bipolar parent

How Mental Illness Affects Police Shooting Fatalities

A version of this post first appeared here on the International Bipolar Foundation’s website, here.

In 2015, the Washington Post conducted the first ongoing tally of officer-involved shooting deaths of the mentally ill. Nationwide, at least 25% of people who are shot and killed by police officers suffer from acute mental illness at the time of their death. People with untreated mental illness are 16 times more likely to be fatally shot during an encounter with police than people with their mental illnesses under control.

According to the Post’s 2018 tally, 1,165 civilians were fatally shot by police. Of those, more than 200 were confirmed to be mentally ill. Someone needs to be paying attention.

How Mental Illness Affects Police Shooting FatalitiesUnarguably, mental illness isn’t the only factor involved in fatal police encounters. Race is one that is often talked about. But the link of mental illness to police brutality doesn’t have the same publicity.

In 2015, the New York City Police Department responded to more than 400 mental health calls per day, more than 12,000 per month. But why do the police respond to mental health crises, and not EMTs? Historically and correctly, law enforcement has been paid to transport people suffering breakdowns to hospitals. And for many mental wards, police involvement is a requirement for involuntary admittance. In Washington state, for example, “under almost all circumstances police involvement is the primary factor in determining whether referral will result in commitment” (Carr, Durham, and Pierce 1984). This happens often enough that the state of Oklahoma’s mental health department includes a budget line item specifically for reimbursing police to transport patients.

The perception of people suffering mental illness as violent and dangerous is another reason police are called. Officers are the only people often perceived by the public to be able to deescalate mental health crises. According to the American Psychiatric Association, most people with mental illness are not violent, but using the law enforcement as a blunt instrument contributes to the stigma that they are. In fact, people with mental illness are more likely than others to be victims of a crime, not perpetuate them.

A Call to Action for Governments

The December 2015 report from The Treatment Advocacy Center, “Overlooked in the Undercounted: The Role of Mental Illness in Fatal Law Enforcement Encounters,” urges lawmakers to make sweeping changes to this broken system. The authors recommended that the lawmakers:

  • Restore the mental health system so that people who suffer from mental illnesses will be treated before they end up in encounters with law enforcement;
  • Accurately count and report all situations involving deadly force by police officers;
  • Identify the number of times those with mental illnesses are fatally shot in an official report, so lawmakers can’t ignore the impact of police fatalities related to mental illness.

Since that study, there has been marginal progress. The 21st Century Cures Act, passed by Congress and signed into law by President Obama in December 2016, mandated that data on the role of mental illness in fatal police encounters be collected and reported. Soon after, the Bureau of Justice Statistics started using a new methodology in reporting arrest-related death statistics. Using the new methodology, the number of arrest-related deaths that were verified and reported to the Department of Justice doubled.

But the act is not as robust as it could be. According to the Post’s tally, police killed about two dozen more people in 2017 than in 2016, and even more in 2018. The numbers don’t lie; things have not improved much, despite more accurate reporting.

What Can I Do?

Progress is slow, and this may feel like an insurmountable problem. But there are things you can do to help. Contact your House representative and let them know that you are concerned about fatal police shootings. Read books like Breakdown: A Clinician’s Experience in a Broken System of Emergency Psychiatry, which describes why psychotic patients need involuntary commitments. Champion police body cameras and mandated government reporting of the role of mental illness in shootings. Advocate for mental health funding at all levels of government. If you are a police officer, rely on your crisis training to deescalate crises involving the mentally ill.

Final Thoughts

Fatal police shootings, especially of when they involve people suffering from mental illness, are not new or rare. Nor are they going away. But there are things you can do to help. We’ve got to stop this trend. With consistent pressure on our lawmakers and law enforcement, we can fix this.

  1. Durham, Mary & Carr, Harold & Pierce, Glenn. (1984). Police Involvement and Influence in Involuntary Civil Commitment. Hospital & community psychiatry. 35. 580-4. 10.1176/ps.35.6.580.

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How Mental Illness Affects Police Shooting Fatalities - CassandraStout.com

 

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6 Steps to Become Your Own Mental Health Advocate

Whether you have a diagnosis of mental illness or are seeking one out, becoming your own mental health advocate is crucial. Many people don’t have the support of others when dealing with mental illnesses. Sometimes, the only people who will advocate for them is themselves.

