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Addressing Mental Health #B4Stage4

Addressing mental health before Stage 4—this year’s theme for May is Mental Health Month—calls attention to the importance addressing mental health symptoms early, identifying potential underlying diseases, and planning an appropriate course of action on a path towards overall health. Mental health conditions should be treated long before they reach the most critical points in the disease process—efore Stage 4.

“When we think about cancer, heart disease, or diabetes, we don’t wait years to treat them,” said Paul E. Keck, Jr., MD, President and CEO of Lindner Center of HOPE. “We start before Stage 4—we begin with prevention. So why don’t we do the same for individuals who are dealing with potentially serious mental illness?

“This Mental Health Month, we are encouraging everyone to learn the signs, ask for help if needed, address symptoms early, and plan an appropriate course of action on a path towards overall health.”

One of the quickest and easiest ways to determine whether you are experiencing symptoms of a mental health condition is to take a mental health screening. Mental Health America has online screening tools for depression, anxiety, bipolar disorder, and post-traumatic stress disorder at mhascreening.org. MHA’s goal is to get every American screened and aware of their mental health, so they can address it #B4Stage4.

MHA has also developed a series of fact sheets available on its website (www.mentalhealthamerica.net/may) on realizing the critical importance of addressing mental health early, recognizing the risk factors and signs of mental illness and how and where to get help when needed.

May is Mental Health Month was started 66 years ago by Mental Health America, to raise awareness about mental health conditions and the importance of good mental health for everyone.

“When feelings and emotions get overwhelming, it’s hard to know what to do,” Dr. Keck said. “Sometimes, these early symptoms might not ever become serious. Like a cough, they often go away on their own, and are nothing to fear. But sometimes, they are a sign of something more severe and shouldn’t be ignored. Taking a screening is the first step to protect your mental health, and addressing mental illness before Stage 4.”

Research shows that by ignoring symptoms, we lose ten years in which we could intervene in order to change people’s lives for the better. During most of these years most people still have supports that allow them to succeed—home, family, friends, school, and work. Intervening effectively during early stages of mental illness can save lives and change the trajectories of people living with mental illnesses.

“Prevention, early identification and intervention, and integrated services work,” concluded Dr. Keck. “When you address symptoms before Stage 4, people can often recover quickly, and live full and productive lives.”

For more information on May is Mental Health Month, visit Mental Health America’s website at www.mentalhealthamerica.net/may.

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When we think about cancer, heart disease, or diabetes, we don’t wait years to treat them. We start before Stage4—we begin with prevention. When people are in the first stage of those diseases, and are beginning to show signs of symptoms like a persistent cough, high blood pressure, or high blood sugar, we try immediately to reverse these symptoms. We don’t ignore them. In fact, we develop a plan of action to reverse and sometimes stop the progression of the disease.

So why aren’t we doing the same for individuals who are dealing with potentially serious mental illness?

When you or someone close to you starts to experience the early warning signs of mental illness, knowing what the risk factors and symptoms are will help to catch them early. Often times, family and friends are the first to step in to support a person through these early stages. Experiencing symptoms such as loss of sleep, feeling tired for no reason, feeling low, feeling anxious, or hearing voices, shouldn’t be ignored or brushed aside in the hopes that they go away. Like other diseases, we need to address these symptoms early, identify the underlying disease, and plan an appropriate course of action on a path towards overall health. Mental health conditions should be addressed long before they reach the most critical points in the disease process—Before Stage 4.

Many people do not seek treatment in the early stages of mental illnesses because they don’t recognize the symptoms. Up to 84% of the time between the first signs of mental illness and first treatment is spent not recognizing the symptoms.

Mental Health America’s screening tools can help. Taken online at www.mhascreening.org, a screening is an anonymous, free and private way to learn about your mental health and see if you are showing warning signs of a mental illness. A screening only takes a few minutes, and after you are finished you will be given information about the next steps you should take based on the results. A screening is not a diagnosis, but it can be a helpful tool for starting a conversation with your doctor or a loved one about your mental health.

