The Stigma of Mental Illness (or, how we found dog poop in the living room!)

dog

Robin Williams’ recent suicide has risen the awareness of many people. One out of five Americans will experience a mental disorder during their lifetime.  But, people can get better.  With proper treatment, most people with a mental illness recover quickly, and the majority do not need hospital care, or have only brief admissions.

Mental illness has traditionally been surrounded by community misunderstanding, fear, and stigma.  Stigma towards people with a mental illness has a detrimental effect on their ability to obtain services, their recovery, the type of treatment and support they receive, and their acceptance in the community.

Exactly what is stigma?  Stigma means a mark or sign of shame, disgrace or disapproval, of being shunned or rejected by others.  It emerges when people feel uneasy or embarrassed to talk about behavior they perceive as different.  The stigma surrounding mental illness is so strong that it places a wall of silence around this issue.

It is like hiding the “pile” instead of dealing with it properly.

The effects are damaging to the community as well as to the person will the illness and his/her family and friends.  But at Mental Health agencies and groups all over are working hard to erase the stigma associated with having a mental illness.

In-House-46638176283_xlargeThe emphasis needs to be on supporting and treating people in their own communities, close to their families, friends and familiar surroundings.

Yet discrimination and community misconceptions remain among the most significant barriers to people with a mental illness being able to actively participate in the community and gaining access to the services they need.

But it is not only people with a mental illness who experience discrimination and stigma.  Rejection of people with mental illness inevitably spills over to the caregiver and family members.

Improving community attitudes by increasing knowledge and understanding about mental illness is essential if people with a mental illness are to live in, and contribute to, the community, free from stigma and discrimination.

People with mental problems are our neighbors. They are members of our congregations, members of our families; they are everywhere in this country. If we ignore their cries for help, we will be continuing to participate in the anguish from which those cries for help come. A problem of this magnitude will not go away. Because it will not go away, and because of our spiritual commitments, we are compelled to take action.”

~Rosalynn Carter

bry-signat

 

Antidepressants for Believers?

What do you think of Christians taking antidepressants?

By Pastor John Piper, given on March 30, 2010

The following is an edited transcript of the audio.

What do you think of Christians taking antidepressants? I have been on them and have been accused of not relying on God.

That relates to an earlier question about how any physical or personal means that you use can signify that you’re not relying on God. So eating might be a failure to rely on God, because he might just fill your stomach by miracle, and you don’t have to eat. Or not sleeping would be a way of relying more on God, since you don’t have to have your psyche made stable by sleep at night. And so on.

God has ordained physical means. Aside from the ones that seem more natural, like food, there’s medicine: aspirin, Nyquil, etc. This water is helping my throat right now. [Sips it.] Was that sip a failure to rely on God?

Could be. “Just throw this away and rely on God! He will keep your throat moist. You don’t need to be drinking. You’re an idolater, Piper. You’re idolizing this because you’re depending on it.”

Well, the reason that’s not the case is because God has ordained for me to thank him for that. He created it and he made this body to need a lot of fluid. And it’s not a dishonor to him if I honor him through his gift.

Now the question is, “What medicines are like that or not like that?” Taking an aspirin?

My ophthalmologist told me about 4 years ago, “Take one baby aspirin a day and you will postpone cataracts or glaucoma or something.” He said, “I can see just the slightest little discoloration, and the way it works is that circulation helps.” So he told me to pop one of these little pills in my little vitamin thing. And I take it every day. And I just said, “Lord, whether I have eyes or not is totally dependent on you. But if you would like me to use this means, I would.”

My answer is that when you start working with peoples’ minds, you are in a very very tricky and difficult situation. But I think I want to say that, while nobody should hasten towards medication to alter their mental states—even as I say it I think of caffeine, right?—nevertheless, I know from reading history, like on William Cooper, and by dealing with many people over the years, that there are profoundly physical dimensions to our mental conditions.

Since that’s the case, physical means can be appropriate. For me it’s jogging. I produce stuff in my brain by jogging. But that might not work for somebody else, and they might be constantly unable to get on top of it emotionally. I just don’t want to rule out the possibility that there is a physical medication that just might, hopefully temporarily, enable them to get their equilibrium, process the truth, live out of the strength of the truth, honor God, and go off it.

When I preached on this one Easter Sunday a woman wrote me, thanking me that I took this approach. She said, “You just need to know that I live on these things, and I know what it was like 20 years ago and the horrors and the blackness of my life. And now I love Christ, I trust Christ, I love my husband, our marriage is preserved, and I’ll probably be on these till I’m dead.”

So I’m not in principle opposed. I just want to be very cautious in the way we use antidepressants.


