Category Archives: Mental Health and Addiction

Brain dysfunction is motive enough

Why are so many so shocked that Stephen Paddock the Las Vegas Mass Murderer had no apparent motive?

If he had been a happily married pediatric surgeon, a father of three children, and volunteered for Doctors Without Borders, I would be shocked.

A compulsive gambler who compulsively collected guns and exhibited traits of OCD who was almost completely disconnected from his community and who was verbally abusive to his girlfriend at times — I am not so shocked.

Brain disorders aren’t given respect. Compulsive gamblers are addicts and addiction can distort brain function. There is no logic with an addict.

Was there some early Alzheimer’s, some paranoia? Agitated depression escalated to psychotic depression? He’s not the first suicide to take others with him.

I just hope his brain is going to science.

 

Leave a comment

Filed under Mental Health and Addiction

Healthcare maze inspired fiction

Ever since I became aware of Bernie Sanders’ platform in the fall of 2015, I have become a bit obsessed with healthcare, because he spoke single payer. Mathematically, it is the only system that makes sense, whether by each state or by the entire nation.

I have several novels started, but only one published, Dream Walking. Recently, it occurred to me that two of my novels were inspired by two distinct healthcare journeys.

I conceived Dream Walking twenty years ago, and it has been through many incarnations. Georgia’s journey through trading addictions and the mental health system is harrowing at times, because although there are many variables in the mental health equation, many of them are not addressed in conventional treatment.

Although brain disorders (a more accurate term than mental illness) and addictions are often braided, they are separate conditions and each needs its own treatment. The subconscious plays a huge role in addiction, which generally is not properly recognized, let alone effectively treated.

I am in the process of writing Baby Fever, a sequel to Dream Walking, which was inspired by my journey toward motherhood. I was a recurrent miscarrier, and then as time ran out had trouble getting pregnant. Without Fern Reiss’s The Infertility Diet: Get Pregnant and Prevent Miscarriage and the detective work of three amazing high-risk obstetricians, I would never have either of my two children. I ended up needing low-level intervention, but if your doctor can’t figure out the underlying issues, it’s hopeless.

For those with overactive imaginations, it’s much easier to tell a story through fiction than memoir.

What’s beyond anyone’s imagination is the twisted and torturous economics that lie at the foundation of our healthcare system. Elizabeth Rosenthal’s compelling An American Sickness details the triumphs of the special interest groups that brought us to where most of us are today — one devastating accident or illness away from bankruptcy and needing a PhD in medical coding to interpret a hospital bill.

 

Leave a comment

Filed under Mental Health and Addiction, Nutrition and Health, Writing and Social Media

The Business of Addiction… 9 Surprising Reasons U.S. healthcare costs the most, yet delivers the least (part 3)

Treating addiction has become a huge business. Rehabs that actually work translate into customers that don’t need to return and a lot less revenue. Addiction takes many forms, such as:

  • Alcohol dependency
  • Drug abuse
  • Clinging to toxic relationships
  • Overeating or compulsive dieting
  • Compulsively using electronics

Until healthcare professionals are trained to recognize functional addiction, and our healthcare system adopts an integrative approach that includes vocational rehabilitation, the cost of treatment and insurance will continue to rise.

Technically, there is no cure for addiction, because it leaves one with an eternal vulnerability toward succumbing yet once more. However, it is possible to figure out its triggers, dynamics, and underlying causes, and to develop routines, alternate coping mechanisms, and tools that make using unappealing and unacceptable…. Or not!

Spiritual disconnection
At its core, addiction is a spiritual disconnection. It is life destroying, not life affirming. It is self, not community.

Lack of sleep, the rapid pace of communication and change, less exposure to nature, less working with one’s hands, and economic uncertainty can contribute to this disconnection and serve as triggers.

Addiction, the subconscious saboteur
Addiction, “cunning, baffling, and powerful,” stunts emotional and spiritual growth. Sometimes, addicts have not learned how to detect, let alone feel, their feelings, and addiction enables them to avoid uncomfortable feelings. Addiction can also stem from the subconscious desire to self-destruct. And sometimes, addictions develop as an attempt to:

  • Soothe symptoms from mental illness, such as depression
  • Cope with processing challenges such as attention deficit disorder
  • Numb the effects or after effects of trauma
  • Deal with the hopelessness of chronic poverty

Pain and denial
Addiction feeds on pain. The addict subconsciously creates pain, so that he or she has a need to feed that pain, soothe that pain, with the addiction.