Becoming your own mental health advocate isn’t a difficult process, but it is a process. There are things to do and things not to do when traveling along that road.

Here are 6 steps for advocating for yourself:

6 Steps to Become Your Own Mental Health Advocate - CassandraStout.com

Step #1: Accept your Symptoms

The first step towards becoming your own self advocate is to accept that your symptoms point towards a mental illness. For example, if you find you’re not sleeping but still have a ton of frenetic, pressured energy, you could be suffering from a manic episode of bipolar disorder. Make a note of your symptoms and take them into a professional.

Step #2: Build a Treatment Team

In order to acquire a diagnosis of mental illness, like bipolar disorder or schizophrenia, you must build a treatment team. You need a therapist at the very least, and if you find your mental illness can’t be managed without medication, you’ll have to find a psychiatrist.

You want to find a team of professionals who can treat you holistically. Ask your primary care physician for referrals to psych doctors.

For a post on how to get a psychiatric evaluation, click here. For a post on how to start seeing a therapist, click here.

Step #3: Educate Yourself about Your Mental Illness

Once you have a diagnosis, find reputable sources to read about your mental illness. The National Alliance on Mental Illness (NAMI) is a fabulous resource on all manner of mental health conditions.

If you have bipolar disorder, there are also books like An Unquiet Mind: A Memoir of Moods and Madness (not affiliate), by Kay Redfield Jameson. Ask your treatment team for resources. They’ll be happy to provide.

Step #4: Be an Expert on Yourself

You know yourself better than anyone else. So capitalize on that. Keep track of your symptoms via mood chart, sleep journal, and/or a symptom tracker app.

You’re not a doctor, so don’t try to be one, but providing information to your treatment team can only help you. Rely on your treatment team to best interpret the information.

Step #5: Practice Self-Care

You won’t be able to help your treatment team take care of you if you’re worn out. Look after yourself. Practice daily self-care.

Get some sleep, eat several small meals, drink enough water, socialize with real people, go outside, and move your body for at least 30 minutes per day. These six self-care tenants, outlined by a post on WellandWealthy.org, will help you feel better if you do them more frequently than not.

Step #6: Express Yourself Calmly

Sometimes, when advocating for yourself, you will face resistance and stigma.

If this happens, then try to remain calm. Take deep breaths and center yourself. Tell yourself that getting angry won’t help you, and control your knee-jerk reactions.

Once you’ve got a handle on your emotions, express yourself calmly. Explain what you need and what you expect from the people you’re explaining this to.

If you can’t express yourself in the moment, take a break, and write down what you need to say. Come back to the people who resisted or stigmatized you and read from your writing.

Final Thoughts

Becoming your own self-advocate is a process, one you can master. Accept your symptoms, build your treatment team, educate yourself about your mental illness, be an expert on yourself, practice self-care, and express yourself calmly in the face of resistance and stigma.

If you practice these steps, then you’ll be well on your way to becoming your own self-advocate.

I wish you well in your journey.

6 Steps to Become Your Own Mental Health Advocate - CassandraStout.com

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How Does Spoon Theory Relate to Mental Illness?

spoon
A picture of a pile of silver spoons on a black background. Credit to flickr.com user liz west. Used with permission under a Creative Commons license.

Sometimes those of us with chronic illnesses, ranging from physical diseases like multiple sclerosis to mental illnesses like bipolar disorder, are unable to keep up with the demands of the day. Especially if we’re suffering from depression, which is the most common symptom of chronic illness.

The Spoon Theory, a concept popularized in a personal essay by the same name by Christine Miserandino, explains the idea of energy in short supply due to chronic illness using “spoons” as units of energy.

Miserandino lives with lupus, a chronic autoimmune disease which causes the body’s immune system to attack healthy cells. To her surprise, her friend, while sitting with her in a café, asks Miserandino what it’s like to be sick. Miserandino answers with the need to take pills, and her friend presses her: What is it really like to be sick?

