Tuesday, September 27, 2011

Will another mental health facility help?

Last week, I wrote a post about the lack of mental health care both in Dayton, Ohio, and in general.  An article from the Dayton Daily News today discussed the grand opening of a new psychiatric hospital in the area, which sounds like a step in the right direction.

Or is it?

Access Hospital Dayton is a for-profit facility, opening where a state hospital (Twin Valley Behavioral Health Center, or TVBH) used to be, until it closed in 2008.  It is run by a private company, owned by two psychiatrists.  It will have 28 beds initially, and the director hopes to expand to over 100 when it's all said and done.  I can't find a website for it (which doesn't mean it doesn't exist, but it's not obvious), and all the information I'm getting is coming from the DDN and from the Dayton Business Journal.

The facility will not take anyone on Medicare or Medicaid; it will only take patients with private insurance that will cover the costs, or patients who are willing to pay for the care themselves. It sounds like, from the Dayton Business Journal article, the owner plans to expand to accept Medicare and Medicaid, but that's a future plan.

[Side note:  In my opinion, 28 beds sounds pretty paltry, so I tried to do a comparison.  I looked up the Linder Center of Hope, a facility down in Mason, Ohio, that I visited (ha, sounds so pleasant) this spring.  It has 48 acute inpatient rooms for adolescents through adults, and has capacity for 16 people to stay long-term in their Sibcy House.  They also have various outpatient programs.  And they take Medicare and Medicaid.]

Maybe this is good news for Dayton.  We need mental health care, and that's 28 beds that Dayton didn't have before, right?  Well, at least since 2008, when the TVBH closed down.

And that's where things get a little more grim.  TWBH was a state hospital, and had an over 100 bed capacity.  They were a state hospital, so they took Medicare and Medicaid.

What's also significant is that over half of their patients at the time of their closure were forensic patients -- that is, people who were in some phase of the criminal justice system.  Now, those patients will either be transferred for care out of the area -- if care can be found -- or shuffled back through the criminal justice system.  Or, worse yet, released without treatment back into society, sure to end up back in front of a judge at some point.  (Statistics come from an articled called "Reopening of Mental Hospital Won't Help Uninsured Patients" from the Dayton Daily News -- may not be available when you click on it).

According to the National Alliance on Mental Health, "64 percent of local jail inmates, 56 percent of state prisoners and 45 percent of federal prisoners have symptoms of serious mental illnesses" (From "Department of Justice Study:  Mental Illness of Prison Inmates Worse than Past Estimates").  

It's been proven, then, that there is a high percentage of mentally ill inmates, and it's no secret that Dayton's crime rate is pretty bad.  From neighborhoodscout.com:
  • Dayton's "Crime Index," with 100 being the safest, is 5 -- this means that Dayton is safer than 5% of the cities in the country
  • An individual's chance of being a victim of violent crime in Dayton is 1 in 98; in Ohio it is 1 in 287
  • The murder rate per 1000 people is .21; the national average is .05
  • Note:  all these stats are from neighborhoodscout.com:  click here to see how they got them) 
Is there a correlation here?  I have to think there is.

So, hip hip hooray that a new mental health facility is opening in town.  Obviously, Dayton (and the country in general) needs all the help it can get.  But, contrary to their name ("Access Hospital"), this facility won't serve the segments of the population most in need.

I guess we still have a ways to go in mental health care for the area, and the country.

Monday, September 26, 2011

Family fun with hypomania

I actually have Bipolar II Disorder, which is different from Bipolar I because of the manic states.  With BP I, the manic states are much more...well, manic.  The person has delusions -- sometimes of grandeur, sometimes of paranoia, whatever -- and can engage in seriously harmful behavior or become detached from reality.

With BP II, the manic stages are milder -- they usually involve elevated energy levels, less sleep, rapid speech, and over productivity.  I've always called my hypomanic states my "creative times," because I seem to get a lot of ideas and want to work on art projects or write.

Recently, I've been in a hypomanic state.  I've felt very pressured to get lots of things done -- write a book proposal, tile my kitchen, paint the kitchen, clean the house, etc.  I've also found myself having racing thoughts and talking more than I should.  I also get irritated a lot faster.  I've been pretty productive, so I can't say that it's a totally bad thing. 

