Schizophrenia Story

My name is Max. I have had schizophrenia for 9 years, and I want to tell you my story through psychological hell to recovery and hope. I’ll tell you at the beginning that beyond giving you an amusing story about my experience, I eventually want to convince you with my story that I discovered something called “Street Epistemology” that is growing in the atheist community, and that it has helped me get better, along with medication and support from the mental health community.
I was born in 1989 to a wonderful family. I have so many fond memories of growing up. I had a big family get together with all of my aunts and uncles and cousins all going over to my great grandmother’s house and having lunch and a good time together. All of the people in my family were very loving and had wonderful bonds. I was close with my siblings, and my brother and I shared a lot of friends. All of the friends and teachers I grew up with, I feel like were wonderful people, and I felt very bonded to many of them. We went on a lot of family trips growing up, and I traveled in a lot of different parts of the United States, and even to Mexico a few times.

I had no particular health problems, and there would have been no way to predict the hell I would go through when I turned into an adult. I never broke a bone, never had a cavity, never had any major diseases, and although i was prone to a lot of viruses, nothing serious was wrong with my health at all. I did have a teacher in about 4th or 5th grade tell my parents that I had ADHD, because I spent a lot of the time in class staring out of the window. I think she was mistaken that this was caused by a disorder, however. I think the truth is that I was a child full of wonder and energy for the world, and didn’t like to be closed up in the classrooms.

I was a smart kid and I loved to learn, and although I had a joke with one of my friends in middle school that we should “keep from working too hard on schoolwork, so that people didn’t start to get too high of expectations for us”, the truth is I was very successful with the schoolwork I was given. When I got to high school I got to be very shy, and only kept a few close friends. I had an awkward disposition and didn’t talk much, but I still do have a lot of good memories with friends that I kept in high school. I also had some friends that I had kept from elementary school who stayed close with me through high school, so I wasn’t particularly socially unhealthy at that time.

I think my problems really began when my friends and I began experimenting with marijuana. Note that I fully support the idea of legalizing marijuana and truly believe that it could help a lot of people, I just think my problems with it were contextual with the way the experimentation happened within my social life. Me and my friends started getting some problematic behavior, and although I refuse to incriminate myself in this writing, I have some bad memories of some of the things that happened during that time of my life, both alone and with my friends creating problems in our lives.

After getting into that kind of lifestyle smoking pot, and creating problems, I started to experiment with LSD and Mushrooms and any other kind of consciousness altering substances I could get my hands on. I was lucky not to get into anything like heroin or speed or cocaine, but I definitely had my fair share of experimentation with drugs. This is where the problems started to get complicated. I have so many feelings about my what my problems could have been, that it’s hard to tease out what the true cause of my long term problems were.

I have heard some scientific speculation, that some people are more predisposed to developing the problems I had with schizophrenia due to genetics, but I don’t know enough about it to make any judgement on that. All I know is that I have had these problems, and I also have hope that there is a way out of them, regardless of whether or not my genetics are predisposed or not. I did not even notice the problems myself. The only way I came to identify with my schizophrenia was that I knew everyone started worrying about me, and I just felt no way to challenge it, I gave into their worry, and came to identify with a new identity as a schizophrenic person.

I can still remember my symptoms, and I do think it started along with the experimentation with drugs and creating problems socially and personally. I remember some of my friends who did LSD and everything with me, a lot of times romanticized hallucinatory experiences. I had some of them try to guide me into certain hallucinatory experiences as well by certain social oddities. I think this is one of factors.

Beyond all of these problems, I began to have a major interest in Buddhism and Buddhist meditation. When I graduated from high school, I traveled to San Francisco for 3 weeks and stayed in a couple of Zen monasteries. I meditated there with the experienced meditators and learned how to do intensive meditation by sitting with them all in the meditation hall twice daily, as well as doing work around the monastery mostly in silence. I had a great experience there, and loved what I learned, but I think that the baggage I brought there with my previous experiences created a problem when I began meditating. I think I thought of meditation as a kind of way that was identical to the way I thought of hallucinogenic drugs. So I basically started living in those experiences more permanently.

It seemed so reasonable to do this and felt very natural. I think that if that is something that you bring as an expectation to intensive meditation, can actually work. The problem, however, is that it led me away from a rational perspective of reality. I completely lost all sense of reason in my life, and my life became one giant acid trip that I thought was what meditation was supposed to induce for people. It could be argued that I had the wrong idea of buddhism, but the point is that that is what I believed, and part of that included these shared hallucinatory experiences I had in my head. I even used a drug called salvia on the weekends on my trip in San Francisco, another hallucinogen, leading me further and further into this rabbit hole.

During my time in San Francisco, through meditation, I started having a much more powerful and profound experience of my life. I really did try to learn how to do meditation the right way, and I think I was pretty successful overall. I remember a certain time when I started to believe that people there could read each other’s minds through meditation. This is an idea that has scriptural support from the Buddhist literature, although I didn’t know it at the time. I remember sometimes as I was sitting in the meditation hall a lot of what felt like a flashing in my mind of powerful lights going on and off, as my experience became more powerful. I felt very alive, in a way that I don’t think I had ever felt before, in a way that they would call in buddhist terminology, a waking up. But it was only in my experience, my cognitions of what my experience was could not keep up, and I didn’t know how to handle it.

When I got back to my hometown I immediately got back into my drugs, particularly ecstasy, or MDMA. I’m pretty sure the ecstasy was mixed with methamphetamines in what I took, and I decided after I took it, that I would go tell my parents that I had taken it, I guess expecting them to be giving me some sort of supportive experience on ecstasy. That did not happen. There was a major conflict my parents with yelling and screaming, and here I was stuck on this drug. It was such a profoundly negative experience in my life, it do not think it can be put into words. All I remember was a lot of yelling and screaming and accusations, and I was yelling I was convinced that I could read their minds and knew everything they were thinking, which was an idea I picked up through my experience meditating. I wanted them to be able to experience what I had learned through meditation, and I kept telling them to “Wake Up!” repeatedly, and for some reason I remember I wound up taking all of my clothes off in a state of madness. It was terribly traumatizing.