This May is Mental Health Month; Lindner Center of HOPE is raising awareness of the important role mental health plays in our lives and encouraging members of the community to learn more about their own mental health and to take action immediately if they are experiencing symptoms of a mental illness.

Mental illnesses are not only common, they are treatable. There is a wide variety of treatment options for mental illnesses ranging from talk therapy to medication to peer support, and it may take some time for a person to find the right treatment or combination of treatments that works best for them. But when they do, the results can be truly amazing and life changing. Lindner Center of HOPE wants to help people learn what they can do both to protect their mental health and know the signs of mental illness #B4Stage4.

It’s up to all of us to know the signs and take action so that mental illnesses can be caught early and treated, and we can live up to our full potential. We know that intervening effectively during early stages of mental illness can save lives and change the trajectories of people living with mental illnesses. Be aware of your mental health and get screened #B4Stage4 today!

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Liza Long with luncheon guests including Craig and Frances Lindner — Liza Long poses with luncheon guests, including Frances and Craig Lindner.

Over 320 people were in attendance at an annual spring fundraiser for Lindner Center of HOPE on Tuesday, April 21, 2015 to be inspired by keynote speaker Liza Long.

Long, author of the nationally recognized essay, “I Am Adam Lanza’s Mother”, was the keynote speaker at Showering You With HOPE, luncheon and auction, on April 21, 2015 in Hyde Park.

The title of Ms. Long’s keynote speech was “From Talk to Action: Ending Stigma, Finding HOPE.”

Ms. Long is a writer, educator, mental health advocate, and mother of four. One of her children suffers with bipolar disorder. In 2007, she started writing a blog called The Anarchist Soccer Mom, where she first published her December 2012 essay, “I Am Adam Lanza’s Mother” which discussed her personal tragedy as it intersected with the school shooting in Newtown, Connecticut. Since her essay published, Ms. Long has become a national speaker and contributor to several publications, and has also written a book, “The Price of Silence: A Mom’s Perspective on Mental Illness.” Read more about Liza Long at lizalong.com.

Showering You With HOPE was the 7^th annual spring luncheon presented by High Hope’s, Lindner Center of HOPE’s fundraising auxiliary. Proceeds from the event benefit patients at Lindner Center of HOPE.

Event co-chairs were Anne Ilyinsky and Marcie Warrington.

Photos by Robert Flischel

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Proclamation result of City of Mason’s commitment to culture of health, mental wellness

City leaders were joined by leaders from the Lindner Center of HOPE and Assurex Health, both significant contributors to research, innovation, education and health care delivery in the field of mental health, at the April 13 City Council Meeting to commemorate national Mental Health Month (May) and Community Mental Health Education Day (May 3). The City issued proclamations acknowledging both events.

The City of Mason has partnered with the Lindner Center of HOPE, one of the premier mental health centers in the nation, and Assurex Health, a rapidly-growing, innovative precision medicine company, to support their ongoing growth and development. This partnership is a result of the City of Mason’s commitment to fostering a culture of physical and mental health and well-being – from the people who work and live in the city, to the companies in Mason’s thriving Innovation and Biohealth corridor.

The Lindner Center of HOPE is hosting an Education Day on May 3

The proclamation for May 3 being Community Mental Health Education Day coincides with the Lindner Center of HOPE hosting an Education Day event on May 3. This half-day event is a community workshop that will focus on mental illness and addiction. Community-wide education is critical to the mission of giving hope and restoration to those who suffer from mental health issues, as well as their family and caregivers. Providing an Education Day on May 3 to the Greater Cincinnati population is a collaborative effort to enhance awareness of mental illness and addiction, and break down cultural stigma. Registration information is available at lindnercenterofhope.org/educationday or by contacting Kelly Hines at [email protected]; 513-536-0328.

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(Part 1) Introduction and Accidental Overdose

Jolomi Ikomi, MD, Chris J. Tuell, EdD, LPCC-S, LICDC, Lindner Center of HOPE, Staff Psychiatrist; University of Cincinnati College of Medicine, Adjunct Assistant Clinical Professor of Psychiatry

Opioids are indicated in treatment of acute and chronic non-cancer pain. Opioids are psychoactive substances and can cause an increased sense of euphoria via their action on the brain opiate receptors. This effect, which is beneficial for altered pain perception, is also the main reason for their misuse potential.