My biggest concern right now is what my kids are thinking.  Mommy's really productive right now, in a good mood (mostly), and around.  What happens when the hypomania wears off (which it inevitable does)?  Will they even notice?  Are they too young to try to explain this to?

In general, I want to shield my kids from the idea, and possibly stigma, of my mental illness.  But is that the best thing?  I did a little web research and found a few links:

Parenting with Bipolar Disorder, from Two Trees Media (the "Bipolar Disorder Experts," so they say)
How does a severe Bipolar parent affect kids?  From Livestrong.com (written by a "contributing copywriter")
Growing up with a Bipolar parent, from Associated Content

What strikes me from these articles isn't their content, but their lack of content.  Where are the articles by psychiatrists?  There are a lot of articles about the hereditary implications of being a parent with BP, but not much about the emotional impact. 

I'll have to do some further research and see if I can find some testimonials or researched info about this topic.

For now, though, we'll just keep having family fun (and productivity) with hypomania.

Wednesday, September 21, 2011

Why can't we find mental health help??

A couple of weeks ago, the nurse from my OB-GYN's office called and left a message, asking me to call her because she had a question "not related" to me, but more of a general nature.

It turns out that there was a patient in the office who was in desperate need of psychiatric care and was having a problem getting an appointment to see any doctors or therapists.  The nurse wanted to know what psychiatrist I saw, if I liked her, and if it was easy to get an appointment in her office.

Now, I have a good relationship with everyone in my OB's office, mainly because when I was pregnant this past year I called them on average, oh, a million times a week.  Sadly, at one point, the nurses knew my phone number when it came up on caller ID and knew to answer if it was me.  They were aware of my mental health problems and my struggle to find help, so I'm not shocked they called me to see if I could recommend someone for their patient.

That being said, how sad is it that the doctor's office was calling me?  I'd like to think I'm something of an expert -- on pretty much everything, really -- but the reality is I'm just a girl (cue Gwen Stefani) who has had mental health problems.  What does it say about the state of our mental health care system when someone is calling me for guidance?  It's terrifying, frankly.

Doing a little research on psychiatric care in this country reveals some really scary statistics.  A 2006 study in North Carolina, conducted in part by Duke University, showed that there was 1 psychiatrist for every 10,000 people in the state.  It also found that many patients' insurance was lacking when it came to mental health care, which made it harder for them to find help.  (Source:  "Report Finds Limited Number of Psychiatrists Statewide")

A blog called "Health and Medical News and Resources" states that there is a shortage of 45,000 psychiatrists in the United States.  If I was teaching, I don't know if I'd let a student use this blog as a credible source, but I did find the statistic repeated on a page on medscape.com.  Apparently it comes from a study with...a lot of impressive looking references.  The medscape.com page also has an interesting interview with several psychiatrists about the state of the mental health system in the country.

Unfortunately, the lack of care isn't just frustrating -- it has serious ramifications.  For example, in the same interview, one of the psychiatrists state that studies show 16% of prisoners have some form of mental illness (you may have to have a medscape.com account to see this page).  These are people who, if given proper mental health care, would likely not be in prison, but in a psychiatric facility or treated to the point they can live productive lives.

I could go on and on -- I haven't even mentioned the epidemic of mental illness among the homeless -- but I'll leave it at that for now.  I also would be interested in looking up statistics on Ohio in particular, but I'll do that in another post. 

In summation, the statistics are staggering. 

It's actually pretty depressing. 

I think I'll go knit.

Monday, September 19, 2011

Can my baby read my mind? Or, is a mother's mood transferred to her baby?

As most parents know, it's hard not to compare your kids to each other.  Since I now have a 5 month old, I keep finding myself comparing her habits to those of her older sisters (2 1/2 and 4 1/2).

Even to the most casual observer, it's obvious that my oldest daughter is more -- how do we say? -- high-strung than the other two.  She had colic as an infant, and has always had a very strong-willed personality.  My middle girl, on the other hand, was an easy baby and, while she's horribly stubborn, she's much more laid-back than her older sister. My baby seems to be taking after my middle girl; she's the easiest baby of all three, and is happy and, for the most part, content. 