It was after this experience that they started taking me to psychiatrists, and I began getting diagnosed loosely with some kind of psychotic experience. I did not quit using drugs at that time, and my continued use just added to the trauma. I also continued meditating at home regularly, and all of the trauma and drug use and psychotic behavior was right in my experience with the meditation, and it all got interwoven together into my meditative experience, and I think this is when I think my problems started to permanently cement into what would become my schizophrenia. Meditation became my problem solving method, but I it was not sufficient to address the problems I was experiencing, although I was expecting it to. In fact I think it was more likely that it got me fixated on my problems, and unable to move on.

Soon after all of this, my Grandfather began declining into dementia and was dying. I volunteered myself to live at my Grandparents house to help him get along, partially because I was feeling virtuous from the meditation, and partially to get a break from my parents. While I was living there, although I do think I was a bit helpful to my Grandfather and we got to bond before he died, my mind went deep into all of my problems. I think the fact that I was living with him having dementia added a profound layer of sadness and existential anxiety to my experience. After about a month of living there, I had wound up calling the police to on my Grandparents, thinking they were using some sort of evil magic on me. A policeman came, and was very nice and talked to my grandmother, and told me she seemed very nice and that he didn’t think anything was wrong, and that he couldn’t help me. Another symptom at the time was that I was also talking to all sorts of “voices” in my head, mainly spiritual people I looked up to, but also other people in my head, I suppose in an attempt that I could get one of them to pray for me. I was so upset, that I was telling people that I was suicidal, and a few days later was my first trip to the psych ward.

I don’t remember much from my first trip to the psych ward, other than I got started on antipsychotic medication, and was in for about 2 weeks. I just remember laying there in bed thinking “I’m in the loony bin”, “I’m in the nuthouse”, and being extraordinarily overwhelmed and shocked that I of all people was diagnosed with schizophrenia. As I told you, most of my life growing up was wonderful, and I was smart, healthy, and loved. I just couldn’t imagine how I could have been the type of person who belonged there. Just the thought of getting diagnosed with schizophrenia weighed very heavy on me, and was very hard to accept. My mother has told me that she would go into see me in there the first time in visits, and she would try to talk to me, and I had a blank stare and wasn’t responding. I can imagine some of this was from the schizophrenia, some of it was from the medication, but most of it was probably my own shock and grief and indignation that I had landed myself in the psych ward of all places, getting diagnosed with schizophrenia.

When I got out, things didn’t change much, but I had medication now at least that was helping me. I didn’t mind the idea of medication that much, the effects weren’t that bad to me, but I was still in shock. I tried to stay with my grandparents and help some more for a while longer. I got in touch with a girl I knew in high school who I knew had used to have a crush on me in high school, and we began dating. I eventually moved back in with my parents and I think they hired some sort of nurse to help with my grandfather because it became a very hard job and I was too overwhelmed. He died pretty soon after this and it was overwhelmingly sad for me.

I got along with my girlfriend, but it was a strange experience, because she considered herself a Wiccan, so instead of talking me out of my superstitions, my experience with her wound up making my beliefs in magic and mind reading etc., even stronger. Her family also had a lot of it’s own problems with very strong conflict. I kept up with meditation though, because I thought that if my doctor says I’m “split from reality” that meditation would be the perfect antidote for that. We stayed together for about a year, and it was a nice distraction, but didn’t make me any better.

After splitting up with her, I decided to start going to Narcotics Anonymous meetings to treat my problems with addiction. I had a fling with another girlfriend there, relapsed once with her, but got back into recovery quickly. I wound up becoming best friends with her brother. He had similar experiences to mine, and we got along like two peas in a pod. He was older, but he had gotten diagnosed with schizoaffective after a breakdown during an attempt to become a monk at a Catholic monastery, and I thought it was similar to my experience with a breakdown after going to a buddhist monastery, plus we could go to NA meetings together.

He and I were great friends, and we supported each other a lot, mainly by supporting each other’s religious commitments. He was very austere about his beliefs and while I was with him I spent most of my time studying and practicing buddhism, while he did his Catholicism. We became very isolated and didn’t seem to branch out with any other friends while we were friends. We did some, I had a few other friends I met in NA, but not much. Part of the reason was that he was gay and I think looking back this was mainly what led us to isolate together so much, was that he thought of me as a boyfriend. I was trying to ignore that part because I liked that we had so much in common and supported each other as friends so much. However, I think he and I had a habit of supporting each other’s delusions as well, so I didn’t really ever get much better during this time either, and continued going in and out of psych wards every once in awhile. I had fun and I learned a lot on my own though, particularly about buddhist philosophy, which also seemed to be support for my delusions a lot of the time as well.

I kept going to NA meetings, and learning and practicing more about buddhism, and hanging out with him, and that was my life for about 3 years. I loved to read all sorts of stuff beyond buddhism as well, science books at least, and spent a lot of time learning on my own through books, and eventually I discovered audiobooks, and got obsessed with those. One of the books I read was called “Rethinking Madness” by Paris Williams. It was about how he had helped people with schizophrenia recover from schizophrenia to the point that they were eventually able to manage their lives without medication. I didn’t read all of it, but the first part of the book was dedicated to demonstrating the dangerous side effects of antipsychotics, and the flaws in the theory of what schizophrenia is and how it should be treated. I didn’t even finish the rest of the book, before I was convinced that I needed to get off of all of my medications. I read some of the rest, where he talked about his alternative theories of recovery, but I was already convinced. Honestly, looking back, I think his alternative theories of schizophrenia and recovery are much less solid than the standard understanding. Some of his ideas that I was influenced by though, about flaws in the current understanding and treatment were actually probably accurate. I think looking back also, I need to know that just because a current theory is flawed, doesn’t give a license to make up alternative theories that are even less corroborated and pretend they are solid theories. I think it may also be true that some people with schizophrenia can manage without medications, but that is not related to his theories being true or false.

So I told everyone I was going to try going without medication, I was pretty hopeful, and fairly cautious, and I got people to accept that this is what I wanted to do, and I told my doctor I wasn’t going to take my medications anymore. He cautioned me, but I was convinced. Part of my convictions were centered in buddhist ideas as well, which Paris Williams was also endorsing in his book. I had become so knowledgeable and practiced in meditation, I was sure that would help me.

