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Mental Health Professionals and Suicide

Suicide – Threat of Liability for Mental Health Professionals

Suicide is the third most common cause of death for young adults – and the ninth highest for the general adult population.  This means that a large percentage of mental health professionals will have a patient that commits suicide. It may be as high as 80 percent of psychiatrists, psychologists, social workers, and other therapists, that eventually have a patient who commits suicide.

Serious Mental Health ProfessionalYou might think that professionals are insulated against emotions that come with the death of a friend or acquaintance – but they aren’t.  Many health professionals report that even when death is expected (natural causes), they spend a great deal of time going over their treatment of the patient. They try to find out if they could have done anything different, (given another treatment) in order to help.

But, what may be surprising is the number of liability lawsuits filed against mental health professionals, when a patient commits suicide.  In fact, it is the number-one cause of responsibility lawsuits brought against mental health providers.
The threat of lawsuits, and also the stigma against people working it in the mental-health profession, has led to many psychiatrists refusals to treat the chronically suicidal. The profession sees it as a failure of the doctorMental health professionals are also less likely to see additional suicidal patients after they have had a patient succeed at suicide.

When a therapist or physician is unable, or unwilling, to treat a suicidal patient – it leaves the patient in the lurch.  It produces feelings of failure and hopelessness, without a doubt, compounding the fact that they are suicidal.  It may also be difficult for an extremely suicidal patient to find a new therapist or doctor.  Many patients report that the mental health professionals suddenly “don’t have time”.

We don’t think much about the way suicide will affect those around us – and certainly the professionals are way down the list of people whose feelings are important.

Mental health professionals also report that there is a lack of training on how to deal with suicidal patients, and processing the death of a patient.  More than half of professionals surveyed also Knocking on Heavens Doorstated that they really don’t believe they can prevent a patient from committing suicide.

Oddly, the complaint process against physicians has been shown to increase the risk of the physician becoming depressed. One of the consequences of this will be a worsening of the situation for mentally ill people. (Chronically suicidal patients)

This is a complicated process with no easy answers, but you should know that it is likely that all psychiatrists, therapists, social workers and other counselors probably need to be in counseling themselves.  When you find a new doctor or therapist – you might want to ask.

Even if you aren’t suicidal, you need to know that your counselor is as mentally healthy as possible, certainly healthier than you.

Melissa Lind

Mental Health Professionals Report a Lack of Training on How to Deal With Suicidal Patients

Bipolar II – Really?

Is it Bipolar II – or just plain Bipolar Disorder not yet recognized?

Google “Bipolar” on the “news” tab and see what you find.  It is astounding how many semi-celebrities have come out and said “I have Bipolar Disorder”.  Unfortunately, the story is often about Bipolar II, which somehow makes it “better”.

Bipolar Disorder is still a serious stigma – prevents people from getting jobs and such.  Technically, as Bipolar Disorder is considered a disability, an employer who did not hire or fired an admitted bipolar patient based only on that fact would be in violation of the American Disabilities Act, but few people are willing to go to the carpet on that.  Plus there is the little issue of being “able” to perform one’s job.  I can perform a job if I am taking meds.  If I am off of meds, I become highly unreliable with a lot of other liabilities – risky behavior that I have decided not to discuss.

Only a couple of years ago, I was warned by a well-meaning family member against posting too much on social media about Bipolar Disorder – and this in his mind included “liking” too many Bipolar pages.  He was concerned about my ability to obtain a decent job.  I don’t know if I have a “decent “job today – I have made my own way which works out better for me – no boss to annoy, no dress code, nobody else’s time clock.  For the most part, I don’t worry about social media – I don’t think I will ever have a “real” job again – no more frequent flyer miles for me.

Bipolar 2I was once diagnosed as Bipolar II – but really, both the doctor and the therapist thought differently – they both knew that I had regular Bipolar Disorder but wasn’t ready to accept it.  Actually, I am pretty sure my doctor tricked me into taking Lithium for the first time by telling me that it would help boost my antidepressant activity.

In retrospect, I am astounded that I believed him since I know so much about medication – but I took the medication.  How many of these people really have Bipolar I Disorder and just don’t say so.

It is much easier for people to say and accept that they have Bipolar II.  In my opinion (which is obviously vast and knowledgeable – just kidding, no really), Bipolar II is a way of sliding by the real diagnosis.  As in “I have Bipolar Disorder but not really”.  “I have Bipolar Disorder but I am not crazy”.  “I have Bipolar Disorder but I am not dangerous”.  “I have Bipolar Disorder but I won’t embarrass you”.
When it gets down to it…wasn’t that true for all of us at one time?  Or at least didn’t we believe it at one time?  I still fit some of the criteria – I am “functional”, “productive”, “hypomanic” – except when I am not.

I often confuse my doctor when he asks how it is going by saying “good enough”.  What I mean is that I am not manic exactly, I am not depressed.  Actually it works better for me if I am teetering on the edge of mania.  If I am just crazy enough that I know that I am crazy – then I will keep taking my meds.  Because I forget.