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What Are You Ashamed Of?

“We all carry about in our pockets His very nails.” –Luther
 

“I am proud of the good news! It is God’s powerful way of saving all people who have faith, whether they are Jews or Gentiles.”  

 Romans 1:16, CEV

 “For I am not ashamed of the gospel, for it is the power of God for salvation to everyone who believes, to the Jew first and also to the Greek.”

Romans 1:16, ESV

What is it, that holds us back?  Is there a significant issue–a new boat or your next vacation to Disneyland?  Would that keep you from following Him?  Would you trade Him, for that?

So many of us are chicken when it comes to witnessing for Jesus Christ. We ‘cluck and duck’ when the subject of God or religion is raised. We hope no one is looking when we ask God to bless our food in a public place.  Honestly, most of the time the issue for us is the fear of rejection. (It’s funny but some have never really gotten past the intimidation we experienced in High School.)

The saints who watch us from heaven, have got to be astonished. (Heb. 12: 1.)  They look and wonder at the way we act, when so many of them have suffered deeply.  They have been repeatedly, and deliberately hurt. We argue about padded pews and the color of the carpeting in our sanctuary.

“For whoever is ashamed of me and of my words in this adulterous and sinful generation, of him will the Son of Man also be ashamed when he comes in the glory of his Father with the holy angels.”

Mark 8:32, ESV

 I suppose we need the spirit of the saints who are suffering for the sake of the Gospel. This very minute they are in prisons, in torture, in abuse all because they profess a love for Jesus Christ.

Could it be possible that God is calling you to leave your comfortable Christianity behind and tell someone that Jesus loves them and wants to save them. Will you do it, or will you be too ashamed? Let this be the year you bring the light of Christ to your dorm, your neighborhood, your apartment building, your baseball team, or  wherever God has placed you. Let Him use you for His glory!

Your faith will activate God– your fear activates Satan.

*

ybic, Bryan

Anorexia & Bulimia

What Are Eating Disorders?

An eating disorder is marked by extremes. It is present when a person experiences severe disturbances in eating behavior, such as extreme reduction of food intake or extreme overeating, or feelings of extreme distress or concern about body weight or shape.

A person with an eating disorder may have started out just eating smaller or larger amounts of food than usual, but at some point, the urge to eat less or more spirals out of control. Eating disorders are very complex, and despite scientific research to understand them, the biological, behavioral and social underpinnings of these illnesses remain elusive.

The two main types of eating disorders are anorexia nervosa and bulimia nervosa. A third category is “eating disorders not otherwise specified (EDNOS),” which includes several variations of eating disorders. Most of these disorders are similar to anorexia or bulimia but with slightly different characteristics. Binge-eating disorder, which has received increasing research and media attention in recent years, is one type of EDNOS.

Eating disorders frequently appear during adolescence or young adulthood, but some reports indicate that they can develop during childhood or later in adulthood. Women and girls are much more likely than males to develop an eating disorder.

Men and boys account for an estimated 5 to 15 percent of patients with anorexia or bulimia and an estimated 35 percent of those with binge-eating disorder. Eating disorders are real, treatable medical illnesses with complex underlying psychological and biological causes. They frequently co-exist with other psychiatric disorders such as depression, substance abuse, or anxiety disorders. People with eating disorders also can suffer from numerous other physical health complications, such as heart conditions or kidney failure, which can lead to death.

Eating disorders are treatable diseases

Psychological and medicinal treatments are effective for many eating disorders. However, in more chronic cases, specific treatments have not yet been identified.

In these cases, treatment plans often are tailored to the patient’s individual needs that may include medical care and monitoring; medications; nutritional counseling; and individual, group and/or family psychotherapy. Some patients may also need to be hospitalized to treat malnutrition or to gain weight, or for other reasons.

Anorexia Nervosa

Anorexia nervosa is characterized by emaciation, a relentless pursuit of thinness and unwillingness to maintain a normal or healthy weight, a distortion of body image and intense fear of gaining weight, a lack of menstruation among girls and women, and extremely disturbed eating behavior. Some people with anorexia lose weight by dieting and exercising excessively; others lose weight by self-induced vomiting, or misusing laxatives, diuretics or enemas.

Many people with anorexia see themselves as overweight, even when they are starved or are clearly malnourished. Eating, food and weight control become obsessions. A person with anorexia typically weighs herself or himself repeatedly, portions food carefully, and eats only very small quantities of only certain foods. Some who have anorexia recover with treatment after only one episode. Others get well but have relapses. Still others have a more chronic form of anorexia, in which their health deteriorates over many years as they battle the illness.