Addicts live in denial and rationalize their addiction so that they don’t have to let go of it. There is no logic with an addict, and circumstances or others are always at fault.

Author John Bradshaw on compulsivity
Where there is disconnection, there is compulsivity.

  • “The common root of every addiction is compulsivity understood as addictiveness.”
  • “Addictiveness is the inner emptiness we try to fill up with any mood-altering behavior.”
  • “Healing the unresolved grief resulting from abandonment is the way to heal compulsivity.”

Bradshaw On: The Family: A New Way of Creating Solid Self-Esteem

Alternate coping mechanisms
There are oodles of alternate coping mechanisms, but habit is everything, and establishing new routines takes time. Most addicts need a lot of support when attempting to switch from “using” to using alternate coping mechanisms, such as meditation, journaling, prayer, exercise, walking, deep breathing exercises, yoga, tai chi, seeking out a fellow recovering addict, or attending a support group.

Using healthy coping mechanisms can calm one down enough to identify feelings, which is the first step in learning how to process them. Learning how to feel one’s feelings takes time too. Once an addicts stops using and begins owning their actions, they become open to spiritual healing, self-knowledge, maturity, and grit.

Support systems
Establishing support systems helps recovering addicts too. The Internet makes it easy to find meet-ups, churches, temples, support groups, and more. And there’s always volunteering. You might not get paid to volunteer, but while volunteering, you don’t have a chance to spend money either!

Seriously, volunteering can enable you to:

  • Shift your focus away from yourself
  • Help out your community
  • Get involved in a cause you are passionate about
  • Help you polish skills, such as graphic design, professional writing, event planning, videography, and fund raising
  • Network

Leave a comment

Filed under Mental Health and Addiction

Nine surprising reasons U.S. healthcare costs the most, yet delivers the least (part one)

What’s lost in all this discussion about repealing the Affordable Care Act is that U.S. healthcare costs more than every other industrialized nation, yet delivers some of the worst returns. United States Comes in Last Again on Health, Compared to Other Countries (Maggie Fox, nbcnews.com, Nov. 16, 2016), “Americans still pay far more for medical care than people in other rich Western nations but have little to show for all that spending.”

Other countries handle their healthcare differently — they create less expense, but produce healthier, more productive citizens. The way our malpractice insurance system is structured, a culture that promotes unhealthy practices, processed food leading to chronic inflammation, which triggers chronic illnesses, overuse of pharmaceuticals, ignorance as to the role addiction plays, lack of functional medicine, and that it is nearly impossible to compare prices for medical treatment are some of the surprising reasons the entire U.S. economy is held hostage to its healthcare system.

Malpractice not the same in Europe
In single-payer systems such as Germany’s, doctors are not independent operators, they are employees of hospitals, and the hospitals are held accountable and the ones sued. Malpractice therefore is less onerous and less costly. “In the other countries, where doctors working in a hospital are employees, there is internal quality control,” Professor Uwe Reinhardt, Health Economist Princeton University (Frontline, Sick Around the World, How Does it Work for Doctors in These Five Countries?, pbs.org).

The Library of Congress explains further, “The causes of liability for medical malpractice under German law are similar to those encountered under the laws in the United States. German damage awards, however, are still much lower than those awarded in the United States, even though the German awards have increased in recent years.

“The German health care system provides universal access and coverage for the entire population. It is, however, a decentralized and diversified system that consists of more than 200 insurers that compete with each other to some extent,” (Library of Congress: Medical Malpractice Liability: Germany, loc.gov).

Culture of unhealth
Much of our culture subtly promotes and rewards illness and injury, which, in turn enriches pharmaceutical companies, insurance companies, and law firms. Some examples:

  • Apartment buildings inches from freeways – asthma anyone?
  • Sleep treated as optional – Alzheimer’s, obesity, auto accidents… (The Sleep Revolution by Arianna Huffington showcases the research regarding the consequences of sleep deprivation.)
  • Sugar on every corner – eating too much sugar and processed food leads to chronic inflammation of the arteries
  • Sitting nearly all waking hours — Too much sitting linked to heart disease, diabetes, premature death (Julie Corliss, Harvard Health Blog, January 22, 2015, health.harvard.edu)
  • Nutrition treated as a nice to have as opposed to disease prevention
  • Financial stress — post-2008 Sharing Economy…
  • Lack of exercise

And then there’s the job juggle. The more jobs, the more hours, the more commuting the average citizen has to endure, the more the health risk factors pile up.