It felt really good for a while. I felt like I was doing the right thing and that I was making the right choice. I wound up getting into a conflict with my best friend of so long for reasons that I won’t get into. I wound up calling another friend I had who I had met from NA and became close with her, who had a lot of problems herself, and was involved with drugs, mainly just marijuana, but wound up getting me involved in smoking pot, drinking, and eventually going back to experimenting with hallucinogenic drugs. I actually managed my symptoms effectively for a little over 6 months this way, but eventually got a DUI, was in jail for a night, and when I got out, had my license suspended, so I was stuck in the house with my parents with no way to get out of the house. Eventually, conflict with my parents started building up slowly again, I started going into a mania, and wound up calling the police because I was convinced that my Dad had killed someone and had buried them in our backyard. I just knew this based on intuition.

The police came, then a crisis came, and my family tried to get the crisis team to put me into the psych ward, but they said they couldn’t do anything because I was not at danger to myself or others. So my sister decided to get a court order telling the police that I was at danger to myself or others, which I think we all knew was not true, to get me involuntarily committed, in an attempt to help me get better. It did not work. I was furious that I was being held against my will when I was truly not a danger to myself or others, and I knew it. I was so furious that when I was in the hospital, I resisted treatment so adamantly, that I was stuck in the hospital for over a month. When I got out, I wasn’t any better, and was still furious about what happened, and still manic, etc.. My parents got to their wits end and told me that if I wouldn’t go to the hospital that they would take me to the homeless shelter. I didn’t want to go to the hospital because I still felt like it was so wrong that I had been wronged like that, so they took me to the homeless shelter. I couldn’t sleep in the homeless shelter I was so upset, so I left and walked over to the jail and used their phone, and called my parents to come pick me up and go ahead and take me to the hospital.

I went into the hospital and was still so worked up, that I was in there for another three weeks freaking out about my situation. I got out and was finally exhausted with it all and fell into a sort of manic depression, and just slept. I just crashed. I was exhausted. I felt like I had been beaten to a pulp through it all. I was that way for a long time. I don’t remember how long. But I remember that during that time, I started studying atheism, because I was worn out with using my faith to fight all of my battles. Just thinking about meditation or my buddhist beliefs or anything religious caused so much negativity, that I needed something to relieve that. And I think that what I learned during this time studying the atheist and skeptic movements has been what I have needed for so long and never knew what I was missing.

Along with taking medication again and getting help from my mental health team, I learned something called “Street Epistemology” that is growing in the atheist movement. It is a method of conversation based on the socratic method, where you ask people about their deeply held beliefs, respectfully, find out why they believe it, how they concluded it was true, and finding out if the methods they are using to come to their conclusions can reliable lead to truth. Epistemology is a branch of philosophy concerned with studying knowledge, what it is, how it works, and particularly how we can know a belief is justified. Often times, with deeply held beliefs, the method used is faith. Many people have their own definition for faith, but you can let them give their own definition, and analyze it with them as a method of coming to truth, It is very simple, but you can use it on everything. It is not focused on what the belief is, or metaphysics, but how you know the belief is true, or epistemology.

Focusing on epistemology is exactly what I needed to learn. I needed to figure out whether or not the methods I am employing to come to my conclusions is actually reliable. I think that is why people have problems with schizophrenia. It has nothing to do with the actual conclusions they are coming to. There is nothing wrong with the particular conclusions in themselves. The problems come by employing faulty methods of reasoning, that creates problems in their daily lives. I am convinced that if we changed the way we think about delusions, by using epistemology, not metaphysics, that people could actually get better by learning critical thinking and reasoning. It has helped me so much, and I am still getting better, but I have hope that there is a way. All of these problems that contributed to my mental health problems are not insoluble, but pretending to know things I don’t know, and can’t know, isn’t a solution to the problem.

I am equally as convinced that when we give an exception from certain metaphysical conclusions as exceptions from being considered as delusions, simply because people consider them sacred beliefs, that it does a huge disservice to the way we are treating mental health problems. It’s what i’ve heard called “belief in belief” or believing holding certain metaphysical conclusions are moral virtues. When you analyze this it doesn’t seem rational that believing in certain metaphysical ideas can be moral virtues.

The idea that we should just let people believe whatever they want and protect certain ideas from scrutiny, leads to a failure in reasoning, that can have real life consequences on our society. We live in a democracy and the ability to engage with each other’s ideas freely and openly and without fear is crucial to our societies functioning properly and healthily. A failure to engage on these topics can have a real detrimental effect on our own and each other’s well being. If you don’t believe it, just turn on the news or open a newspaper. It is alarming. And once you become aware of the problem, you will see that to live and let live may not always be the best policy. We need to be able to engage with each other.

I’m going to go to school for philosophy, and stay involved with the skeptical community, and keep practicing Street Epistemology, but I’m not going to give up hope on people.

Disease Profile: Bipolar Disorder

What comes to mind when you think of bipolar disorder (also called manic depression or bipolar depression)? I polled some users on r/bipolar2 and asked them what they thought were the most common stereotypes about bipolar disorder. Here are some thing that they said: Bipolar people are expected to have erratic, uncontrollable mood changes. Bipolar individuals can’t have genuine or justified emotions. That bipolar disorder isn’t real or that you are simply going crazy. Somehow having bipolar disorder means you can’t form or have meaningful relationships and drive cars.

Bipolar disorder is characterized by periods of extreme high mood (mania/hypomania) and periods of extreme low mood (depression). These periods of extremely high mood typically consist of very high energy and risky behavior. Depression is essentially the opposite, with very low energy and mood. This all seems very extreme, but sometimes bipolar disorder can be very subtle. Hypomania is a less severe form of mania, more like the depression just lifting. It may even feel good to some patients. Or some may experience periods of mixed emotions, both manic and depressive symptoms at once. Sometimes the person can function during these episodes very well and sometimes not so well.

There are two types of bipolar disorder, with some people falling a bit outside of these two categories. Bipolar 1 is the most thought of when it comes to bipolar disorder. These patients experience the manic highs, depressive lows, and occasionally psychosis (experiencing delusions or hallucinations). Bipolar 1s will cycle only a couple times in a year, maybe less. Manic episodes typically last three to six months, while depressive episodes are longer at six to twelve months. Bipolar 2 is the lesser known type, experiencing hypomania instead of mania. The criteria for bipolar 1 diagnosis is only the presence of a manic or mixed episode for one week that significantly impairs normal functioning. The bipolar 2 diagnosis requires both a hypomanic  and depressive episode. This suggests that depressive episodes are more common in bipolar 2s, though not exclusively found in bipolar 2s.