I originally sought treatment for severe depressiondepression bad enough that I had to decide whether to kill myself or study (I had a big exam the next day).  In retrospect, I was actually in a mixed episode with plenty of energy but in a really bad mood.  Oh, and then there was the slight issue of the hypnogogic hallucinations which I denied at the time.  See, even if I know that I have Bipolar DisorderManic Depression – I still forget.

It would be easier for me to say that I have Bipolar Disorder but it is “just” Bipolar II.  I thought that too.

Melissa

Alternative Treatment for Anxiety

Alternative treatment is available if you are suffering from anxiety

While a certain amount of anxiety is perfectly normal and does not require treatment, anxiety can indeed become very serious, preventing one from living life to the fullest.

Too Calm?However, because people do want to enjoy life fully, they may be opposed to taking medications that may make them “too calm.” For those people, there are alternative treatments for anxiety.

First and foremost, you need to discuss your anxiety with your doctor, and let him or her know that you prefer more natural treatment.
Let the doctor know that you would prefer not to take chemical medications. In most cases, your doctor will listen to you and will make suggestions for alternative treatment, although counseling may also be suggested.

Many herbs will help in the treatment of anxiety. These can be cooked with, in many cases, or taken as a tea. Green tea and kava tea are very popular choices, as well as chamomile tea.

Along with the ingestion of certain herbs, you may also want to include aromatherapy in your treatment. This is done with essential oil of certain herbs.

Scents that work well for calming include rose, basil, juniper, sage, marjoram, bay, ylang-ylang, lavender, cinnamon, sandalwood, hyssop, comfrey, patchouli, geranium, bergamot, cedar wood, frankincense, orange blossom, Melissa, cypress, and chamomile.

For the relief from stress, you should consider chamomile, sandalwood, lavender, peppermint, marjoram, geranium, and Melissa.

Aside from herbal therapy and aromatherapy, you may also want to consider acupuncture, massage therapy, and deep breathing exercises for the relief of anxiety.

Again, there is an alternative treatment available if you are suffering from anxiety, but you still need to work with your doctor to get the right treatment for you.

Note that not all treatments will work right away, and may require a little time and patience on your part. Make sure that your doctor stays up to date with what you are doing, and try to ease the anxiety.

Review of the product Yogi Kava Stress Relief Tea:

Yogi Kava Stress Relief Tea

I bought this Yogi Kava Stress Relief Tea in order to be able to fall asleep. I wasn’t expecting anything more than perhaps a placebo effect from drinking something warm. I did not know what Kava was and had never heard of it. Well, after one cup, I felt “carefree”, and yes, relaxed, but my mental abilities were sharp.

I didn’t believe it was the tea really, and waited another week to have another cup, and yes, had the same results.

It hasn’t made me sleepy or drowsy, just takes the nervousness and anxiety down one or two notches, allowing me to lay down and not think about things.

I have since done quit a bit of research on what is available and have decided that as long as the kava is prepared from the root and does not use ethanol or other chemicals, the risk of hepatotoxicity should be lessened if not deleted.

This stuff is much better than taking a drug such as diphenhydramine. You should be able to stay alert and focused with Kava, not so with diphenhydramine.

Highly recommend this tea for those occasions where anxiety or stress are impacting you negatively. I have not experienced any numbing, pain relief and any GI issues but I only have one cup a week, maybe one cup every 10 days.

Aromatherapy as Treatment of Depression

We are all affected by sights, sounds, and smells.

That is why aromatherapy is effective for so many different things that we may experience in our lives. It includes physical illnesses as well as mental setbacks, such as depression. In fact, aromatherapy is highly effective in easing the symptoms of depression.

LavenderLavender is one of the most effective scents for the treatment of depression. This scent increases the instance of waves in the back of the head, which promotes relaxation. Jasmine is also another well-known scent, as it increases the example of waves in the front of the head.

However, the waves increased in the back of the head with lavender are alpha waves — for relaxation — while the waves increased in the front of the head are beta waves — for alertness.

Aside from lavender and jasmine, other scents are also useful for various aspects of depression symptoms. These include clary sage (insomnia), basil (fatigue), rose (nervous system), and sandalwood (tension). Other prominent scents that may ease symptoms of depression include chamomile, patchouli, bergamot, rosemary, and geranium.

Essential OilWhile you can use candles for aromatherapy, the ideal method is to use essential oils of the herb scent that you require. Essential oils can be used as diffusers, in baths, massages, or even as perfume or body splashes.

Again, when using scents for aromatherapy, the oils are more effective than candles. These oils can be purchased from health food stores and online sources. In many cases, you will receive a small break on the cost when ordering larger quantities.

While aromatherapy will ease symptoms of depression, it should not replace therapy that is needed to treat depression, and it may not even replace medications used for treatment of depression.

Be sure to discuss treatment options with your doctor.