Opioids can be highly addictive. When used for recreational purposes, or when prescribed by treatment providers and not adequately monitored, can progress rapidly to an opioid related disorder. Opioid related disorders include opioid use disorder, opioid withdrawal, opioid intoxication, opioid induced mood disorder, opioid induced anxiety disorder and opioid induced psychotic disorder. There is an increased prevalence of mental illness in individuals with opioid related disorders than within the general population. About 90% of patients with opioid dependence will also have an additional psychiatric disorder, most commonly major depressive disorder, alcohol use disorders, anxiety disorders and personality disorders.

Since the 1990s, there has been greater awareness about adequate pain control for patients experiencing not just acute pain, but also chronic non-cancerous pain. This has led to an increase in the rise of prescription opioids, which in turn has led to a steady rise in opioid prescription addiction. The United States and Canada have significantly higher rates of prescribed opiates than any other developed country in the world. Prescription opioids are costly and the high cost of obtaining them has led individuals to seek cheaper alternatives. Heroin resurgence has occurred in the last decade. Patients addicted to prescription opiates are seduced by its cheap price and more rapid onset of action. Increased prevalence of heroin use has led to a rise in drug related felonies (larceny, prostitution) and medical complications such as HIV and Hepatitis C seroconversion and accidental overdose.

Accidental Overdose

Opioid overdose is a global health concern accounting for considerable mortality among patients with opioid use disorders. About 50% of all deaths of heroin users in the United States are as a result of opioid overdose. 73% of all prescription overdose related deaths are due to prescription opioid medications.

To understand overdose, we first need to define the term “Tolerance”. This refers to an individual requiring more of a psychoactive substance to achieve a desired effect or when the same dose of a previously used substance does not give the desired effect. Individuals with opioid use disorders develop tolerance to the drug over a prolonged period of time. Opioids have respiratory depressant as well as euphoric effects. Tolerance to respiratory depressant effects occurs much slower than to the euphoric effects. This means whenever an individual rapidly increases the amount of the drug used in order to achieve a euphoric effect, they are at significant risk of respiratory compromise and death. Tolerance also rapidly decreases during periods of abstinence, such as following an opioid detoxification. Risk of overdose is greatly increased during the immediate opioid detoxification period. This is as a result of intense craving for the drug, as well as loss of tolerance to the drug.

Treatment of Overdose

Naloxone (Narcan) is a short acting opioid receptor blocker that is a life saving measure and should be immediately administered in suspected overdose. Signs to look for in an individual with suspected overdose include diminished level of consciousness or coma, pinpoint pupils and respiratory depression with rate less than 12 per minute (normal is 12-20). Administration of intravenous Narcan works within 2 minutes and slightly longer if given intramuscularly. This medication is safe and has no significant side effects. The main draw back with Narcan is the short half-life so its effects last much shorter than the effects of most opioids. Thus, once the medication has been administered, emergency medical services must be called immediately. Failure to do so will lead to immediate return of overdose symptoms within minutes, after effects of Narcan have worn off.

Administration of Narcan is easy and everyone, not just trained professionals can administer it. It can be administered in the community by trained lay persons. Family members and friends usually witness early symptoms of overdose. Training the support network as well as the individual with a history of opioid use disorder is imperative for the risk reduction of overdose deaths. Prescription of a Narcan kit to all individuals with a history of opioid use disorder has been shown to significantly reduce overdose deaths in the community. This is being practiced in some European countries and in several states across the U.S.

Narcan is not treatment, it is only an emergency life saving measure to prevent death and buy time before the arrival of emergency services and referral to treatment centers for long term treatment. Long-term treatment of opioid use disorders will be discussed in the subsequent series.

