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Saturday, 31 August 2013

Get started your career by means of getting started toon commence

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Sunday, 25 August 2013

Mindfulness and Hypomania

I wrote in a post titled Discipline and Diagnostics that one of the benefits of meditation to a person with a mental illness is the ability to detect episodes early.  Well, I’m in one.

It’s been hard to sit at all, let alone for the thirty minutes I do each day.  I find myself agitated and fidgety.  My thoughts are all over the place.  This is not unusual during meditation, but in taking note of the subjects of my thoughts, I can see hypomania creeping in.  I’m thinking of buying stuff.  I’m thinking of trading stocks.  I’m thinking of another career change, discarding good ideas for more exciting, if undoable, ones.  All of my thoughts are about getting and doing.  Anything.  Right now I feel smarter, more creative, and more energetic than I usually do.  That might be dangerous, but that’s what I’m feeling, and that’s what I encounter during meditation.

Here’s where meditation helps.  I’ve picked-up these early signs of hypomania, so I can work to avoid myself going full-blown manic.  During meditation, which I now have to force myself to do, I become calm for a time and clearly see the maelstrom I’ve entered.  I give my wife my credit cards.  I walk past the corner pub without going inside.  I implement the two-week rule for purchases, investments, changing my LinkedIn profile, and publicly flouting new ideas.  The two-week rule allows me to note what I want, or want to do, and set it aside.  If, two weeks later, it still seems like a good idea, I can act on it.  Meditation sessions keep me honest.  I note if I’m breaking the rules, or planning anything big and stupid.

This is when meditation becomes a little different.  In quieter moods, while focusing on the breath I note thoughts and release them, always returning to the present moment. But when I recognize the signs of creeping mania (or depression), I incrementally change my relationship to my thoughts.  As they arise, I pay a little more attention to them as I note them.  I investigate what my thoughts are about.  Are they fantasies?  Is there anger?  Am I subconsciously planning?  What thoughts keep returning?  Are there consistencies, or even deep inconsistencies?  As I note repeating and defeating thoughts, I can see how they are affecting my behavior when I’m not meditating.  Then I can make what changes I need to make in my day, my plans, and my expectations, and avoid trouble and minimize the impulsivity.

Hypomania.  Although it can lead to very bad things, it has its benefits.  As I stated, I think it does make me more creative and energetic.  By meditating, staying present and responsible, and noting my thoughts, I can both stay focused and harness some of that energy and creativity.  Meditation helps me hold on to the good ideas and keeps me away from acting out the bad ones.

Anyone who’s experienced hypomania and felt the energy, charisma, and flush of ideas it often brings, knows that if we could bottle this stuff we’d make millions.  But we can’t bottle it.  If left to ramble it often becomes grandiosity, poor judgment, and hurtfulness.  Through the focused attention of mindfulness meditation, I can harness the positive and work to avoid the negative.  This episode will pass, and I hope to leave it with my life intact - and a few good ideas.

Friday, 23 August 2013

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Thursday, 22 August 2013

Stepping Up

It’s impossible to write a blog about mental illness without confronting the violence that has descended on this country all too often.  Too many innocent victims have fallen at the hands of too many offenders to set the issue aside.  My heart bleeds for the victims lost and the loved ones remaining.  Nothing written can take away the pain of the survivors.  But a call to action may help to prevent such crimes from continuing.

The offenders in these incidents are often troubled and plagued by recurrent mental illness.  The tragedy begins when our mental health system fails these individuals and their families as they seek help that is sometimes unavailable.  It layers as so many people who do not have direct experience with mental illness find their only exposure to people with serious mental illness in these stories.  This adds to an already daunting stigma against those with psychiatric disease, and too many of those who need help avoid it for fear of being labeled or ostracized.  Every incidence of violence leaves me heartbroken, and waiting for the inevitable story about someone with mental illness gone wrong.

The result of a broken mental health system and the stigma that drives people with serious mental illness into the shadows is fewer people getting treated than need treatment.  Some people (a very small percentage of the population with mental illness, but a disturbingly large real number) with untreated mental illness act out and sometimes violence occurs.  In addition to the senseless tragedy that results, this adds to the stigma placed on those with psychiatric challenges as the general population hears the stories of mentally ill offenders who were “off their meds,” or otherwise refusing treatment.  Or being refused treatment.

In truth, even though sensationalized in the media, very few people know anyone with mental illness and violent tendencies.  However, almost everyone knows someone with mental illness who is managing life well.  Yet because of the stigma, more often than not few know that those managing well have a mental illness at all.  There is so much to risk in stepping from the shadows and saying “I have bipolar disorder, or schizophrenia, or anxiety disorder, or major depression or…”   Jobs and relationships could become tenuous.  Still, until those of us who have a mental illness and do cope well stand up and act as role models for those who are not currently able to deal with disease, the stigma will hold, people will avoid treatment, and society will view the mentally ill as disturbed, demented, or violent.  Those of us who do well owe it to those who are suffering to light a path toward recovery.  Only we can testify that treatment often works, and only we can tell our stories and reveal to the larger population that those with mental illness are not miscreants, vagrants, and criminals.  We are your teachers, your accountants, your child’s playdate’s parents, your boss, your mechanic, your kid’s soccer coach, your favorite musician, actor, or writer, your doctor, your council person.