Poor nutrition creates markets for high-priced pharmaceuticals
Recurrent miscarriages and the ticking of my biological clock prompted me to improve my nutrition. I have, at times, struggled with extreme eating habits since childhood. I found the help I needed to change in a support group that practiced a spiritual discipline. I knew I was an emotional eater, but I discovered that I was sugar sensitive and had an addictive response to sugar and white flour. I learned tools such as planning meals, meditation, outreach calls, and journaling that provided alternatives to overeating and helped me to change my habits.

Hundreds of individuals passed through those meetings. Some had lost 100 pounds or more and had kept the weight off for years. Many had lost 30 to 50 pounds. I used to think that the only consequence from eating too much processed food was gaining weight, but I repeatedly witnessed members sharing significant health improvements with conditions such as diabetes, heart disease, arthritis, and more. Many no longer needed pharmaceuticals to treat their chronic conditions. Not only had they changed their nutrition, but they had changed their attitudes and their lifestyles to make the changes stick.

Preventing heart disease with nutrition
Several cardiologists explain why magnesium and healthy eating are generally the answer to heart disease, not statin drugs.

“We know that inflammation in the artery wall is the real cause of heart disease. Simply stated, without inflammation being present in the body, there is no way that cholesterol can accumulate in the wall of the blood vessel and cause heart disease and strokes. Without sufficient magnesium in the body inflammation results and it is the inflammation that causes cholesterol to become trapped. Quote?” (“Inflammation and Pain Management with Magnesium,” last modified on Feb. 9, 2017, drsircus.com).

“There is no escaping the fact that the more we consume prepared and processed foods, the more we cause inflammation in the body. The human body cannot process, nor was it designed to consume, foods packed with sugars and soaked in omega-6 oils. Treat the inflammation and not the cholesterol (“Treat the inflammation and not the cholesterol,” July 16, 2015, drsircus.com)

I only touched on the link between how eating an abundance of processed food year after year helps to manifest chronic illnesses.

(end of part one of three parts)

Leave a comment

Filed under Mental Health and Addiction, Nutrition and Health

Will effective treatment for addiction ever become the norm?

Addiction is complex, yet simple. Addiction enables you to avoid uncomfortable feelings by escaping, not accepting, one’s reality. Addiction lives in the subconscious and mask’s one’s soul. It is fueled by denial.

The Atlantic’s The Irrationality of AA” reveals seldom talked about treatment options for addiction, but it’s title is curious.

Alcoholics Anonymous (AA) and all the 12-step programs are spiritual programs. Spirituality, faith, is the opposite of rationality. Faith is based on believing in that which cannot be proven or seen, whereas rationality is based on facts, the tangible.

The article quotes AA as having a success rate of seven to eight percent. Good luck applying conventional statistics to 12-step programs. Anyone who has spent any amount of time hanging around addicts knows that someone trying to get clean or sober or cease any type of compulsive behavior, such as overeating or gambling, can try and fail 365 times in one year alone. If each time counts as a failure, then the statistics would be royally skewed.

Rip-off rehab
The Atlantic article tells the story of an attorney, J. G., who started drinking at 15:

He spent a month at a center where the treatment consisted of little more than attending AA meetings. J. G.’s rehab was a rip-off. The documentary The Business of Recovery documents the abundance of flawed rehab facilities throughout the U.S.

Offering only a spiritual remedy to a complex, insidious, and potentially terminal affliction would be akin to firing every medical doctor in every hospital and replacing them with shamans, ministers, and priests.

Addiction is complex, because it often masks many other issues such as mental illness, learning disabilities, post-traumatic stress disorder, poverty, toxic family and/or marital dynamics, consequences from a lack of nurturing or effective education during childhood, and disastrous career choices.

Neurobiology
Except behind the walls of most rehabs, it is no secret that neurobiology often plays a role in addiction ­— some of us are wired to respond dramatically to various drugs such as stimulants, opiates, and sugar. The Atlantic article points out that countries such as Finland routinely assess neurobiological factors in their addiction treatment facilities. The New York Times “The Sober Truth: Seeing Bad Science in Rehab” discusses the relationship between neurobiology and addiction.