Treatments for bipolar disorder can be any combination of medication, psychotherapy, and possibly other treatments. Medications aim to stabilize mood and prevent psychosis. This can be through mood stabilizers such as lithium, antidepressants such as Prozac, or antipsychotics like perphenazine. Some people need a combination of these and others need just one. Psychotherapy can also be helpful for patients in coping, education, and support. Electroconvulsive therapy (ECT) may provide relief for patients who have not found relief from other treatments or cannot take medication.

Bipolar disorder is a lifelong illness. There is no cure. Treatments are very effective, but at the end of the day a bipolar patient will always have some issues with mood episodes. I took to the website Reddit and specifically the subreddit r/bipolar2 to ask actual patients what their experiences were. Here are some things they said:

  • They are scared of themselves while experiencing an episode. Mania makes them irresponsible and self-destructive. Their decisions while manic affect their mental and physical well-being when the mania ends. They have ruined relationships and their finances. They have to take time off work, especially when depressed. They talked about how horrible finding the right medication can be. How it takes so long and all the while you are still dealing with the disorder.
  • They feel like no one understands them. They haven’t found a good support system. They feel like whenever they are manic they are easier to deal with and they can make friends. When the depression comes, they get the riot act from others about how it is all about their attitude and how hard they are to deal with all the time.
  • Medication keeps them stable, but it makes them feel very numb. They enjoy being hypomanic. The depression makes doing anything hard for them. They mostly try not to be negative, but it’s really hard when the voice in their head is so critical of every choice.
  • When they’re hypomanic, they can do anything and everything. Everyone else is just dumb and slow. They are very productive and goal-oriented. When they are depressed, they get suicidal. They panic with any small thing and that triggers the suicidal thoughts.

These are real people struggling with something they desperately wish they could control. It’s all about finding the right medication and having a good support system. I hope this has increased your understanding of bipolar disorder and of the people dealing with it. I also hope that maybe you can be that support system, not just for those with bipolar disorder, but for anyone with a mental illness.

 

Sources:

NIMH Bipolar Disorder. (2014). Nimh.nih.gov. Retrieved 13 June 2017, from https://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: fifth edition. Arlington, VA: American Psychiatric Publishing.

#StigmaFreeFishers

This week in Fishers, Indiana, a set of 12 brain sculptures arrived and were placed around the downtown area. Yesterday, I went downtown to find all of them. The brains are part of an initiative by the Mental Health Task Force to raise awareness about mental health. Each of the 12 brains have a different theme related to factors in brain functioning/health and awareness:

  • Growth and development

  • Brain branches

  • World music

  • Brain food (see below)
  • Brain mapping

  • Brain facts

  • Mental health (see below)
  • Communication

  • Brain innovation

  • Evolution of learning

  • Physical health and brain wellness

  • Thinking outside the box

They were commissioned by Dr. Jill Bolte Taylor, a neuroanatomist who is famous for her “stroke of insight”. These brains have travelled through other cities in Indiana to arrive in Fishers. The brains will be displayed around the downtown area of Fishers until August, when they will be moved to Hamilton Southeastern high schools.

When I went to visit the brains, I wasn’t sure what to expect. I hadn’t heard anyone talking about them. There were barely any posts using #stigmafreefishers. I’m on the ground floor with this. I was not disappointed. I think it is a little odd to call this an awareness project, but it is definitely an educational one. It is a step in the right direction toward understanding brain wellness and the link to general health. Each composition showed an understanding of the assigned area of focus, usually with a different design for the left and right sides. Sometimes it was simply the contrast between the two sides that made the best impact, and sometimes it was different perspectives that contributed the most to the piece.

For the sake of the length of this post, I’m going to highlight a couple of my favorite statues. First is the Brain Food themed statue.

IMG_0399

This sculpture was just so fun! All the representations of different foods were really cute. If you look at the fish in the middle of this picture, the teeth are made from pencils. All the different textures, colors, and styles really represented the subject. It was well made and creative. Diet is so important to many areas of health, mental health being only one of them. It should not be overlooked when considering any area of wellness. The sign attached to this statue described how different foods affect body chemistry as well as listing some superfoods. An entire textbook could have (and may have) been written about how different foods affect the body, but the artist kept it simple and relevant while still creating an impact. All of these things make it my favorite of the 12.

It would be remiss of me not to mention the mental health brain.

The mental health one was interesting because of the medium used on the right side of the brain. The right side was made from what looks like pipe cleaners, or at least something similar. It was really warm and inviting to touch. The animals depicted on it were silly and fun. This is how brains are nurtured and grow, especially chronically ill brains. The left side was a bunch of distorted faces with speech bubbles. The speech bubbles were made out of chalkboard material. Some words were written in chalk, but most of them were too light to read. I think it was supposed to represent giving a voice to traditionally outcasted individuals. If that was the purpose, it was executed really well and I love the concept. Fighting stigma begins with giving a voice to those affected by mental illness.

I can’t possibly go through every single sculpture and talk about them in depth. I included many pictures as I can of each one. Overall, I was very impressed, particularly that the city of Fishers managed to complete this initiative. I’m waiting with baited breath to find out what the mental health task force will do next.

Special Report by GWEN T. 

Out of Context

Actual sentence heard on a college campus: “Those shoes gave me PTSD.”

Statements like these are all too common. Mental health terms are used out of context on a regular basis in popular culture. “I was so depressed.” “He went totally schizo.” “She was so bipolar about it.” Were you really clinically depressed? Was he actually seeing things, hearing voices, and having delusions? Did she cycle through periods of high moods and low moods that she could not control? Something tells me none of those were true.

So what is mental illness, then? Just an emotional state? Will a schizophrenic patient only be schizophrenic temporarily? Because that’s what it sounds like. When people saying things so flippantly like that, it makes it seem like being mentally ill is just a switch you can turn on and off. Like being mentally ill is a choice and why don’t you just turn it off?