Treatment is difficult and access is often limited.  But there is no denying that even when treatment is readily available, many refuse it for fear of the stigma.  These same people often get worse.  Some do stupid or reprehensible things.  This can be avoided if we can chip away at the stigma.  And we can chip away at the stigma by taking a stand and showing our neighbors that mental illness does not mean maladaptation.  There is much pain in knowing that in all of these incidents of violence we could not be there to intervene or help.  But we can help avoid the next one by testifying to the very ill that:  “I did it.  I overcame this.  You can, too, and I can help show you how.”  If more of us act as responsible role models the stigma will erode.  As the stigma falls away, more people will seek help.  Examples of people who have been successfully treated may open up access to treatment for others, as policymakers see that dollars spent on psychiatric care are well spent.  As more people seek and receive care, fewer incidences of mindless violence will occur.

It’s our responsibility to let society know that those with mental illness can lead peaceful, productive, creative, and meaningful lives.  We are examples of this.  The stigma against people with mental illness is one factor that leads to so many bad outcomes.  We owe it to those who have lost loved ones, and to those suffering from illness as we surely once did, to stand up and be seen as examples of how things can turn out well. 

Wednesday, 14 August 2013

Mindfulness and Meditation

The successful management of mental illness requires an attention to the mind and body that is directly opposed to the compulsions inherent in many mental illnesses.  In mania we want to follow every desire.  Our ideas are expansive, grandiose, and often wrong.  In depression we doubt, dread, and sometimes even hate the very self we have cultivated throughout our lives.  In psychosis we ultimately lose contact with reality.  The build up to these states often passes unnoticed, and we find ourselves in episodes, reeling in symptoms, unable to find a center, or safety, or home.

The outcome of many episodes is confusion.  “How did all of this happen without my awareness?”  We’re stuck with bills, wrecked homes, scars, strained relationships, and damaged jobs, if any job is left at all.  But episodes can be managed, if not completely controlled.  What we can do is be in tune with our bodies and minds and predict when mood changes begin.  Then we can act, adjust, and avoid bad outcomes.

A technique to achieve this is meditation.  The word may bring up all sorts of preconceived ideas, but most of these are wrong.  We’re not talking about robes or mantras, altered states or enlightenment.  It will not make you lose your edge or turn you into a calm, centered, but boring person.  All we seek is an awareness of the present moment.  This can be both liberating and diagnostic.

Try this.  Sit comfortably but with good posture.  Let your hands fall comfortably onto your legs or into your lap.  Close your eyes.  Focus your mind on your breath, your natural breath, as it moves through your body.  Thoughts will dance or stumble through your mind.  Just acknowledge each one and let it go.  You don’t need to complete each thought or add reason.  Return to the breath.  Begin counting.  On each out breath count one, then two, and up to ten.  Then count down from nine to zero.  Your mind will certainly wander.  You may lose your place.  Just return to a number and continue.  When you reach zero sit for a while longer, hearing the sounds around you, sensing every breath.  Then open your eyes and observe.

In this exercise you have not escaped for a moment, you have experienced the moment.  As a matter of fact, escape most often occurs when we are awake and think we are alert.  Instead we are usually replaying the past, worrying about the future, or wishing ourselves somewhere else.  But if we stay here, in this moment, we can fully experience life as it is.  We can sense each mood and feel it taking us.  Then we can intervene, if necessary, and return to a place of health.

This exercise may take three to five minutes.  Practice it two to four times a day.  Note where your mind tries to take you.  Concentrate on your ability to bring it back to the present moment, back to the breath.  This is the first step toward the awareness necessary to manage mental illness.   Comment with your experiences and in future posts we will build from there.

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Monday, 12 August 2013

Science Weighs In

A recent study reported by the National Academy of the Sciences indicated that mindfulness meditation practice “could provide a means for intervention to improve or prevent mental disorders.”   The study followed a group of people who practiced mind-body integrative meditation for four weeks while a control group only practiced relaxation techniques.  Compared to the control group the group of meditators showed a dynamic pattern of increased brain signaling in the anterior cingulate cortex, showing that the brain can be changed by meditation.  It is especially significant that these changes in the brain took place in the anterior cingulate cortex as this region of the brain is involved with mood regulation, and deficits in this region have been associated with attention deficit disorder, dementia, depression, and schizophrenia.  As brain changes took place, the participants in the meditation group did in fact report improved moods.  The control group showed no such changes.

The study was conducted at the University of Oregon, repeating the techniques and verifying the results of an earlier study at the Dalian University of Technology in China.

It is important to note that the meditators practiced consistently for four weeks, twenty minutes each day.  While an MRI showed few changes in the brain after two weeks, after four weeks the changes were significant.  This illustrates how, as with many psychopharmaceuticals, brain functioning changes can occur relatively quickly but not immediately.  The study also demonstrates that the effects of meditation are more significant than mere relaxation exercises alone.  Actual changes in brain functioning do occur.  More positive moods are possible.  So if you begin a meditation practice stick with it and be consistent. Changes in mood will not be immediate but may likely follow after only a few weeks of practice.  Change your mind.  Meditate.


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