“How do I explain every detail of every day being affected, and give the emotions a sick person goes through with clarity,” Miserandino writes. “I could have given up, cracked a joke like I usually do, and changed the subject, but I remember thinking if I don’t try to explain this, how could I ever expect her to understand. If I can’t explain this to my best friend, how could I explain my world to anyone else? I had to at least try.”

Miserandino gathers up spoons from the nearby tables, so many that it seems excessive. She hands the twelve utensils to her friend, and tells her that she always has to be conscious of how many she has, and can’t have any more. Then Miserandino asks her to spell out her day.

Her friend says she gets out of bed, and Miserandino takes a spoon. Her friend says she takes a shower, and Miserandino takes a spoon. She explains that getting dressed is a trial: if her hands hurt, she can’t use buttons; if she has bruises, she has to wear long sleeves, and that dressing takes two hours. Eventually, her friend realizes that Miserandino’s “spoons,” her time and energy, are severely limited by stress and pain–and breaks down crying. “Christine,” she says, “how do you do it? Do you really do this everyday?”

Miserandino probably had no idea that so many people would connect with her theory. For people living with chronic illnesses, spoon theory is a perfect way to explain to healthy people how diseases impact their lives. Some of those people call themselves “Spoonies.” In 2013, Dawn Gibson, a woman who suffers from spondylitis and food allergies, created #SpoonieChat on Twitter. It’s a chat held on Wednesday nights from 8 to 9:30pm Eastern time, where people can share their experiences as Spoonies. Dawn also runs a Spoonie Chat community on Facebook, for those of you looking to connect with other Spoonies.

But how does Spoon Theory relate to mental illness? Easily. If you’re suffering from bipolar mania, you might spend all of your spoons all at once in the morning. Mania and hypomania inflate your sense of your spoons and borrow them against future days, whereas depression puts a limit on the spoons you start out with.

Someone afflicted by panic attacks will drop their spoons trying to manage their disorder. Substance abusers are generally replacing their spoons with chemicals that do ridiculous amounts of damage to their bodies. And someone with schizophrenia might not be aware of how many spoons they have at any given time.

Your spoons are precious. Try to keep them, and try to manage them better. Sleep well if you can, eat healthily, and practice mindfulness, and hopefully you will be able to combat the days when you spend your spoons too soon.

Good luck.

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Are You White? You Have a Better Chance of Being Properly Treated For Bipolar Disorder

Bipolar disorder, affecting up to 4% of the global population, does not discriminate. The disease manifests equally in people of all races, comprising of mood episodes involving “highs” called mania, and “lows” called depression. But your experience being treated for

mental health
A picture of a woman holding a sign saying “Accept Mental Health As Part of Our Life Experience. Anon. :)” Credit to flickr.com user Feggy Art. Used with permission under a Creative Commons license.

mental health issues, including bipolar disorder, depends on your race.

Study after study shows that black, Hispanic, and Latinx people face disparities in mental health care. Minorities have less access to mental health treatment than whites, are less likely to seek care, and are more likely to receive poorer quality care when they do seek it.

Specific to bipolar disorder, black people are more likely to be misdiagnosed with schizophrenia than bipolar disorder, as compared to whites. Similarly, Hispanic people are more likely to receive a misdiagnosis of depression. Even though the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) has improved, racial differences in diagnosis continue to exist. And African Americans are more likely to terminate mental health treatment prematurely.

The results of one new study prove that non-Hispanic whites are significantly more likely than other racial groups to receive medication. Asians are least likely to use prescribed medication.

Take a look at this chart, which lists mental health treatment statistics by race:

Hispanic/Latinx African American Asian

Some of these outcomes, such as the likelihood of Asians to allow their families to influence their mental health treatment decisions, are culturally-based. Others are due to racial inequalities present in the U.S. healthcare system.

Possible Solutions

But what can the white person do about this discrimination? The mental health field is dominated by white people, specifically women, describing their experiences with anxiety and depression–even though both conditions are more likely to occur in blacks.

If you’re white and you suffer from a mental illness, don’t stop talking about it, but be cautious about presenting your experience as the default. Make sure to use your platform to allow other racial groups to speak. Support organizations like Black Mental Health Alliance.

