Category: General

With my background in pharmacy, I spend a lot of time thinking about medications.  In my experience, we typically seem more concerned with adding or keeping medications, not taking them away.  Today I want to touch on deprescribing, which involves ways to potentially reduce or remove the number of medications that are being used by an individual.

When I think about it, deprescribing is very important.  How many people end up on a medication and continue to take it for years when they may no longer need it?  Maybe someone takes a medication that gives them certain side effects, and they start taking another medication to treat the side effects.  Is the medication worth the side effects if you have to use another medication to treat them?  Or, if the medication is beneficial, could the dose be lowered to minimize the side effects and maintain a benefit?  Perhaps the medication does not seem to cause any noticeable or bothersome side effects, but it doesn’t seem to provide any benefit either.  Is there any reason to continue a medication if it doesn’t seem to be helping?  These are all questions that reflect the need to consider deprescribing.

Of course, there are potential risks with deprescribing, and it is something that should be considered and undertaken with a health care provider.  Many medications should not be stopped cold turkey, and many would be safer if they are tapered off over time.  And, since every individual has a different medication regimen, deprescribing is going to look different for everybody, and some people may not be candidates for deprescribing at all. 

Overall, I think deprescribing should be considered every time there is a visit with a health care provider.  Like others things in life, less can be more, and it is important to consider what medications are truly needed.  And, by talking about deprescribing, I am not saying that we get rid of all medications.  Many medications can be helpful and have a place in treatment, but in my opinion they are not always the only answer.  Regardless, I encourage everyone to consider having a discussion with their provider about reducing or removing some of the medications that may no longer be needed.

Perhaps you have heard of peer support before, but for me it has been a somewhat vague term.  Today, I want to explore what peer support is and how it works.  There are many websites available that describe peer support, but today’s information is coming from the following webpage: http://www.mentalhealthamerica.net/conditions/what-peer

In general, a peer is someone that we can identify with in some way (such as someone your age or someone who speaks the same language as you).  In mental health, a peer is typically used to refer to someone who shares the experience of living with a mental illness and/or substance use disorder.  Peer support is the process of giving and receiving encouragement and assistance to reach recovery.  Peer supporters can offer emotional support, share knowledge, teach skills, provide assistance, and connect people with resources.  In mental health, peers offer their unique lived experience with their conditions to provide support focused on advocacy, education, and mentoring.

Peers can facilitate education and support groups and work as a bridge linking people to services as they transition from health care facilities or jails into the community.  Peers also can act as role models, mentors, coaches and advocates.  As you can see, there are many ways that peers can help others and many opportunities for peer support in the community.  Peer support is a another possible option for those facing a mental illness, and I hope this is yet another piece that is considered when thinking about treatment and recovery. 

How about you?  What do you think about peer support?  Is it something you have been a part of or tried?  It is something you have considered?  Based on what little I have read, it seems that peer support will continue to grow and help more and more people, and that is exciting news to share.

Today I want to point out another resource that is available for another group of people – college students.  It is called “Starting the Conversation: College and Your Mental Health”, and it can be downloaded for free on NAMI’s website at https://nami.org/collegeguide.  NAMI worked with the JED Foundation to create this guide.  The JED Foundation is a national nonprofit that helps protect the emotional health of teens and young adults.  The JED Foundation also works on suicide prevention in these age groups.

The guidebook is almost 30 pages long, but it can easily be reviewed if you don’t want to read every word.  Topics covered include talking about mental health with others, managing stress, common signs of a mental health condition, campus resources for mental health, substance use, mental health care on campus, health information and privacy laws, and general mental health resources. 

Like the caregiving resource mentioned in my previous post, I think it is great to have a guide like this available.  I assume a lot of college students would appreciate having help in knowing what they can do if a mental health issue affects them or someone they know.  I also think it is important that we let college students know that it is ok to talk about their mental health and any struggles they may be having.  Everyone needs to know they can get support, and although it might be hard for college students to ask for help, I feel that the more college students hear about it the more they will be willing to get assistance when they need it.