When aromatherapy is used as treatment of depression, oils are more effective than candles

Bipolar Disorder and Adolescents

Symptoms of bipolar disorder in children and adolescents may look like other disorders

Traditionally bipolar disorder has been thought to first show in early adulthood – and more often in females.  Bipolar disorder was considered to be quite rare as few as 20 years ago, to be more exact. The first emergence came in the early 20s, mainly in females. But, our knowledge about bipolar disorder has grown rapidly in the last 20 years.

Instead of the single manic-depressive diagnosis – which included diagnostic criteria of both depressive periods, alternating with manic periods – described as “euphoria”?

Those who did not have clearly rhythmic, alternating periods of a “happy” and frantic manic phase with a classic depression period were mishandled, misdiagnosed, mistreated, or dismissed.

Bipolar ChildrenIn addition, it wasn’t really known that bipolar disorder could start in adolescence or even childhood, or that there are different types of bipolar disorder.  Today, it still isn’t “officially” recognized in the “psychiatric bible” – the Diagnostic Statistical Manual of Mental Disorders (DSM), but at least more practitioners do know that it exists.

Today, we don’t exactly know what causes bipolar disorder (only that there is a genetic link of some kind, and often some past trauma). But, we can at least identify adolescent and childhood bipolar illness.  We also recognize a variety of different types of bipolar disorder (Such as mixed manic episodes, rapid cyclers, people without a depressive phase, hypomania, dysphoria rather than euphoria and cyclothymia). We also have a “catch-all” type – Bipolar NOS or “not-otherwise-specified”.

Adolescent or childhood bipolar disorder is official known as: “early onset bipolar disorder”.  In fact, childhood bipolar disorder can be more serious than a similar disease in adults and may have slightly different symptoms.

Symptoms of bipolar illness in children can often be more severe, and the cycling period may be more frequent.  Children also have more mixed episodes.  Children also have slightly different symptoms – so even the depression phase of the cycle may not be obvious.

Pediatric patients (children and adolescents) with bipolar disorder may have:

Bipolar Disorder in Children•    Abrupt mood swings
•    Periods of hyperactivity followed by lethargy
•    Intense temper tantrums
•    Frustration
•    Defiant behavior
•    Chronic irritability

These symptoms have to appear in more than one setting (school and home) and cause “distress”.

The problem is that many of these symptoms may look like other disorders.  They might be disorders such as ADHD, childhood depression, anxiety disorder, obsessive compulsive disorder, conduct disorder, premenstrual syndrome, oppositional defiant disorder and others. The danger might come from a misdiagnosis and improper treatment.

Bipolar disorder is treated with anti-manic agents (lithium), anti-convulsants (Depakote, lamotrigine) or atypical antipsychotics (Abilify, Risperdal).  In many cases, anti-depressant won’t be needed.  Treatment for other disorders like ADHD or depression may make bipolar disorder worse. Childhood bipolar disorder is something that desperately needs treatment as the distress caused to the patient, and the family can predispose the youngster to

•    Drug or alcohol abuse
•    Stealing
•    Involvement with law enforcement
•    Poor social integration
•    Poor academic performance
•    Suicidal tendencies
•    Premature sexual behavior

The Balanced Mind has a good self-check list of symptoms that can help a parent or a teen decide if bipolar disorder might be an issue.  Self-testing is not always accurate and should be discussed with a doctor, (preferably with test results in hand).  Not all doctors accept pediatric bipolar disorder. Parents may have to seek advice from more than one mental health professional and be aware that insurance may not cover the illness.

Melissa Lind

Depression – When to Seek Help

Some level of depression is perfectly normal and does not require treatment

Sad and Depressed GirlWe all feel a little down or a little “blue” from time to time. We all have life events that will make us feel very sad as well, such as the loss of a loved one, the breakup of a relationship, financial difficulties, etc.

In most cases, however, these down periods are temporary. At what point, however, should you seek help for your depression? While people feel depression in different ways, and to different extents, there are specific warning signs that one should look for when determining whether or not they actually need treatment or not.

First, if your depression has lasted for more than a period of two weeks, you most likely need to seek treatment. Make an appointment with your medical doctor for a checkup, and discuss your feelings with him. He will most likely perform a physical exam to determine if there is a physical cause for those feelings, and he will also ask about your life events and current stressors.

Other than seeking help if the sadness lasts for more than two weeks, another sign that help is needed — immediately — is if you are having suicidal thoughts, or if you have already attempted suicide.
Do not wait to seek treatment. Contact your doctor, or call a suicide hotline for immediate help!

Feeling HopelessEven if depression is temporary, all of the other symptoms of depression are normal — except for the two discussed above. You may have a change in sleeping and eating patterns, you may feel like everything is hopeless. You may have the fatigue and the aches and the pains.

But again, if those symptoms do not go away within two weeks, or you feel suicidal, treatment is needed.

In many cases, a medical doctor can treat you for the depression, depending on the cause and the severity of your mental state. The important thing is to seek the help and to be as honest with your doctor as possible — whether your doctor is a therapist or not, he (or she) must still keep all conversations with you in confidence.

When should one seek help in cases of depression?