Responsible rehab
Whatever brain genetics make someone more likely to be an addict, substances such as opiates further disrupt brain function and create overpowering cravings. Effective rehabs would offer addicts a systematic approach for rewiring their brains so that they don’t crave their fix and would teach how to develop positive habits to counteract occasional cravings. This could involve personality tests and interest surveys, goal setting, and work with addiction specialists, life coaches, and vocational counselors. You have to want something more than getting high, and you have to build support systems and take inventory of every individual in your life and every aspect of yourself.

Change is tough.

Working a program
Attending 12-step meetings can be inspirational, boring, annoying, or a waste of time. However, those motivated to “work a 12-step program” can learn effective life skills for free such as goal setting, practicing gratitude, introspection, accountability, and building a supportive network. For example, practicing gratitude, functions somewhat like cognitive behavioral therapy.

12-step programs are free
Although addiction is often the result of a tangled web of adversities/challenges, our mental health system is its own tangled web. Although 12-step programs are often not enough to address every aspect that led one to addiction, they are free and accessible.

Higher power
J.G. mastered the art of blame that is essential for every addict. He blamed AA for his relapses. J.G. says it was this message—that there were no small missteps, and one drink might as well be 100—that set him on a cycle of bingeing and abstinence.

The use of the word God also hung up J.G.— he must moonlight splitting hairs.

The concept of God baffles me too. However, I do understand the simple concept of higher power — there is something out there more important than myself. I do believe in the spiritual energy of the universe that is manifested in nature. The ocean. The sky.

Related links
Many others were taken aback by The Atlantic article. Here are a number of related links:

Psychology Today, Irrationality of AA? A critique of the article
Huffington Post, Spirituality vs. Science? A Rebuttal to The Atlantic Article, ‘The Irrationality of Alcoholics Anonymous’
Addiction.com, The Irrationality of The Atlantic’s piece on AA (paste link
https://www.addiction.com/8449/the-irrationality-of-the-atlantics-piece-on-aa/)
New York, Why Alcoholics Anonymous Works
If You Work It, It Works!: The Science Behind 12-Step Recovery, a book by Joseph Nowinski, PhD

2 Comments

Filed under Mental Health and Addiction

The stigma surrounding mental health costs us all

You think coming out of the closet is tough? Try coming out of the padded closet. Since an admission of having been treated for mental illness renders one virtually unemployable, it effectively silences most.

Women feel comfortable sharing every gory detail of their labor and delivery experience, yet you won’t hear them standing in line for the potluck chatting about visits to the psych ward, the merits of cognitive behavioral therapy, or springtime mania.

But there’s hope. The editor of Women’s Health disclosed her OCD diagnosis in their May 2016 issue. The issue profiles women who have been treated for mental illness, “Whether we have OCD or anxiety or bipolar disorder or schizophrenia, all of us share one common challenge: stigma. It shrouds mental illness, leaving patients to suffer alone and in silence, fearful of repercussions.”

Coping successfully with schizophrenia
The subhead of this 2015 Women’s Health profile of Rachel Star Withers, a 30-year-old successfully coping with schizophrenia, reads, “I’m hallucinating to some degree 90 percent of the time.”

Withers’ journey to the independent life she lives today involved a lot of trial and error as well as plenty of courage. She developed enough confidence to make a career out of various part-time jobs such as working behind and in front of the camera for cable television shows and teaching acting. In the article, she admits, “I get really edgy if I have to sit at a desk for 40 hours a week.”

Society loses out
Not using an integrative approach for treating mental illness borders on malpractice, because there are so many individuals struggling with mental illness and on disability who could work. Work not only provides independence via self-sufficiency, but also is therapeutic as it engages the mind.

Flawed disability system
The all-or-nothing way disability is structured needs to change. There are many people on disability diagnosed with mental illness who cannot commute, work 40 to 60 hours every week, or work in high-stress environments, but they could work part-time or close to full-time. There should be a formula that lets them replace part or most of their disability with wages (beyond the current token amount), but still stay in the system, because those with chronic illness have times in which they cannot work, which can last for weeks, so that they can get back to equilibrium.

Exercise overlooked
Exercise is one simple accommodation that has been proven to be the most effective treatment for mild to moderate depression. It is given lip service, but not seriously prescribed or monitored. Exercise is biochemistry. Strength training benefits the brain in certain ways and aerobic exercise benefits it in other ways.