How about you?  What are your thoughts on this guide?  Does it give you some helpful information?  Is it missing important pieces that would be helpful for you to know?  I hope you will take some time to download and review the guide to see if it can be helpful to you or someone you know.

Today I want to point out a resource that is available for caregivers.  It is called the “Circle of Care Guidebook”, and it can be downloaded for free on NAMI’s website at https://www.nami.org/About-NAMI/Publications-Reports/Guides/Circle-of-Care-Guidebook.  NAMI worked with the National Alliance for Caregiving to create this guide.

The guidebook is a little over 50 pages long, but it has many different sections, so you can pick and choose what is important to you if you don’t want to read the entire guide.  It is important to note that the guide is for family, friends, or others who care for an adult with a mental health condition.  Topics covered include finding a compatible provider, communicating with health care workers, making sure you have an accurate diagnosis, discharge planning from a facility, dealing with health insurance, looking into community services that may be available, working with the criminal justice system, planning ahead for the future, confidentiality and involving the family, and self-care. 

Personally, I think it is great to have a guide like this available.  I assume a lot of caregivers would appreciate having help in navigating their roles and responsibilities.  As a lot of us have come to realize, understanding the healthcare system and insurance can be challenging, even if you are not faced with a mental health condition.  And, from what I have seen over the last few years, there is more emphasis being placed on the well-being of caregivers, and I think that is very important.  Everyone needs to be cared for, whether it is by others or by themselves. 

How about you?  What are your thoughts on this guide?  Does it give you some helpful information?  Is it missing important pieces that would be helpful for you to know?  I hope you will take some time to download and review the guide to see if it can be helpful to you or someone you know.

In my last entry I did a brief 2018 year in review.  Now, I want to look ahead to 2019.

Although personally I felt like we did a lot of great things in 2018, I know we still have a lot more work to do.  There is still a lack of education, support, empathy, and advocacy out there, and there is also a lot of discrimination against the mentally ill.  We must keep going until the day that discrimination is completely gone.  We need to continue educating others and working with policy makers to make impactful changes in our society, and we need to continue to use the current momentum we already have for advocating for mental health change.

Next, my hope is that 2019 brings more effective and safe treatment options.  Last year I mentioned treatments such as TMS, ketamine, psychedelics, and EMDR, and it would be great to see more research on these and many other options.  As I have said before, I am very excited about all of the work that is being done to try to understand mental illness and start looking at ways that we can better treat it.  Even more exciting is the work being done to determine how we might be able to prevent these illnesses from occurring in the first place.  Wouldn’t it be amazing to get to a place where we know what to do (or not do) to prevent a mental illness from happening?  My wish is that 2019 will be a year that takes us closer to that reality.

Overall, I think 2019 will hold some interesting and promising new information when it comes to mental health.  Assuming all goes as I plan, I want to continue to explore those topics on my blog.  I hope that you will continue to join with me.

How about you?  What are you looking forward to in 2019?

As I write this entry, it is the last day of the year.  I thought I would use this entry to reflect on 2018, both in a personal sense and as it relates to the topic of depression and mental health.

Personally, I feel like I have worked hard to advocate for mental health and encourage more education and support for those affected by mental illness (which is pretty much everyone in some way).  In my local area we have passed legislation that will bring improvements to mental health, and I think we are seeing more and more conversations around how we can better care for everyone’s mental health, regardless if an illness is present.  There is also a growing interest in mental health education, whether for health care workers, family, friends, schools, and children, among many others.  We continue to see momentum, and I think in my corner of the world we can be proud of our accomplishments.

On a larger scale, I think there is a lot of momentum around mental health as well.  Topics like depression and suicide and others have become part of a larger conversation and are covered in the media on a far reaching scale.  Of course I have a bias, but I feel like you would have to be hidden in a cave to have not heard about mental health at some point in 2018.  This is so important, because the more we talk about it, the more people will understand mental illness and health.  Ultimately, I think this reduces the fear that people have about it, and that can lead to more compassion and support.  2018 has brought me some hope, and I want it to continue into the next year.

How about you?  How has 2018 been for you?  Did you experience any hope around mental health?  What did you learn?