Having a mental illness, not to mention more than one, is difficult and horrible. It is no different than any physical ailment. People spend years getting stabilized on medications and other treatments. Typically, stabilization is the best that you can do with a mental illness. There are no cures. The struggle is lifelong. When others pull mental health terms out of context, it diminishes the struggle down to a passing comment. No discussion. No kindnesses shown. It invalidates the feelings and experiences of those that are dealing with whatever illness you’ve chosen to disregard. This is hurtful and only worsens the plight of those with mental illness.

Please be mindful of those who are suffering internally with mental illness. Don’t use mental health terms out of context to describe situations that have nothing to do with the amount of pain that comes with the term you are misusing. Show compassion and offer support instead. You have the power to make someone else’s life better through your actions and words. Choose those words carefully.

Assignment for U.S. colleges: privacy laws 101

By Nora Lockwood Tooher

Jolted by the Virginia Tech shootings in April 2007 and a state panel’s report critiquing the university’s response, colleges are re-examining how to deal with troubled students, while maintaining students’ privacy rights.

The panel’s report by a state panel, which was released in late summer, said there is “widespread confusion about what federal and state privacy laws allow.”

A maze of federal and state privacy laws currently govern the release of student records. The Family Educational Rights and Privacy Act (FERPA) applies to educational records, while HIPAA governs medical records.

State laws and professional ethics also control what information can be disclosed without a student’s consent.

“There is a great deal of confusion in the administrative suites on college campuses right now – both about the extent to which the federal rules in either HIPAA, FERPA or both apply to student health records, and about the balance between the responsibility of a college to protect the student body in general and its obligations toward individual students,” said Dr. Paul S. Appelbaum, director of the division of psychiatry law and ethics at Columbia University’s psychiatry department in New York.

FERPA and HIPAA allow disclosures if a student is deemed to be a risk to himself or others. But Janet E. Walbert, vice president for student affairs at Arcadia University in Glenside, Pa., and president of the National Association of Student Personnel Administrators, said administrators and staff are often confronted with gray areas in determining whether to disclose confidential records.

“If a counselor knows a student acts out under the influence of alcohol, but doesn’t know if the student will drink that night, is there an imminent threat?” she asked.

Robert B. Smith, head of the college and university practice group at Nelson, Kinder, Mosseau & Saturley in Boston, and former associate general counsel for Boston University, said that because the exceptions are ill-defined, college administrators are wary about disclosing information.

“You still have to have someone on the campus make a judgment, and, of course, in the litigious society we live in, administrators are concerned and constrained from doing that,” he said.

Confusion reigns

Gary Pavela, director of judicial programs at the University of Maryland, contended, however, that problems related to privacy laws and student confidentiality “appear to [stem from a] lack of information about the laws, not the laws themselves.”

Federal privacy laws are “really not an obstruction to sharing information with parents or releasing information to law enforcement,” he said.

But the Virginia panel’s review of student privacy laws cited a “widespread lack of understanding, conflicting practice and laws that were poorly designed to accomplish their goals.”

In addition to exemptions for “health or safety” emergencies, FERPA allows the release of information to parents if the student is under 21 and has had a drug or alcohol violation, or if parents claim the student as a dependent for tax purposes.

But few parents or colleges are aware of the loopholes, several experts said.

Some colleges also offer waivers student can sign, authorizing the release of records to their parents. But the forms do not require the schools to release information, and many schools withhold academic and health records even after students sign the waivers, according to privacy law experts.

While much of the state panel’s report was aimed at clarifying student privacy laws, some of its findings may have actually increased confusion.

For example, Appelbaum noted, it had been assumed that student health records were not covered under FERPA because they aren’t educational records. But the panel’s report included two letters from the Department of Education indicating that such records are covered under the Act.

The education department letters “also contained some confusing analysis as to why FERPA applies and what the limits on disclosure are,” he added. “I suspect will be hearing calls for still greater clarification from DOE and perhaps for reconsideration of some of the conclusions they reached.”

ADA issues

Fueling the legal and ethical dilemmas surrounding students’ mental health records is the growing number of college students who suffer from depression.

According to the 2006 National College Health Assessment, 44 percent of almost 95,000 students surveyed said they “felt so depressed it was difficult to function” during the past year; 9.3 percent had seriously considered suicide during the year.

Several experts said they fear that colleges – in their haste to lower the risk of student suicides and violence – may trample student rights.

“The tendency of some campuses to want to exclude students as soon as they manifest any kind of behavioral or emotional problems runs a strong risk of violating student rights under the ADA,” Appelbaum said.

Concerned about liability, some colleges in the past several years have expelled students with mental health problems. (See “Suicide suits put universities in a tight spot,” Lawyers USA, May 22, 2007. Search terms for Lawyers USA Archives: Gertner and Broe).

George Washington University in Washington was sued after it forced a student to leave who had sought help for depression at the university’s counseling center. The case was settled last year.

Hunter College in New York settled a similar lawsuit last year for $65,000. The suit had been brought by a student who had been locked out of her dorm room by campus security after she was hospitalized for a suicide attempt.

“My concern is that schools will over-react even more, and because of Virginia Tech, will stereotype students with mental illness,” said Karen Bower, a senior staff attorney with the Bazelon Center for Mental Health law in Washington, which represented the students.

Bower said she fears that campus counselors will be pressured to disclose confidential information to college administrators.

“Confidentiality is very, very important. If there’s no confidentiality students will be discouraged from getting treatment,” she said. “But the other piece is I would hope there would be an environment where you could go to the dean and say you are feeling suicidal and the dean would get you help and not kick you off campus.”

Last year, before the Virginia Tech shootings, Virginia became the first state to pass legislation barring public colleges and universities from punishing or expelling students “solely for attempting to commit suicide, or seeking mental-health treatment for suicidal thoughts or behaviors.”

Erring on safety’s side

According to Karen-Ann Broe, senior risk analyst for United Educators, an educational insurance company in Chevy Chase, Md., most colleges are in the process of setting guidelines for sharing information with non-health personnel on campus, such as campus affairs, public safety and student affairs; non-campus agencies, such as police and mental health centers; and parents.

“I think there has been a reluctance to share information internally within campuses about at-risk students – those that have some increased risk of violence to themselves or others – and that’s been because of a misunderstanding of the legal requirements and out of deference to student privacy and not wanting to stigmatize students,” she said.

