Our CureTalk Mental Health Panel Discussion is coming up on Tuesday and I can’t wait! I think it’s going to be wonderful, both for us as panelists and for the listeners. This is the first time I’ve ever participated in something like this, so it’s very exciting. If you’re interested in tuning in on Tuesday, May 14th at 4pm PST, please RSVP at CureTalk’s website.
I read an article in NAMI Advocate Spring 2013 issue titled “Genes and Diagnosis: One Key Puzzle Piece Revealed.” The article was written by Dr. Ken Duckworth, NAMI’s Medical Director. Dr. Duckworth writes about his own experience working with young adults who have recently begun to experience psychosis. I mentioned in my previous blog post about the currently accepted practice of using DSM diagnoses that are based on a consensus about clusters of clinical symptoms. Dr. Duckworth states that because there currently is no neurobiological diagnostic framework that reflects precisely what is happening in his patients brains, he, and every other psychiatrist must “organize symptoms into reliably observed clusters to drive his diagnostic thinking.”
Dr. Duckworth also mentions a February 2013 study published in the journal Lancet titled, “Identification of Risk Loci with Shared Effects on Five Major Disorders: A Genome-wide Analysis.” This study is also moving the field of psychiatry toward diagnoses rooted in neuroscience rather than symptoms. “The study team found that having a few key genes can raise the probability of an individual developing any one of the following mental illnesses: schizophrenia, bipolar disorder, ADHD, depression and autism.” The problem is that different individuals with the same gene(s) may exhibit different clusters of symptoms. Dr. Duckworth states that this is probably because of the impact of the individual’s environment on gene expression, the interaction of multiple genes, or other unknown factors.
As far as I can tell, neuroscience is a very complicated field, and I’m sure that I will never come close to understanding the complexities of the brain. I admire the scientists who undertake this critical yet mysterious field of research. I believe the more we know about how our brains function, the better. I also believe that we should not forget about the human (social, emotional, thinking, feeling, remembering) component of these types of mental illnesses. Helping people to live healthy, happy lives while managing a severe psychiatric illness is more than just understanding what went wrong in their brain. It is also about understanding and tapping into the ability each person has to heal themselves.
In a few weeks, the American Psychiatric Association will release its new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The DSM-IV was released in 1990. The DSM is used by virtually everyone who works in the field of psychiatry to diagnose mental illness. About one week ago, Thomas Insel, the Director of the National Institute of Mental Health released a statement titled Transforming Diagnosis, in which he describes various problems with the way the DSM is used to diagnose mental illness. Insel states, “DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. Their weakness is their lack of validity.” Insel goes on to describe how mental illnesses are still defined and diagnosed according to agreed upon clusters of symptoms, (i.e. auditory hallucinations, visual hallucinations, delusions, paranoia, etc… for schizophrenia) rather than according to an objective laboratory measure. He compares this to diagnosing and treating a patient based on the “nature of their chest pain” or the “quality of their fever”. In Insel’s statement, he describes a new NIMH project called the Research Domain Criteria (RoDC) that aims to create a new classification system for mental illnesses based partly on genetics, imaging, and cognitive science. Although this is a decade-long project that is just beginning, Insel believes that patients and families will benefit from this shift in defining and diagnosing mental illnesses, as it is a step toward “precision medicine”, the movement that has transformed cancer diagnosis and treatment.
On Tuesday, May 14th, we will be discussing the use of brain, cognitive and genomic data to identify and treat mental illness with Dr. Fallahpour. Dr. Fallahpour is currently helping develop one of the largest databases of brain, cognitive, and genomic data across mental disorders, and his work uses a personalized approach in the diagnosis and treatment of neuropsychological disorders. We will also be discussing how this type of data can be used to better help those suffering from mental illness. Please join us next Tuesday!
I was extremely shocked and very surprised when I heard a story on the local news recently about a Nevada psychiatric hospital that has been discharging mentally ill patients with nothing more than a one-way bus ticket out of state. The Sacramento Bee reported that the Las Vegas Rawson-Neal Psychiatric Hospital bought bus tickets for more than 1,500 mentally ill patients over the past 5 years, although Nevada officials maintained that nearly all of those discharges were “appropriate”. Some of these patients had been given one-way bus tickets to San Francisco, and San Francisco City Attorney Dennis Herrera’s office launched an investigation into the alleged “patient dumping” from Las Vegas.
How can a psychiatric hospital, a hospital whose sole purpose is to care for the mentally ill, treat its patients so inhumanely? This incident makes me question what kind of people are employed at the Rawson-Neal Psychiatric Hospital? People who do not care about the plight of the mentally ill should not be employed in a psychiatric hospital. To me, the decision of the Rawson-Neal staff to “discharge” their patients with nothing more than a one-way bus ticket to San Francisco is the decision of a person who has mental health issues themselves. How could anyone be so cruel?