I was meaning to post some more videos to YouTube today, but for some reason YouTube said my first new video was too long. My video was less than 17 minutes, so I do not believe that, but I am also not going to sit around for another hour while it processes and uploads the video only to be told it is “too big”. That being said, if you would like to have all of the video series I have created please let me know, and we will work out a deal. Thanks!

Today I want to discuss another type of therapy I had never heard of until about a month ago, like EMDR (obviously, the conference I went to gave me a lot of new information!).  The therapy I will describe today is called multisystemic therapy, also known as MST. 

According to the Wikipedia article (https://en.wikipedia.org/wiki/Multisystemic_therapy), MST is an intensive family focused and community based treatment program for chronically violent youth.  MST was developed by the Family Services Research Center (FSRC) of the Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina.  In 1996, MST Services and MST Institute was formed.  MST Services is for-profit and distributes and supervises MST information.  MST Institute is non-profit and sets quality assurance standards and monitors program implementation.  Although the specifics of the therapy are not detailed here, it is easy to see why it was named “multisystemic” because of its focus on different systems encountered by the youth.

This is a very general overview, and MST still seems a little vague to me.  Actually, when I heard the term “multisystemic therapy” I thought it would be about looking at all of the body systems to see how they work together to create health or disease.  So, I was way off.  And, like EMDR, I have never heard of anyone who has used MST.  However, at the very least, it is good to know it is out there and possibly another option for youth, some of which might be struggling from depression or some other mental illness.  Although I don’t know much about it, I like the idea of looking deeper and looking at systems instead of assuming the youth may be to blame for everything. 

What do you think about MST?  Do you need more information?  Does its focus on systems sound appealing to you?  Hopefully we will see MST become more beneficial as experience with it increases.

As I write this entry, I have just returned from a long weekend to celebrate Christmas with some of my family.  During the road trip I also got to see a few of my oldest and dearest friends, and it felt so good to see some of my favorite people in the world all in one trip.  And, while it was great to catch up a little bit, it always seems inevitable that seeing old friends and family gets me to thinking about the past.

What could I say about the past that hasn’t already been said?  Of course, my own past is unique to me, and that is honestly mostly what I will touch on today.  What is it about the past that makes me so pensive?  Why does it seem to make me sad sometimes?  Do I ever believe that the past signifies better times in my life?  Is my past better than my present?  Is it better than my future?  I typically like to think that life just keeps getting better, but sometimes I wonder…

However, I think that is where I stop.  I wonder, but I don’t try to relive my past.  What I do try think about are the fun things and the good things that have happened, and I see if I can incorporate some of that into my present life.  For example, I love 80s music, so that is constantly in my life.  I also loved rainbows growing up, and I continue to surround myself with those.

If you are struggling with depression, maybe looking at the past does not help your situation, especially if it might have in some way led to the depression.  However, if this is the case, it might be helpful to think about what you would love to look back on in the future that makes you smile and enjoy some memories.  It may sound simplistic, but connecting with the good things in your past (or your anticipated past) may be a helpful technique for thinking about depression.

Today I want to touch on a topic that I think could be very helpful in the future of mental illness prevention.  It is fairly straightforward, and on paper seems like a fairly simple thing to do.  I am talking about mental health screening for children.

When I think about screenings, I remember some of what I experienced as a child.  I know we had vision screenings and hearing screenings at school, and I think we had some screenings and vaccines done in different health care settings.  The primary goal was to prevent or catch a problem early on and do something about it before it became a bigger problem, and I assume these still happen today.  But, all of the screenings that I have mentioned had to do with physical health – what if there were screenings for mental health?

As it turns out, mental health screening for children is possible.  I do not know if and where it is currently available, but in the state I live in they are recommending universal mental health screenings from birth to at least age 18.  Not all of the details have been worked out yet, but overall the intent is to screen all children.  To be honest, until I heard about this I had never thought about universal mental health screening for children, but now I am a big fan of this idea.  Why not screen all children and possibly prevent or catch problems early on?  I think it sounds like a great idea.

What do you think?  Should all children be screened for mental illness?  How do you think it should be done?  My hope is that this will one day become standard for all children all over the world, and I look forward to seeing this become a part of the care that all children deserve.