What has me wondering right now is the old wisdom that an anxious parent makes an anxious kid.  My mom used to tell me so often, "Oh, she [the baby] is picking up on your mood, that's why she's upset," that I started thinking the kid could read my mind.  I'd get upset when I had a bad thought, thinking that she could hear it, like some sort of infant seer or something.  This was especially true with my first daughter, because I had horrible postpartum depression and anxiety for the better part of six months after she was born.  I've always kind of wondered if this has made her a more anxious kid, prone to more difficult behavior.

On the other hand, I had pretty bad postpartum depression after my third daughter, plus major depression while pregnant, and she seems to be mellow and happy.  So maybe the prevailing wisdom is more of an old wives' tale than anything else.

Out of curiosity, I started looking online (because I know that if someone has thought about a topic, there's gotta be something online about it) for studies or information on the whole parent-to-kid anxiety/depression idea.  I found a few studies, but there wasn't overwhelming information.  Interestingly, most studies came from the UK, which leads me to wonder if maybe the US is a little behind with this area of research.  Here's what I found:

An article from USA Today about how anxiety and depression can pass from adults to kids, both genetically and through environment.  It centers more on adolescents and teenagers rather than babies, and discussess the benefits of CBT for kids.  

A posting on PsychCentral.com about the difference between normal perinatal anxiety and obsessive perinatal anxiety, but nothing really about how either kind affects the baby.

A few articles from Science Daily talking about sleep behavior in babies with depressed or anxious parents, relating babies' poor sleep to their parents' moods.  ("Babies Born to Women with Anxiety or Depression are More Likely to Sleep Poorly", and "Maternal Depression is Associated with Significant Sleep Disturbance in Infants")

Another article from Science Daily about how maternal postpartum depression is linked to depression in children, even into their teen years,

I went to the JAMA website (Journal of the American Medical Association) to see if they had any studies related to the issue.  I couldn't find too much, other than a lot of stuff about DHA and how it affects depression and anxiety. So if you want to know about fish oil, hit JAMA.

I'm not really sure what to take away from my very rudimentary research; it sounds like maybe there is a link between maternal anxiety and depression and that of the kids, but it's not hugely researched or documented.

I'm still sure my baby can't read my mind, though.  Well, somewhat sure.  A little sure.

Okay, I'm not sure at all.

Friday, September 16, 2011

Fall's in the air...so's my Noni bag!

Last spring, I knitted a Noni Crossover Bag in black, pink, and blue.  But by the time I'd finished it, it was 85 degrees, and I thought I'd look a little silly carrying around a black felted bag.

Now, though, the weather has turned just chilly enough (thankfully!) for me to break out my purse.  I usually like changing purses at the change of seasons, so this is perfect -- I finally get to carry my new knit bag.  I'm actually pretty happy with the way it wears.  I do need to put a zipper in it, though -- I've learned that the hard way.

The strap is a  JUL "Simple Sexy Leather handle" I ordered from Dreamweaver yarns.  I got the pattern from Dreamweaver, too; it's a cool pattern, because it has like six different purses/sizes on just the one pattern.  The yarn is Cascade 220 Tweed (7608 & 7705) and Cascade 220 Wool (8555) because it seems to felt the best of all the yarn I've tried.  I also like the way it knits; my biggest complaint about Cascade is that it's a b@#$! to ball from the hank -- I always end up getting the last several yards tangled and have to chuck them.  I know I could have them balled, but I hate to pay for it.

Which leads me to my other complaint -- while I think Noni has the most gorgeous patterns I've ever seen, I always screw them up and end up frogging (aka, ripping it out) & re-knitting.  I'm not sure if I don't pay attention enough when I'm knitting, or if their patterns are a little confusing.  Admittedly, the last two Noni projects I've completed have been when I was in a seriously crappy mental state, so it may be me. 

Regardless, I did finish this bag and have a nice, new purse to use.  And, yes, I see that little end hanging off the bottom.  I'll go clip that right now.

Wednesday, September 14, 2011

Lithium: Edgy cultural reference or psych drug?

I was excited last week to find out that I had a free trial of Sirius XM radio, which my car is enabled for but I don't subscribe to.  One of my favorite stations on XM is called "Lithium," which claims to play edgy 90's alternative/grunge rock (I say "claims" because one day I heard Creed, so I think it's questionable how "edgy" they are).

One day as I was driving around, I started thinking about the name of the station.  Since Lyddie (girl #3) was born, I've been on lithium as a mood stabilizer.  It's the first time I've been on lithium, personally, but it's one of the oldest and most-tested psych meds around, and is widely acknowledged to be the "gold standard" (per CrazyMeds) for bipolar disorder.  And I know it seems to be working for me.