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Center’s Fundraising Auxiliary to Feature National Speaker as Call to Action to Fight Stigma Surrounding Mental Illness

Liza Long, author of the nationally recognized essay, “I Am Adam Lanza’s Mother”, will be the keynote speaker at Showering You With HOPE, luncheon and auction, on Tuesday, April 21, 2015 at 10:30 a.m. at Cincinnati Country Club.

The title of Ms. Long’s keynote speech for April 21^st is “From Talk to Action: Ending Stigma, Finding HOPE.”

Showering You With HOPE is the 7^th annual spring luncheon presented by High Hope’s, Lindner Center of HOPE’s fundraising auxiliary. Proceeds from the event will benefit patients at Lindner Center of HOPE. The silent auction will begin at 10:30 a.m. with lunch and program at noon. Ms. Long’s book will be available at the event, where she will be available for signing.

Tickets for the luncheon are $75 per person or $750 for a patron table of 10. Reservations are limited and can be made at https://www.regonline.com/builder/site/Default.aspx?EventID=1688581.

Event co-chairs are Anne Ilyinsky and Marcie Warrington.

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Singer and Actress Mackenzie Phillips to Open Half-Day Workshop with Keynote Address

Lindner Center of HOPE employees raised funds this past fall and winter to be able to offer the community an Education Day on Sunday, May 3, 2015. As education is the key to understanding, the half-day workshop will enhance awareness of mental illness and addiction and ultimately, help reduce stigma surrounding these conditions.

The Education Day will be held at Manor House, 7440 Mason-Montgomery Rd. in Mason from 11 a.m. to 4 p.m. Registration and an information fair opens at 11 a.m. with buffet brunch opening at 11:30 a.m. Lindner Center of HOPE President and CEO, Paul E. Keck, Jr., MD, will welcome the community at noon and introduce the keynote speaker, Mackenzie Phillips, actress and singer. Phillips’ presentation will conclude at 1 p.m. with three hours of breakout sessions following. Guests will be able to customize their afternoons with sessions that will most benefit them, as at least four topics will be available for each of three breakout session timeslots. Topics include eating disorders, addiction, mood disorders, anxiety, adolescent mental health, obsessive compulsive disorder and more.

Registration and the full schedule are available at lindnercenterofhope.org/educationday or by contacting Kelly at [email protected] or 513-536-0328.

Event partners include: Assurex Health, Prestige and City of Mason.

Mackenzie Phillips is an actress and singer best known for her roles in American Graffiti and as a rebellious teenager on the well-known sitcom One Day at a Time. As a troubled teen star, Phillips struggled with addiction and depression. Now she serves as a Recovery and Treatment Advocate.

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Chris J. Tuell, EdD, LPCC-S, LICDC, Lindner Center of HOPE, Clinical Director of Addiction Services; University of Cincinnati, Department of Counseling, Adjunct Professor, Addiction Studies

For many of us growing-up in school, February was all about the Presidents, most notably, Abraham Lincoln. As our opinion of politicians has waned over the years, we can only wish that our political choices were of the caliber of our 16^th President. Though the history books play a significant role in our perception and understanding of the “rail-splitter” from Illinois, it often becomes easy for us to forget that Abraham Lincoln was very human. Lincoln led this nation through its worst crisis, while at the same time battled his own internal war of chronic depression.

At the age of 32, Lincoln writes, “I am now the most miserable man living. If what I feel were equally distributed to the whole human family, there would not be one cheerful face on earth. Whether I shall ever better, I cannot tell; I awfully forebode I shall not; to remain as I am is impossible.”

Within the past few years, recent books and articles have addressed Lincoln’s melancholy by examining his own letters and the recorded observations of those who knew him. Lincoln scholars have clear evidence that he suffered from depressive episodes beginning in his twenties and lasting throughout the rest of his life. Lincoln’s school teacher, Mentor Graham stated, “Lincoln told me that he felt like committing suicide often.” Law partner and biographer, William Herndon, stated, “He was a sad looking man, gloomy, and melancholic.” Herndon adds, “His melancholy dripped from him as he walked.”

