for more information on the tools and resources available to support you. We also have a section dedicated specifically to work on our website, so if you are looking for more resources around work and employment, you can find them here.

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