Above all, listen to minorities when they share their various trials. Demonstrate that you care about their struggles and signal boost their posts. If you’re white, you have a powerful privilege and a responsibility to use it properly, to help buoy others.

Good luck!

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Maternal Bipolar Disorder Significantly Increases Risk for Premature Births

premature
A premature infant lying on a hospital bed just his size. Credit to flickr.com user César Rincon. Used with permission under a Creative Commons license.

Premature babies–infants born before the 37th week of pregnancy–endure a great number of challenges, such as high blood pressure, hypoglycemia, and breathing properly. No one wants their baby to be born early, unless there’s a risk to the mother.

But, unfortunately for mothers with severe bipolar disorder, they may not have a choice. A 2015 study published in the American Journal of Obstetrics and Gynecology showed that mothers with bipolar disorder are twice as likely to give birth prematurely than mothers with no mental illnesses. And a 2010 study published in the Journal of Affective Disorders demonstrated that in Taiwan, the incidence rate of premature births among pregnant women with bipolar disorder was 14.2%, compared to 6.9% of women without mental illnesses. The Taiwan study also included statistics about infants with low birth weights (9.8% vs. 5.7%), and smaller-than-gestational-age babies (22.3% vs. 15.7%).

Unfortunately, premature babies are also 2.7 times more likely than full-term babies to develop bipolar disorder later in life. For a full breakdown of these statistics, including the risk for psychosis and schizophrenia, click here.

But it’s not all bad news. The rates of premature births for bipolar mothers aren’t very high. A 14.2% chance to have a preterm baby means that you have an 85.8% chance to have a full-term baby. That’s pretty good!

So what can you do to prevent preterm births? The risk factors for a premature infant include:

  • Already having had a premature baby. This is a major risk factor.
  • A second pregnancy soon after having a baby.
  • Being pregnant with twins or more.
  • Having uterine or cervix problems.
  • Being overweight or underweight.
  • High blood pressure, stress, diabetes, and some infections.
  • Smoking and substance use.
  • Becoming ill with the flu.

Some of these things you can’t control, like having twins. But others, you can, such as avoiding pregnancy soon after having a baby, stopping substance use, or getting your flu shot. Maintaining a healthy weight during pregnancy also helps, so be sure to exercise and eat a healthy diet.

Final Thoughts

Premature birth can be scary and challenging. But, while the likelihood of giving birth prematurely is increased for bipolar mothers, the overall rate isn’t that high. Follow your obstetrician’s advice. There are some steps you can take in order to hopefully prevent a preterm infant.

Good luck!

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How to Survive a Stint in the Mental Hospital

 

 

hospital
A picture of San Juan Regional Medical Center. Credit to flickr.com user teofilo. Used with permission under a Creative Commons license.

A stay in a mental hospital can be a frightening thought. Some patients may be a danger to themselves or others. People are hospitalized in psychiatric wards for a variety of reasons. Some may suffer from depression. And still others may endure anxiety disorders, mania, or any other number of mental illnesses, like bipolar disorder, schizophrenia, or postpartum psychosis.

But what about you? How do you survive a stint in the mental hospital, if you need one? Let’s dig in.

Deal with Potential Anger

When starting out your stay in a psychiatric ward, you may find yourself angry. If you’ve been involuntarily committed, you may not believe that you deserve to be there. Even if you do believe you deserve to be there, anger is a common emotion to feel when hospitalized, especially in the first few days. The nurses should be aware of this and will prevent violent interactions between patients, but will largely ignore your outbursts otherwise.

Because the nurses are ignoring your potential anger, you will have to handle it yourself. So now that you know you might have some anger to process, how do you deal with it? Here are some steps that can help:

  • When you feel the first stirrings of anger, try breathing deeply through your nose. (For a technique for deep breathing, click here.)
  • Create a calming and positive mantra, and repeat it to yourself. Try something like, “chill,” “relax,” or “take it easy.” Repeat this to yourself until you feel the anger ebb.
  • Wait to express yourself until after the initial rush of adrenaline has passed, and do so in a calm and appropriate manner. Try to be assertive rather than angry.
  • Keep a journal of what makes you feel angry and why, and try to avoid those triggers.
  • Listen to those around you. Practicing good listening skills can help clear up disagreements before they start.
  • If another patient is trying to get your goat, then walk away, and alert the nurses. Disengage as quickly as you can.