But what, exactly, does it mean that an "edgy, hardcore" radio station has taken "Lithium" as its name?  Is the use of the word, and, undeniably, the associations with it, giving a negative or incorrect image to a drug that otherwise has helped millions of people?  Is it casting the wrong kind of light on mental illness?  According to Wikipedia (which, of course, is the God's honest truth and we can believe everything it says), the name "Lithium" is a nod to the Nirvana song of the same name.  I know the song, and, as with most Nirvana songs, have no idea what the hell it means.  So, I again turn to Wikipedia, where it says the song is about religion and it being a sort of "opiate" for the person in the song.  Frankly, I have no idea what lithium has to do with that, either.

I honestly don't know how I feel about the name of the radio station (and the name of the song, now that I think about it).  Maybe I'm being overly sensitive -- I tend to over-think things like words and their connotations, I guess it's a hazard of being an English teacher.  But in a world where "crazy" and "mentally ill" and "psych ward" and "looney bin" are all words and phrases thrown around way too carelessly and with negative stigma, maybe I really can't be too sensitive.

Monday, September 12, 2011

Grief, acceptance, and understanding

Per the National Institute of Mental Health (NAMI), one of the most common forms of mood disorder is major depressive disorder.  According to one source, depression affects over 18 million Americans every year.  While many of these major depressive disorders are purely chemical, often, they are triggered by trauma, loss, or other significant life events.

Everyone who has lost someone close to them has experienced sadness and depression in some form.  It's unavoidable; grief and sadness is as much a part of life as joy and happiness.  Cliche, but unfortunately true.  Sometimes grief can turn into a major depressive disorder, or sometimes it can run its course and the individual can slowly regain joyous and positive feelings after time has passed.

I've been thinking about grief and loss lately because a friend of mine from high school's mother died suddenly last week.  I haven't really talked to my friend in a while, but I actually had talked with her mom -- not only was she a good friend of the family, but she was a realtor and helped me sell our old house and buy a new one last year.  I actually just got an email from her about a month ago telling me she wanted to come see what we'd done with our house and meet our new baby.

At this point, I need to say a few things about Janie, because, well, it's impossible not to say something about Janie.  She was one of the most joyful, fun, hilarious people I've ever met.  I've known her since I was probably 11 or 12, and I have some of the most wonderful memories of her from grade school and high school.  And, looking for a house with her was so much fun, as hard as that is to believe.  She took a stressful, potentially depression-inducing process and make it a wonderful, enriching experience.  From the time a dead mouse fell out of a ceiling fan onto her head, to the time my insane cat escaped into our garage during an open house (and I know cats definitely weren't her favorite), she took it all in stride, and with grace and humor.

There are few people I'd say this about, but the world is a little less colorful, a little less joyful, and a little sadder now that she's not in it.

During her funeral, I was thinking about the stages of grief and how the final stage is "acceptance."  It is so hard to accept when something so incomprehensible happens, like the sudden death of an otherwise full-of-life person.  Watching her kids grieve so much made it hard to say the prayers of the traditional Catholic funeral, to "lift up to God" and trust in His guidance.

But maybe acceptance isn't really about accepting death, and coming to the understanding that "this is okay."  Because death, whether sudden or slow, whether young or old, is never "okay."  It's not okay to the people left behind -- but maybe not being "okay" is okay in and of itself.  Maybe acceptance isn't being okay with what happened, but accepting that it sucks, and you hurt, and the bad feelings may lessen but life will never, truly be "okay" in the way it was before.

Maybe I just had too many "okays" in that last paragraph.  But that's okay.

Thursday, September 8, 2011

Bipolar pregnancy

I started this blog while I was pregnant and having serious mental health issues.  One of the most frustrating problems I faced was a complete lack of information about mental health during pregnancy.  There's a ton of information -- both online and in print -- about postpartum depression and mental illness in the postpartum period, which is a good thing, but very little information about mental illness while one is actually pregnant.

