Sunday, March 24, 2013

Sharon Brings Them In ! Talk on Family Involvement With Mood Disorders

A full house for Sharon Katz, prescribing nurse and owner of Collaborative Care wellness center in Abington, PA.

Whole families showed up to learn how to communicate with the diagnosed individual.

I held up our Compass and encouraged everyone to take a copy and give a few to their health-care providers. The Kaleidoscope is our literary section and indeed, Martha, a fine poet who wrote the lead poem "Time" in the Kaleidoscope was there.

A 70-year-old man had recently retired and hit the abyss of depression. He was grieving the loss of his job and his identity now that he wasn't working.

You need a plan when you retire, said Sharon.

The medicine had just started to kick in. Sharon also suggested 'talk therapy.'

Retiring w/o a plan means that the routine you've relied on for most of your life has vanished. These circadian rhythms are one way our body takes care of itself.

His long-suffering wife was there, crying, as well as their four grown children and spouses. Such great support for him. They were at a loss on how to help him, how to talk to him.

Sharon suggested he go for daily walks and develop hobbies and interests when his 'anhedonia' - lack of pleasure - goes away.

Sharon handed out a mood chart. On here you record your moods between doctor/therapist visits.

Sample dialog from Family Member:

"This is what I've noticed" .....  not sleeping, making many purchases, speaking rapidly

"What can we do about this?" ... work with family member to stabilize mood, such as call doctor or therapist.

Important to avoid hospitalization if possible b/c it takes a big chunk out of your life - timewise, financially, and your self-esteem plummets.

"Tell me why you can't get out of bed. What can I do to help you?"

"What triggered you to feel so depressed?"

The bad economy and inability to get a job, said Sharon, can trigger a bad depression.

Don't allow a family member to isolate themselves. Take a walk with them. Keep them as part of the family even though they don't feel like it when they hit the abyss of depression or the wildness of mania or hypomania.

Many families do not understand that depression is a medical-biological condition and the suffering individual is not simply lazy. This is also one of our columns in the Spring 2013 issue of the Compass: What People with Mood Disorders Want Their Families to Know.

"Jenn" is a newly diagnosed bipolar woman, image off the Net. Like most of us, she doesn't wanna take meds for her recent mania and hospitalization at Horsham Clinic.

Let's say she comes to see Sharon Katz who gets her meds stabilized. As we know, hospitals load up the meds and it's up to the follow-up psychiatrist to taper down the meds.

Why don't we like meds? By taking them, we're reminded that we have an illness disdained by our society.  Knowingly or not, we've taken on this same horrid value system of society. There's no stigma against diabetes or cancer.

Sharon will get the newly diagnosed individual on the right meds, often using the new technique of "genetic saliva assays" she spoke about at her last talk. 

The newly diagnosed between 18 and 30 have the hardest time accepting their illness. 

Sharon will get to know the personality of the individual. "Vibrant, loving, creative," etc.

Our personality is totally out of whack when mania or depression hit. 

Then, upon occasion, she will allow her patient to take a "med vacation." 

Some patients are really insistent on going off the meds, so Sharon will take this into account, as well as women who wish to get pregnant.

Always with the proviso of going back on if necessary.

 It's advisable, said Sharon, to do a family history of mental illness.

Although genetics is not destiny, she said, it's useful to take a look. "Although we never talked about it, your grandfather did kill himself."

"Let's make sure this doesn't happen to you."

Statistics show that people with mental disorders die 25 years earlier than 'normal' people.

Why? Smoking, drinking, risk-taking behavior, using illicit drugs, complications of prescribed medications.

How to help you live successfully with your mood disorder:

- Good sleep hygiene - the most important thing. The family should be aware of the patient's sleeping patterns and discuss it if the individual wakes up at 2 am and cleans the house until 6 am.

- Nutrition - healthy foods including green leafy vegetables.

- Exercise - the mind gets fed as well as the body.

- Vitamin supplements - our neurotransmitters, such as serotonin, dopamine and norepinephrine are all built upon basic vitamins.

She recommends you take Folic Acid, B-6, B-12 and D.

- Avoid triggers such as a job you don't like or abusive relationships.

It was wonderful to hear about MOTIVATED individuals who wanted to change their lives. With Sharon's help, a young woman changed jobs, journaled, and lost 150 pounds due to her overmedication when she first saw Sharon.

This woman knew that employees don't like hiring obese individuals. A real health risk!

Let's talk! Here's mom Marion and daughter Diane.

If living at home, the bipolar or depressed individual should:

- Be on a daily schedule. Be awake and showered by 10. This routine is necessary. Even if the person is not responding yet to medication, his or her body is maintaining a similar routine as before the depression.

- Have specific tasks to do around the house. One project per day even if depressed.

- Be on a curfew, if young

- If having an episode, take away car keys, credit cards, etc. These things should be discussed in advance as part of a Family Plan.

- The ill person should learn to verbalize what they're feeling with both their family members and therapist.

  Ah, welcome to my home Ludwig! Nice of you to stop by. Guess you knew I'd been listening to a radio show about you and your Eroica Symphony, narrated by songwriter/performer Suzanne Vega.

Most likely, you suffered from manic-depression during your life. In a letter to your brothers, you wrote, Don't call me ill-tempered or misanthropic, you have no idea of what I'm going through inside. Worst of all, I am losing my hearing. That this should happen to me, of all people, is cause for the utmost despair.

Though there's no sign he tried to kill himself, what Beethoven did was to put his feelings into his Third Symphony Eroica - originally based on Napoleon's triumphs - until he became a dictator.

Beethoven "bent and twisted" symphonic conventions which caused a scandal when it was first performed.

DA-DA-DA-DAH!!! The brief pause after the initial phrases indicated "a look into the abyss" of his mind, said the narrator.

"The Third Symphony shows all the emotions of life. Of Beethoven's life."

Thanks for coming Jim and Ed.  Ed is one of our terrific discussion leaders.

Great job, Sharon! Let me walk you out to your car.

At the foot of the stairs, a group of people from the group were gathered together.... talking! This is what we love! Communication.

Mental Health Awareness Magnets.

$10 apiece. We sold quite a few at the show. Profits go to New Directions, the little support group that could! Hey, Judy, when you gonna come over and pick up your Compass? It's still on the couch waiting for you.

PS - Speaking of genetic assays, my library book club is reading "The Immortal Life of Henrietta Lacks." Lacks, a black woman, was dying of cervical cancer, and w/o her permission, doctors grew her cancer cells in a petri dish, which have subsequently been used as the basis to treat and help many conditions. Read today's Times article about the recent publication, again, w/o her family's permission of her entire genome. 

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