While those concerns are legitimate, colleges’ reluctance to identify and deal with at-risk students may have gone too far, she said.

“Colleges realize they’ve got to balance student privacy with student safety,” Broe commented.

Smith said he advises college administrators: “If you are caught between a rock and a hard place in terms of someone’s privacy concerns and your legitimate concerns that they are going to hurt themselves or others, you’d much rather have the privacy lawsuit than the death lawsuit.”

Panel recommends revising privacy laws

A report by a state panel studying issues related to the Virginia Tech shootings has recommended overhauling student privacy laws to better share information about at-risk students.

The panel’s recommendations include:

Revising privacy laws to include “safe harbor” provisions that insulate colleges from liability for disclosing records based on a good-faith belief that the disclosure was necessary to protect the health and safety of the person involved or the general public.

Amending the Family Educational Rights and Privacy Act (FERPA) to explicitly explain how it applies to medical records, and whether it preempts state law regarding medical records.

Creating an exception under FERPA for disclosing treatment records from university clinics to off-campus health care providers.

Allowing more flexibility in interpreting FERPA’s emergency exception. The regulations currently allow the release of records when disclosure is needed to protect the health or safety of

either the student or other people. The panel said the limitations on what constitutes an “emergency” feed the perception that non-disclosure is a safer choice.

The panel also recommended that universities give college law enforcement, medical providers and others who assist troubled students the authority to share student records.

Questions or comments can be directed to the writer at: nora.tooher@lawyersusaonline.com

© 2007 Lawyers Weekly Inc., All Rights Reserved. Redistributed with permission. Internal Use Only.

Student survey reveals 45 percent feel stressed

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 Graphic by Adam Ismail

A mental health survey completed by 135 University students covered issues such as excessive stress and depression.


In an attempt to end his life, a Princeton University first-year student ingested 20 pills in his room. A few days after in February 2012, he was asked by university officials to voluntarily withdraw from the school.

The student, who was evicted from the school with no refund, was told he would have to leave once he missed about three weeks of classes, said Lewis Bossing, senior attorney at Bazelon Center for Mental Health Law, in an nj.com article.

Yet issues regarding mental health cannot withdraw from college campuses. About 30 percent of college students reported feeling “so depressed that it was difficult to function,” according to American College Health Association – National College Health Assessment’s 2011 survey.

In response, The Daily Targum gathered statistics to assess the state of Rutgers students’ mental health.

The results of the survey were shared with Mary Kelly, lead psychologist at Counseling, Alcohol (and other Drugs Assistance Program) and Psychiatric Services at Rutgers, and she provided her interpretation of the data via email.

Mental health is not just the absence of a mental disorder. World Health Organization defines it as an individual’s ability to realize their own potential, cope with the everyday stresses of life, work productively and fruitfully and make a contribution to their community.

The Targum surveyed 135 students, with 33 surveys distributed physically and 102 online. The survey encompassed topics such as stress, depression, eating disorders and drug use.

Out of students who answered the survey, 84 were female and 47 were male. Forty-three percent identified as liberal arts majors and forty percent as Science, Technology, Engineering and Mathematics majors. Ten students were business majors and three were public health majors.

While six students said they felt depressed daily, 46 students said they feel depressed “less than once a month,” 38 said “less than once a week,” 27 said “a few times a week” and 15 said “never.”

“I can tell you that according to the 2010 National College Health Assessment, 9.7 percent of Rutgers students who responded to the survey reported feeling so depressed in the past year that it was difficult to function, and 12.5 percent said that they had been diagnosed with depression,” Kelly said. “As such, your numbers look high, but again, it depends how the students you talked to defined depression.”

To the survey question about suicide, 20 percent of the students responded they have thought about suicide multiple times, while 58.5 percent said “never.”

In the case of Princeton University, the student filed a complaint in July 2012 with the U.S. Department of Education’s Office of Civil Rights, according to the nj.com article.

The student, currently 20 years old, left Princeton for two semesters to secure a partial refund of his tuition, room and board and “to make it less of an issue for his record,” Bossing said in the nj.com article.

He returned in fall 2013 as a sophomore and is currently enrolled at Princeton, Bossing said.

University officials said they believed the student posed a direct threat to himself and was therefore encouraged to voluntarily withdraw, and the student would have to show six to nine months of “demonstrated stability” to return, according to the complaint.

The survey also asked students if they thought their use of social networks affected their mental health.

Kelly said she had seen references in research that suggest a correlation between social media use and depression — yet this correlation may not mean causation.

“It’s not clear whether depressed people use more social media or if social media use leads to depression,” she said. “Anecdotally, I’ve talked to many students who find social media to be a source of anxiety and stress, particularly if they are compulsive in their use to the point where it interferes with other important aspects of their lives, such as academics and relationships.”

Drug use was another component of the Targum survey. Eighty-nine of the 135 students refused to take drugs for treating depression, 12 students said they used alcohol and nine said they used marijuana.

“I think it is absolutely true that the majority of students do not use drugs,” Kelly said. ‘It’s also been demonstrated in the NCHA survey that many Rutgers students do not drink alcohol at all, and of those who do, two-thirds stop at three drinks or fewer.”

Unique Hurdles to Managing Stress in College

Managing Stress

College requires significantly more effort from students than high school.  Once you enter college, you will probably find that your fellow students are more motivated, your instructors are more demanding, the work is more difficult, and you are expected to be more independent. These higher academic standards and expectations are even more evident in graduate school. As a result of these new demands, it is common for college students to experience greater levels of stress related to academics.

Many students find that they need to develop new skills in order to balance academic demands with a healthy lifestyle.  Fortunately, the University of Michigan offers many resources to help students develop these skills.  Many students find that they can reduce their level of academic stress by improving skills such as time management, stress management, and relaxation.

The Pros and Cons of Stress

Stress is anything that alters your natural balance. When stress is present, your body and your mind must attend to it in order to return you to balance. Your body reacts to stress by releasing hormones that help you cope with the situation.  That in turn takes energy away from the other functions of your brain, like concentrating, or taking action.  There are two different sources of stress: external triggers, like getting a poor grade or breaking up with your girlfriend/boyfriend, and internal triggers, like placing high expectations on yourself.