There are a couple of books on Amazon.com that discuss having bipolar disorder during pregnancy:  Bipolar and Pregnant..., and Ride at Your Own Risk...   The first is more about managing your bipolar disorder before you get pregnant (therefore avoiding problems during pregnancy), and the second seems to be more of a personal memoir.  Both also suffer from the "way too long title" disease.  There is a good book called Pregnancy Blues that addresses mental illness during pregnancy, but it's written by a doctor and it's a little inaccessible to the Average Josephine.

With all this lack of information, I was initially excited to see a new article posted at psychcentral.com titled "Pregnancy Planning for Women with Bipolar Disorder."  The article has good information about how to talk to your doctor about your Bipolar Disorder and pregnancy, what drugs to stay away from, and what drugs may be less effective with birth control (and what drugs make birth control less effective).

Of course, my excitement flagged a little when I realized the article that it is about planning, and not about what to do once you're pregnant (yes, that's what the title says, so I shouldn't have been surprised). Out of curiosity, I did a search on "bipolar pregnancy" on Psych Central, and it yielded exactly two results:  the aforementioned article, and something about teen marriage.  I understand that pregnant women with bipolar disorder are probably a small population, but shouldn't there be something for them?  I was one of them, and it may have helped if I found even just one piece of information about how to deal.  In the world of the internet, where every tiny little personality quirk and population is indulged, how is this population being ignored?

Tuesday, September 6, 2011

The shoe never fits

I had a therapy appointment today, the first one in a long time.  I didn't feel like I really needed it, but the reminder call came too late for me to cancel the appointment (there's a $75 fee for cancelling less than 24 hours in advance).  So I went, and just bailed early by saying I had someplace else to be.

My therapist is a nice guy, but he spent 15 of our 30 minutes together talking about his vacation and his vacation home.  If he was just a friend, fine, but I'm spending like $90 to meet with him, so time is money.  I have decided I'm not going to go back to see him.

The problem is, he's the...let's count...fifth therapist I've seen and dumped.  To be fair, one stopped practicing, but that was after I stopped seeing her regularly.  I really have never found a therapist who I "clicked" with.  Is it me?  A doctor once suggested I had Borderline Personality Disorder, based on my serial doctor-relationship issues.  Maybe she was right.  I just know I've never found a good fit.

Now, much like a perpetual spinster (does anyone actually use that word anymore?), I'm starting to wonder if there really is a therapist out there that's right for me.  Maybe I'll never find my match.  Maybe I'll fumble through life without the all-important therapist-patient relationship, destined to walk the earth with unexplored psychoses.  And, much like the perpetual spinster, I'm ready to give up on therapy altogether, writing it off as a romanticized ideal that never lives up to its promises.

Or maybe all therapy is a bunch of crap, and I'm just coming to this conclusion now. 

Off topic:  I did a Google image search for "pencil and paper," and this terrifying picture came up (it really is terrifying, so if you don't want to see it, don't click).  What the HELL?

Thursday, September 1, 2011

Routine, Interrupted

I'm not OCD; far from it.  I'm not particularly clean or organized or particular.  That being said, we are in the process of  remodeling our kitchen, and oh my, it is driving me nuts.

I should state upfront that I am really excited for the new kitchen.  It's going to be great.  I've worked hard putting it all together, and it's not going to take that long to do -- just a couple of weeks or so, then I'll have a beautiful new kitchen to enjoy.

However...there's something about my routine being disrupted that causes me to totally crash.  I've gone through two bathroom remodels and various other smaller projects, and it's always the same -- it get irritable, depressed, and anxious.  I can't cook anything, I can't really wash dishes, it's hard to get to my refrigerator (at least I still have one, though), and all the contents of my kitchen are strewn around my living room and dining room.  I found my two-year-old trying to eat a beef bullion cube she found yesterday because she assumed if it was in a shiny wrapper, it was candy.  She was disabused of that notion pretty quickly.

Out of curiosity, I did a little web searching on bipolar disorder and routine, and found quite a few articles that talk about how people with bipolar disorder may be helped by regular routines.  I'm not surprised, because a disruption to my routine certainly wreaks havoc with my mood, so it would stand to reason that the opposite is true.  Here are the articles:

From webmd.comDaily Routine May Help Bipolar Disorder
From the American Journal of PsychiatryThe Importance of Routine for Preventing Recurrence in Bipolar Disorder
From healthyplace.comStability in Bipolar Disorder Requires Routine

At least I feel a little justified that I'm not just making up an excuse for my bad mood.  Here's hoping the reno goes quickly.