Calm acceptance of your stay in the mental hospital will come in time, unless the anger is a deep-rooted issue. Handling conflict properly with other patients and the hospital nurses is very important. If you don’t deal with your anger, you’ll create problems for everyone involved.

Make Friends

In a mental hospital, you will may be bored and lonely. Some wards don’t allow internet access or phone use, so you might be completely cut off from the outside world. One of the best ways to cope with this problem is to make friends with the other patients. Try to be open to starting new friendly relationships with people. It may relieve you of your boredom and even speed your recovery, because having someone to cheer you on is always good. You’re all in this together.

Even though making friends is good, people can become too close. Nurses are instructed to break apart people who grow too chummy. For example, during my own stay in a mental hospital, I made a friend with whom I became quite codependent. Every time she left the room, I wondered if she was abandoning me. My doctors instructed me not to make my emotional health dependent on her.

That is why establishing healthy boundaries with others is so important. If you don’t want to lend out your personal items, then decline politely whenever someone asks. And don’t tolerate abuse from people either. If they don’t stop hurting you when you ask, be it emotional or physical harm, walk away and alert the nurses.

Note: While making friends is advised, starting a romantic relationship is not. Needless to say, a stay in the hospital is emotionally charged. You’re there to stabilize and recover, and you’re not at your best self. Neither is any other patient. You might find yourself in a whirlwind romance, which won’t benefit either of you. Your ultimate goal is to improve and be released, and a romantic attachment may hinder that.

Fall in Line

Psychiatric wards have a lot of rules. You may receive a tour of the hospital explaining what most of these guidelines are. Pay attention to what the nurses and doctors say with regard to your behaviors and treatments. Make sure you know what expectations are placed on you so you can be released, possibly earlier than expected.

In addition to general rules, there are basic steps you can take to get released. Comply with your individual treatment plan. Attend all the therapy and crafting sessions, and take your medication as prescribed. If you disagree with the treatment plan, talk to your doctors. A willingness to discuss things rationally is better than outright refusal.

You might think, like I did, that the doctors are out to get you or that they’re incompetent. You might believe that they want to keep you in the hospital forever, because it pads their bottom line. I can assure you that that’s not the case. They want you to recover. Talking with them will help both you and them.

You won’t recover until you’ve stabilized, which the medication and therapy is intended to help with. Your doctors have years of experience under their belts, treating all manner of mental illnesses and substance abuse problems. They know what they’re doing, and they really do have your best interests at heart. You don’t need to like them, just work with them.

Conquer Boredom

Having your daily routine interrupted by a stay in the hospital will be very difficult. And without the challenges of work or school, you may end up facing extreme boredom. You will have a lot of time to think, and you might not want to get wrapped up in your thoughts. Try constructive ways to fill your time, such as:

  • Exercise. Studies have shown that there are very beneficial effects of working out for your mental health, especially people suffering from bipolar disorder. Ask the nurses if there is an open space where you can get your heart pumping. Jogging in place, doing a few crunches, and trying some pushups for a few minutes is all you really need to do, especially if you’re largely sedentary outside the hospital.
  • Reading. Most psychiatric wards own books and magazines available for the patients. Mine had old copies of Reader’s Digest. If you have friends willing to come visit you, ask them to bring reading materials.
  • Crafting. You will likely be assigned a crafting or skill-learning class. Take notes and learn how to craft the presented item or perfect the taught skill. Why? It might sound stupid, but creating a handprint turkey is better than being bored.
  • Doing crossword puzzles or coloring pages. If possible, ask the nurses to print some of these out for you, or your friends to bring some.

Final Thoughts

A stay in the mental hospital doesn’t have to be a disaster. If you deal with your anger, handle interactions with others appropriately, comply with treatment, and fill your time with constructive activities, you can ensure that you’ll make the best of your stay.

Good luck!

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How Sugar May Harm Your Mental Health

Sugar, especially refined white sugar which has been processed, inflates waistlines and contributes to obesity. But, while some studies have shown that sugar may have a detrimental effect on the mood, not a whole lot of research has been done on sugar’s effects on mental health.