La Di Da by Asher Roth:
“How are you dealing?”

Watch this music video which shows how six college students deal with stress.
From halfofus.com

Stress is a part of everyday life. There are many instances when stress can be helpful. A fire alarm is intended to cause the stress that alerts you to avoid danger. The stress created by a deadline to finish a paper can motivate you to finish the assignment on time. But when experienced in excess, stress has the opposite effect. It can harm our emotional and physical health, and limit our ability to function at home, in school, and within our relationships. But the good news is that, since we are responsible for bringing about much of our own stress, we can also do much to manage stress by learning and practicing specific stress-reduction strategies.

Click here to learn more about academic stress.  This link will take you to information and helpful tips including a study skills checklist.

Are you experiencing too much stress?

Here are a few common indicators:

  • Difficulty concentrating
  • Increased worrying
  • Trouble completing assignments on time
  • Not going to class
  • Short temper or increased agitation
  • Tension
  • Headaches
  • Tight muscles
  • Changes in eating habits (e.g., “stress eating”)
  • Changes in sleeping habits

People with mental health disorders are more likely to notice that their specific symptoms reemerge or grow worse during stressful times. In many cases, stress can act as the “spark” that ignites a mental health episode. But this does not mean that every time you are busy or face a difficult challenge you will have a mental health episode. Not everyone responds the same way to potentially stressful circumstances. For example, during final exams many students feel very overwhelmed and anxious, while others are able to keep their stress under control. If you are one of the many people who have difficulty managing stress during difficult times, look for some helpful tips below.

Ways of reducing and managing stress

  • A feeling of control and a healthy balance in your schedule is a necessary part of managing stress. Learning how to manage your responsibilities, accomplish your goals and still have time for rest and relaxation requires that you practice time management skills.
  • Try setting a specific goal for yourself that will improve your mood and help you reduce stress. Start by filling out a goal-setting worksheet.
  • Avoid procrastination. Putting off assignments or responsibilities until the last minute can create more mental and physical stress than staying on top of them.  Procrastination can affect many aspects of daily life, such as the quality of your work, the quality of your sleep, and your mood.
  • Exercise regularly. Physical activity can help you burn off the energy generated by stress.
  • Practice good sleep habits to ensure that you are well-rested. Sleep deprivation can cause many physical and mental problems and can increase stress.
  • Try mindfulness meditation.
  • Limit (or eliminate) the use of stimulants like caffeine, which can elevate the stress response in your body.
  • Pace yourself throughout the day, taking regular breaks from work or other structured activities. During breaks from class, studying, or work, spend time walking outdoors, listen to music or just sit quietly, to clear and calm your mind.
  • Start a journal. Many people find journaling to be helpful for managing stress, understanding
    emotions, and making decisions and changes in their lives.
  • Realize that we all have limits. Learn to work within your limits and set realistic expectations for yourself and others.
  • Plan leisure activities to break up your schedule.
  • Recognize the role your own thoughts can play in causing you distress. Challenge beliefs you may hold about yourself and your situation that may not be accurate. For example, do you continuously fall short of what you think you “should” accomplish? When our minds continuously feed us messages about what we “should” achieve, “ought” to be, or “mustn’t” do, we are setting ourselves up to fall short of goals that may be unrealistic, and to experience stress along the way. Learn techniques for replacing unrealistic thoughts with more realistic ones.
  • Find humor in your life. Laughter can be a great tension-reducer.
  • Seek the support of friends and family when you need to “vent” about situations that bring on stressful feelings. But make sure that you don’t focus exclusively on negative experiences; try to also think of at least three things that are going well for you, and share those experiences.
  • Try setting a specific goal for yourself that will improve your mood and help you reduce stress. Start by filling out a goal-setting worksheet then help yourself stay on track.

Suicide Attempts and Immune Response

Suicide kills more than 40,000 people in the United States every year, an estimated 90% of them with a diagnosable severe psychiatric disease. Yet little is known about what causes some individuals to take their own lives, limiting the ability to reduce the number of such deaths.
Findings from a new study published in the Journal of Psychiatric Research suggest that identifying blood-based antibodies may offer a route to more personalized assessment and treatment of suicide risk and, ultimately, to more effective suicide-attempt prevention. The study compared antibody levels to viruses known to attack and inflame the nervous system in psychiatric patients with a history of suicide attempt and patients who had not attempted suicide.
Findings
In the study by Faith Dickerson and colleagues, 162 patients with schizophrenia, bipolar disorder or major depression were assessed for suicide-attempt history and antibodies to neurotropic infectious agents including Toxoplasma gondii (T. gondii). All the patients were in psychiatric treatment and receiving medication during the study.
Among the participants, statistically significant correlations were found for:

  • Lifetime history of suicide attempt and the level of antibodies to T. gondii
  • Lifetime history of suicide attempt and the level of antibodies to a common herpes virus (cytomegalovirus or “CMV”)
  • Lifetime history of suicide attempt and current cigarette smoking.

Individuals with antibodies to both T. gondii and CMV were found to be at heightened risk of attempting suicide, suggesting that exposure to both viruses might be additive, according to the authors. Individuals with antibodies to both viruses were also more likely to have made multiple suicide attempts.
No statistical correlations were found for:

  • The deadliness of suicide attempt and the level of antibodies to either virus
  • Patient age at time of assessment, gender, race, diagnostic group, clinical care setting, cognitive score, psychiatric symptom score, or any of the medication variables

Implications
Suicide rates in the United States have been rising since the mid-2000s, with more individuals per 100,000 population killing themselves than previously. The 21stCentury Cures Act and other federal, state and local initiatives, as well as many national nonprofits, have focused on reducing suicide risk, but the task remains challenging without clarity about the underlying causes.
While “the mechanisms by which inflammation may be associated with increased suicide risk are not known with certainty,” the authors of this study wrote, “the successful identification of blood-based antibody markets would represent an advance in the prediction and prevention of suicide attempts” among psychiatric patients.
“Suicide, for which a previous suicide attempt is the greatest risk factor, is a major cause of death worldwide and is highly prevalent in patients with serious mental illness,” they conclude. “Unfortunately, the ability to predict suicide remains limited and no reliable biological markers are available. The identification of blood-based antibody markers should provide for more personalized methods for the assessment and treatment, and ultimately prevention, of suicide attempts in individuals with serious mental illnesses.”