I imagined myself as a patient at the Las Vegas psychiatric hospital waiting to be discharged, only to receive a one-way bus ticket to a huge city I had never been to before. I had no food, no medication, no one to contact in San Francisco, and I didn’t know anyone there. I brought with me only the clothes that I was wearing at the time. After a long, hot bus ride, we arrived in downtown San Francisco. I stepped off the bus, and look around. Where was I? I was hungry, and it would be dark in a few hours. What would I eat? Where would I sleep? I’m a woman. San Francisco is more dangerous for me.
I can’t imagine anything more terrifying for a mentally ill person to experience, yet are the Rawson-Neal Psychiatric Hospital staff concerned about any of the patients they “discharged” to major metropolitan areas over the past 5 years? Probably not. “San Francisco Health Director Barbara Garcia said outreach workers in the past year identified two psychiatric patients who arrived in the city on buses after being discharged from Rawson-Neal with neither relatives nor treatment plans awaiting them in San Francisco.” This is scary. We need to take care of the mentally ill, not transport them to urban areas to become homeless and live in shelters for the rest of their lives. What if this happened to you?
I continued revising my manuscript this afternoon. I realize that I’ve got quite a bit of material to work with, but it needs to be better developed. Now I’m on my 2nd draft. Still, it’s coming along and I feel like I’m on the right track. I keep telling myself, as difficult as it is to tell my story, it will never get written unless I write it! I try to write every day except the weekends, and for the most part, I’m doing it. I’m still keeping my blog and I’m still writing guest posts for CureTalk, so it’s getting to be quite a bit of writing!
Mentally and emotionally, I’m doing better and continuing to make progress. I’m monitoring my negative thinking to make sure it doesn’t spiral out of control. I’ve found that whenever I need a cheerful, happy thought to cheer me up, all I need to do is think about my writing. I envision myself a successful writer with my memoir published and working on children’s stories in the years ahead. This is much happier than worrying about what other people think and things I have no control over. When it comes right down to it, the only person we really have any control over is ourselves. We cannot change the people around us, we can only change ourselves. I often wish other people around me would change, but I really only have myself to change. I think I’m doing pretty good so far!
For me, confidence is still the key. Especially in large groups of people. I went to a large Buddhist meeting on Saturday, and I immediately felt intimidated by all the other people at the meeting, many of whom I knew. I had the urge to leave in the middle of the meeting to avoid having to talk to anyone after it was over. I really wanted to go to the meeting so that I could support one of my Buddhist friends who was joining the SGI that day and receiving her Gohonzon. Her parents were visiting her, so I met them briefly and introduced myself (which I rarely ever do). I congratulated her, and gave her a book I had bought for young women. I talked to her for a few minutes, chatted briefly with another friend and then John picked me up. It was a very encouraging meeting, but sometimes I dread the end of meetings when everyone gets up and talks to whoever they know that’s there. I usually feel awkward, but if I remember to be confident and smile, I’m ok. I’m so much more happier when I’m confident and friendly than when I am angry and reclusive. It just takes practice and effort – and chanting too, of course!
I created a new Facebook author page for myself today, so now I have two Facebook pages. My new Facebook page I am linking to this website and it will provide information about my memoir, as well as notes and news about mental health issues, writing resources, and publishing. Please feel free to check it out!
I went to my monthly Buddhist discussion meeting last night and it was a really wonderful meeting. We had such an encouraging, inspiring experience from one of our woman’s members about her struggles with her first baby. Every time someone shares their own personal experience about how they have won in their lives with their Buddhist practice, I am encouraged. I always come away with an encouraging piece of guidance or an inspiring tidbit that reassures me that yes, I too can achieve my dreams! This never give up spirit would never be possible without the support and encouragement from the SGI. I know some people turn up their nose at organized religion, but it is so much more encouraging with other peoples’ support!
I also mentioned to one of my Buddhist friends that I will be co-hosting CureTalk’s first panel discussion on mental health in May. A few weeks ago I saw her at the Buddhist Center and she mentioned that she and another young woman are interested in starting a mental health group specifically for SGI members. I think this is a wonderful idea! I know there are many other SGI Buddhists who would really benefit from a mental health support group, and exploring mental health issues from a Buddhist perspective. I’ve been using my Buddhist practice to help improve my own mental health for many years, but it’s a great idea to have a support group for other Buddhists to share their experiences with their own mental health and their Buddhist practice. Even those who have loved ones struggling with their mental health could use the support! This is definitely a worthwhile undertaking, and I’m really looking forward to getting something like this going within the SGI!