According to some studies, people with anorexia are up to ten times more likely to die as a result of their illness compared to those without the disorder. The most common complications that lead to death are cardiac arrest, and electrolyte and fluid imbalances. Suicide also can result.

Many people with anorexia also have coexisting psychiatric and physical illnesses, including depression, anxiety, obsessive behavior, substance abuse, cardiovascular and neurological complications, and impaired physical development.

Other symptoms may develop over time, including:

  • thinning of the bones (osteopenia or osteoporosis)
  • brittle hair and nails
  • dry and yellowish skin
  • growth of fine hair over body (e.g., lanugo)
  • mild anemia, and muscle weakness and loss
  • severe constipation
  • low blood pressure, slowed breathing and pulse
  • drop in internal body temperature, causing a person to feel cold all the time
  • lethargy

TREATING ANOREXIA involves three components:

  1. restoring the person to a healthy weight;
  2. treating the psychological issues related to the eating disorder; and
  3. reducing or eliminating behaviors or thoughts that lead to disordered eating, and preventing relapse.

Some research suggests that the use of medications, such as antidepressants, antipsychotics or mood stabilizers, may be modestly effective in treating patients with anorexia by helping to resolve mood and anxiety symptoms that often co-exist with anorexia. Recent studies, however, have suggested that antidepressants may not be effective in preventing some patients with anorexia from relapsing. In addition, no medication has shown to be effective during the critical first phase of restoring a patient to healthy weight. Overall, it is unclear if and how medications can help patients conquer anorexia, but research is ongoing.

Different forms of psychotherapy, including individual, group and family-based, can help address the psychological reasons for the illness. Some studies suggest that family-based therapies in which parents assume responsibility for feeding their afflicted adolescent are the most effective in helping a person with anorexia gain weight and improve eating habits and moods.

Shown to be effective in case studies and clinical trials, this particular approach is discussed in some guidelines and studies for treating eating disorders in younger, nonchronic patients.

Others have noted that a combined approach of medical attention and supportive psychotherapy designed specifically for anorexia patients is more effective than just psychotherapy. But the effectiveness of a treatment depends on the person involved and his or her situation. Unfortunately, no specific psychotherapy appears to be consistently effective for treating adults with anorexia. However, research into novel treatment and prevention approaches is showing some promise. One study suggests that an online intervention program may prevent some at-risk women from developing an eating disorder.

Bulimia Nervosa

Bulimia nervosa is characterized by recurrent and frequent episodes of eating unusually large amounts of food (e.g., binge-eating), and feeling a lack of control over the eating. This binge-eating is followed by a type of behavior that compensates for the binge, such as purging (e.g., vomiting, excessive use of laxatives or diuretics), fasting and/or excessive exercise.

Unlike anorexia, people with bulimia can fall within the normal range for their age and weight. But like people with anorexia, they often fear gaining weight, want desperately to lose weight, and are intensely unhappy with their body size and shape. Usually, bulimic behavior is done secretly, because it is often accompanied by feelings of disgust or shame. The binging and purging cycle usually repeats several times a week. Similar to anorexia, people with bulimia often have coexisting psychological illnesses, such as depression, anxiety and/or substance abuse problems. Many physical conditions result from the purging aspect of the illness, including electrolyte imbalances, gastrointestinal problems, and oral and tooth-related problems.

Other symptoms include:

  • chronically inflamed and sore throat
  • swollen glands in the neck and below the jaw
  • worn tooth enamel and increasingly sensitive and decaying teeth as a result of exposure to stomach acids
  • gastroesophageal reflux disorder
  • intestinal distress and irritation from laxative abuse
  • kidney problems from diuretic abuse
  • severe dehydration from purging of fluids

As with anorexia, TREATMENT FOR BULIMIA often involves a combination of options and depends on the needs of the individual.

To reduce or eliminate binge and purge behavior, a patient may undergo nutritional counseling and psychotherapy, especially cognitive behavioral therapy (CBT), or be prescribed medication. Some antidepressants, such as fluoxetine (Prozac), which is the only medication approved by the U.S. Food and Drug Administration for treating bulimia, may help patients who also have depression and/or anxiety. It also appears to help reduce binge-eating and purging behavior, reduces the chance of relapse, and improves eating attitudes.

CBT that has been tailored to treat bulimia also has shown to be effective in changing binging and purging behavior, and eating attitudes. Therapy may be individually oriented or group-based.

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For more on these Eating Disorders, see: http://www.nimh.nih.gov/health/publications/eating-disorders/complete-index.shtml

For a Christian perspective: http://www.christiananswers.net/q-eden/eatingdisorders.html