4 things every college student must know about mental health on campus

America’s college students are facing a mental health crisis.

College is where your mental health goes to die

— Jacob Griffin, Griffin Ambitions Ltd. Founder

Mental illness affects a student’s ability to concentrate, study, work, sleep and eat, according to Rhonda Dalrymple, a professional counselor at Brookhaven College in Dallas, Texas.

Here are four ways you as a student can become more informed on mental health and change the mentality surrounding mental health during Mental Illness Awareness Week, in May.

  1. KNOW THE WARNING SIGNS.

While mental illnesses such as depression and anxiety are different in everyone, there are a few warning signs you can keep an eye out for. The National Institute of Mental Health states that persistent sadness, anxiety, feelings of guilt, loss of interest, difficulty concentrating or sleeping and even physical pains can all be signs of depression.

Related: How to identify depression and get help on campus

Restlessness, muscle tension or constantly worrying can be signs of anxiety. An obsession with food, body shape or weight can be signs of an eating disorder. Keep in mind that symptoms are not one-size-fits-all, and only a professional can make an official diagnosis.

  1. LEARN ABOUT THE SERVICES YOUR COLLEGE PROVIDES — AND DON’T BE AFRAID TO SEEK HELP.

for all college students with anxiety/depression/etc. please please please use the resources on your campus. they do as much as they can

(@younggwhite) October 5, 2016

70% of the student body at the University of Missouri did not know about the mental health services provided on campus, according to a recent study. Most universities and two-year colleges have a health center and a counseling center for students. Take time to learn about the services provided and how they can help you or a friend cope with a mental illness.

It’s depression screening day and at my college they’re testing people for free I think I’m gonna go tbh

— Inactive-college (@zigzagziall) October 6, 2016

The counselors who work at these centers are trained to help you deal with and overcome mental health issues, all while maintaining confidentiality.

“We always strive to explore [the stigma] with students, allowing them to build trust and normalize for them that it is okay to feel nervous in the beginning,” Dalrymple says. “We discuss confidentiality and try to create a trusting, comfortable atmosphere.”

  1. EDUCATE YOURSELF AND HELP STOP THE STIGMA SURROUNDING MENTAL ILLNESS.

There is a stigma surrounding not only mental illness, but asking for help, seeing a therapist or even acknowledging that you might have a mental illness.

Ana Arbalaez, a nursing student at Texas Women’s University in Denton, believes many students avoid seeking help because they feel ashamed.

“Students fear that they are going to feel judged, and people are going to look down on them,” Arbalaez said. “This fear causes them to continue suffering in silence instead of asking for the help they need.”

Having a mental illness is not something to be ashamed of. According to the National Alliance on Mental Illness, one in five adults in the United States experience some form of mental illness. Take the time to educate yourself on mental health and help get the conversation started so that students can change the way people view this issue.

  1. STOP JOKING ABOUT SUICIDE.

Because it’s really serious. There are over 1,000 suicides on college campuses every year, according to a study by Emory University, and tragically, suicide is the third leading cause of death among people aged 15 to 24.

Joking about suicide could be a cry for help. If you or friends ever have any suicidal ideations, do not take them lightly. Confide in somebody you trust or call a hotline; help lower the number of suicides.

Need help? In the U.S., call 1-800-273-8255 for the National Suicide Prevention Lifeline.

 

Mental Health 101

How common are mental health issues?

Studies have shown that 1 in 4 individuals globally struggle with a mental health issue at any given time. If you expand that to the course of a lifetime, the number increases to 1 in 2. That means if it’s not you who is struggling, it’s someone you know or love.

Why is it important to talk about stigma?

When discussing mental health, two main types of stigma exist. One type is external stigma, which refers to the attitudes held by society that people with mental health issues are somehow lacking, incapable, incompetent, or not worthy of dignified and equitable treatment. The other type is internal stigma, which is the attitude held by the person with mental health challenges that they are unworthy, unlovable, and unvalued.

Stigma does a lot of harm to our society. For the people struggling with a mental health challenge, they often lack hope in recovery and don’t pursue treatment because they either don’t believe they can get better or fear discrimination from others. For those who don’t struggle but hold positions of power (such as law enforcement, educators, landlords, community leaders, etc.), stigma can lead to discrimination, which is the unfair treatment of those with mental health challenges.

Having honest conversations about stigma and sharing our personal stories of recovery are small steps we each can take to making our society more equitable and inclusive.

Is recovery actually possible?

Absolutely! One of the biggest misperceptions in society is that mental health issues are a life sentence.

Recovery means many things to many people and is personal in nature. For some, recovery is the complete absence of symptoms. For others, recovery means successfully managing symptoms as a normal part of life with no disruption to daily activities. Research has shown that even for those with the most serious mental illnesses, the right treatment can have someone living an independent, fulfilling, and successful life.

Does everyone with a mental health diagnosis need medication? What alternatives to medication exist?

It’s a common thought that the only cure to a mental health diagnosis is medication and if one stops taking his or her pills, it’s all downhill from there. While medication works for some people, it is hardly a cure-all. In fact, some medications can have side effects that are more harmful than the symptoms of the mental health challenge!

Deciding to try medication is a personal decision. The good news is that it is not the only option. Research has shown that other types of therapies can be extremely effective in maintaing a person’s level of wellness, including mindfulness, talk therapy, peer support, physical activity, and visual and performing arts, to name a few.

So, do I have to share my mental health issue with the world?

Not unless you want to! Some people are very open about their mental health issues because they value transparency and/or want to be an example of recovery. Others may not feel comfortable because they fear stigma, or simply don’t want the world knowing their personal business. Some may choose to tell family and close friends, but not coworkers or acquaintances. There is no right or wrong answer. You should do what makes you comfortable. If you want to start dialogue around mental health but aren’t quite sure if you’re ready to share your experiences, you can always frame the conversation around wellness, which applies to everyone, diagnosis or not.

What should I do if someone discloses their challenge to me?

Just listen. Providing a supportive ear is the best thing you can do for someone who chooses to open up. It’s not always easy to share something so personal with another human being, so taking a genuine interest and being free of judgment can go a long way and do a lot of good.