Co-occurring disorders
Addiction, including codependency, often accompanies depression and bipolar disorder, yet often it is not addressed or treated. PTSD, learning disabilities, nutritional deficiencies, and vocational challenges can all play a part too, yet pharmaceuticals are expected to fix everything.

Cultural Aspect
With mental illness, part of the problem is cultural. In addition to its stigma, which compromises treatment and career options, our culture celebrates sleep deprivation and endless work hours rather than productivity, and promotes obesity and daily habits that do not contribute to mental health. Try walking a block without encountering a Frappuccino, frozen yogurt, or French fries. There’s candy for sale at the checkout in the hardware store, clothing store, and even sporting good store.

Campaign to fight mental health stigma
Clinical psychologist Lisa Aguilar Slover has undertaken a publicity project, I Am the Face of Mental Illness, that aims to “greatly decrease the stigma attached to having a mental illness.” Quoting from her website:

I hope for a day that someone can say, “I’m sorry, I can’t come into work today, I just had a major panic attack and now I just need to sleep,” in the same way that someone can call and say, “I’m sorry, I’m having a severe migraine and cannot come into work today.”

Leave a comment

Filed under Mental Health and Addiction

Did Lakeisha Holloway temporarily “lose her mind”?

Lakeisha Holloway lost access to her judgment the moment she decided to shelter her three-year-old daughter overnight in an automobile parked on the streets of Las Vegas. Whatever condition Ms. Holloway’s thought processes were in before her “vacation” in Las Vegas, spending several days attempting to care for herself, let alone a three-year-old, from a car (minus a bathroom, kitchen, play area, living space, or heat) could not have improved them. Not to mention that her shelter-on-wheels was being constantly asked to move.

During the days Ms. Holloway and her daughter were living out of an automobile, did any of the hotel staffers who chased the two of them off their employer’s property refer this homeless mother with her toddler in tow to a shelter or call the police? The police would have referred Ms. Holloway to mental health professionals who would have evaluated her, and a tragedy most likely would have been averted.

Words cannot express how tragic it is that a mother of three lost her life while simply taking a walk.

What is mental illness, but the vulnerability to impaired judgment that is not due to the influence of mind-altering substances? What is mental illness, but a brain disorder? If your brain is not functioning properly, who do you become?

According to those who knew Ms. Holloway well, on Sunday, December 20, Ms. Holloway became someone other than herself. Ms. Holloway’s cousin and former co-workers have attested to her character in various news reports. They describe a grateful, loving, spiritual, resilient young woman who loved working for the forestry service.

If Ms. Holloway had brain cancer or had her blood sugar slipped perilously out of control to the extent that it could have impaired her judgment and behavior, would societal wrath be so strong?  Brain disorders that we call mental illness are far more complex to identify, let alone treat. There is no way to prick your finger, draw blood, dip a test strip in that drop of blood, and get a reading that represents the state of your judgment.

I do not believe that Ms. Holloway acted intentionally, that she intended to harm pedestrians. I think she lost her temper, and, in her diminished capacity that was a great departure from her true character, threw a tantrum. Judging from witnesses, she appeared to be in such an impaired state that, at that time, she was possibly delusional or in a dissociative state — not present.

Although at 24, Ms. Holloway is legally an adult, she is still a young adult with a brain not quite fully developed. The development of the prefrontal cortex, the section of the brain that is responsible for judgment, impulsivity, and other executive function is now considered complete at 25.

There might not have been any way to predict that the prefrontal cortex of this vibrant young mother would lose function to the degree that her judgment would become grossly impaired, the filter to counter her anger would disappear, and impulsivity would take over and allow her to vent her frustration and anger with what had become her prison, her car. Does an angry three-year-old understand the consequences of driving a car on a sidewalk? Someone whose brain has become disordered lacks the ability to reason just as a three-year-old lacks that ability.

I pray that Ms. Holloway has access to spiritual guidance as well as an integrative psychiatrist who can help her restore her shattered spirit and teach her how to take care of herself so that she never experiences another break from reality. Brains are our most complex organ, and those who succeed in overcoming their brain disorders learn many strategies to monitor brain function such as tracking their sleep and moods and other aspects of health that influence brain function.

Lakeisha Holloway was a productive member of society once, and she can be again. Her little girl must miss her mommy a lot.

Leave a comment

Filed under Mental Health and Addiction