Depressive disorders affect approximately 18.8 million American adults or about 9.5% of the U.S. population age 18 and older in a given year, according to the National Institute on Mental Health. Depressive disorders may include: Major Depressive Disorder, Dysthymia (an ongoing, low grade depression), and Bipolar Disorder (mood swings of depression and mania). Depression can affect every aspect of one’s life: physical health, sleep, eating habits, job, and your relationships with friends and family. It affects thoughts, feelings and behaviors.

Lincoln was a man with human strengths and frailties. His depression or melancholy did not define who he was as a person, nor can the same be said for the millions of individuals who suffer from depression every day. Depression is one of the most common and most serious mental health issues facing people today. It is also one of the most treatable.

Lincoln had much cause for sadness throughout his life. His only brother died in infancy. His mother, an aunt, and uncle died from an epidemic when he was nine years of age. Ten years later his sister died giving birth to a stillborn infant. Historical records indicate that Lincoln’s mother and father were disposed to melancholy and that one side of the family “was thick with mental disease.” According to mental health professionals, bereavement in childhood can be one of the most significant factors in the development of depressive illness in later life.

As an adult, Lincoln experienced the loss of a close friend, Ann Rutledge, of whom who he grew fond of while living in New Salem, Illinois in 1835. As a father, Lincoln experienced the death of two young sons, Eddie and Willie. As Commander-in-Chief, one can only imagine the emotional toll the Civil War had upon Lincoln and the 680,088 lives that were lost in its cause.

Before the age of psychotherapy and medication, Lincoln learned to live with his depressive disposition. He would frequently utilize humor and story-telling to elevate his mood and distract himself from his depression. Only his closest friends had any insight concerning the extent of his condition. Learning how to manage his life with his depression was his only choice. The only other option would have been for him to succumb to these adversities. It does not appear that it was in the 16^th President’s persona to acquiesce. Lincoln persevered and served this country eloquently.

We can only speculate what Lincoln would say or do about our current state of political affairs, or even what thoughts he may have towards the new millennium’s understanding of depression and mental health. But now, some 150 years later, Lincoln’s historical persona continues to “belong to the ages.” Abraham Lincoln believed in the human spirit and spoke of the role we must all serve toward one another. This was no more clearly expressed than through Lincoln’s own words, “With malice toward none; with charity for all.”

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© 2014National Eating Disorders Association.Permission is granted to copy and reprint materials for educational purposes only.National Eating Disorders Association must be cited and web address listed.www.NationalEatingDisorders.org Information and Referral Helpline: 800.931.2237

The goal of National Eating Disorders Awareness Week is to put the spotlight on the seriousness of eating disorders and to improve public understanding of their causes, triggers and treatments. By increasing awareness and access to resources, we can encourage early detection and intervention, which can improve the likelihood of full recovery for millions.

This year the National Eating Disorders Association is focusing on the importance of early intervention and recognizing the diverse experiences of people personally affected by disordered eating. Too often, signs and symptoms are overlooked as insignificant behaviors when in fact many of these are early warning signs of eating disorders.

If someone is exhibiting signs or thoughts of struggling with an eating disorder, intervening during the early stages of development can significantly increase the likelihood of preventing the onset of a full-blown eating disorder. It also leads to greater chances of a full recovery. It can prevent years of struggle and can even save lives. A key goal of NEDAwareness Week is to direct individuals to a free online screening for eating disorders at MyBodyScreening.org.

Educating yourself and those around you about eating disorders is a great way to get involved. Correcting myths and spreading awareness about the facts are important steps to eating disorder prevention. Visit NEDAwareness.org to review information about how eating disorders develop and why they are so complex, as well as finding out how you can be proactive in recognizing contributing factors and being a part of the fight against these life threatening illnesses.

While eating disorders are serious, potentially life-threatening illnesses, help is available and recovery is possible. It is important for those affected, and their loved ones, to remember that they are not alone in their struggle. Others have recovered and are now living healthy fulfilling lives. Let the National Eating Disorders Association (NEDA) be a part of your support network. NEDA has information and resources available via our website and helpline: www.NationalEatingDisorders.org, NEDA Helpline: 800-931-2237.