In a past post, Good, Good, Good Nutrition, part II: Foods to Avoid When Managing Bipolar Disorder, we covered how sugar can cause wild mood swings in bipolar patients. And how obesity can make some bipolar medications ineffective, especially if the weight is gained around the middle. But there are other ways sugar harms mental health.

Let’s dig in.

Addictive Properties

The addictive properties of sugar have been studied in recent years, though the research is still controversial. But anyone who’s craving a chocolate fix can understand how additive sugar is. Sugar and actual drugs both flood the brain with dopamine, a feel-good chemical which changes the brain over time. Among people who binge eat, the sight of a milkshake activated the same reward centers of the brain as cocaine, according to a Yale University study. Speaking of cocaine, rats actually prefer sugar water to the hard drug. And according to a 2007 study, rats who were given fats and sugar to eat demonstrated symptoms of withdrawal when the foods were taken away.

sugar
A spoonful of sugar on a black background. Credit to flickr.com user Gunilla G. Used with permission under a Creative Commons license.

Cognitive Effects

Sugar may also affect your ability to learn and remember things. Six weeks of drinking a fructose solution similar to soda caused the rats taking it to forget their way out of a maze, according to a University of California Los Angeles (UCLA) study. In the same study, rats who ate a high-fructose diet that also included omega-3 fatty acids found their way out of the maze even faster than the controls, who ate a standard diet for rats. The increased-sugar diet without omega 3s caused insulin resistance in the rats, which leads to diabetes and damaged brain cells crucial for memory.

Depression

Countries with high-sugar diets experience a high incidence of depression. Mood disorders may also be affected by the highs and lows of sugar consumption and subsequent crashes. In schizophrenic patients, a study has shown that eating a lot of sugar links to an increased risk of depression.

The researchers behind the study produced a couple of theories to explain the link. Sugar suppresses the activation of a hormone called BDNF, which is found at low levels in people with schizophrenia and clinical depression. Sugar also contributes to chronic inflammation, which impacts the immune system and brain. Studies show that inflammation can cause depression.

Anxiety

Sugar consumption doesn’t cause anxiety, but it does appear to worsen anxiety symptoms. Sugar also causes the inability to cope with stress. Rats who ate sugar and then fasted showed symptoms of anxiety, according to a 2008 study. In a study in the following year, rats who ate sugar (as opposed to honey) were more likely to suffer anxiety. While you cannot cure anxiety through a change in diet, you can help the body cope with stress and minimize symptoms if you avoid sugar.

The Bottom Line

The good news is, people are consuming less sugar now that the risks to eating it are clearer. A decade ago, Americans ate sugar for 18% of their daily calories, but today that’s dropped to 13%. The more we learn about the human body and how our choices in foods affect us, the more we can tailor our diets to maximize the benefits to our health and minimize the risks.

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Genes Linked to Creativity Could Increase Risk of Bipolar Disorder, Schizophrenia

paintbrush.jpg
Credit to flickr.com user John Morgan. Used with permission under a Creative Commons license.

Genes linked to creativity could increase the risk of bipolar disorder and schizophrenia, according to new research done by scientists at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London.

 

Creativity and mental illnesses have long been suspected to go hand in hand, with several famous artists suffering from psychiatric illnesses–such as Vincent Van Gogh. Prior studies have shown that bipolar disorder in particular is often found in families with many members who are part of creative professions. But it wasn’t until the IoPPN study that scientists were able to definitively say genetics played a part, as opposed to environmental factors.

Schizophrenia and bipolar disorder both affect thought patterns and emotions, which includes creativity. Creativity is difficult to define in a scientific context, but the IoPPN study looked at 86,292 individuals from Iceland, pinpointing the trait in the artists, dancers, and song writers, and linking their genes to the risk mental illnesses.

The findings suggest that creative individuals are predisposed to thinking differently, which may contribute to psychiatric disorders. By understanding the thought processes behind healthy behaviors, such as creativity, and how that trait links to bipolar disorder and schizophrenia, scientists hope that they can understand how the brain goes wrong.

This should lead to better treatments for mentally ill people, always good news!