Make Mental Health Your Priority Every Month

By Felicia Wong, M.D



As the month of May comes to an end, make a promise to yourself that personal mental wellness will remain a daily priority.  Mental Health America has been working for 100 years to promote well-being for all Americans and recently developed a resource called 10 Tools to Live Your Life Well based on extensive scientific evidence.

Each day, we face all sorts of demands and drama which can lead to insomnia, lack of concentration, problems in our relationships, and other mental health issues. 

These "10 Tools" provide proven, healthy ways to cope with stress and boost your overall well-being.  Make a commitment to follow this list and feel more relaxed, fulfilled, and focused long after Mental Heath Month is over. . .  

1) Connect with Others. People who feel connected are happier and healthier--and may even live longer.

2) Stay Positive. People who regularly focus on the positive in their lives are less upset by painful memories.

3) Get Physically Active. Exercise can help relieve insomnia and reduce depression.

4) Help Others. People who consistently help others experience less depression, greater calm, and fewer pains.

5) Get Enough Sleep. Not getting enough rest increases risks of weight gain, accidents, reduced memory, and heart problems.

6) Create Joy and Satisfaction. Positive emotions can boost your ability to bounce back from stress.

7) Eat Well. Eating healthy food and regular meals can increase your energy, lower the risk of developing certain diseases, and influence your mood.

8) Take Care of Your Spirit. People who have strong spiritual lives may be healthier and live longer. Spirituality seems to cut the stress that can contribute to disease.

9) Deal Better with Hard Times. People who can tackle problems or get support in a tough situation tend to feel less depressed.

10) Get Professional Help if You Need It. More than 80 percent of people who are treated for depression improve.

So now you know the tools. . . Today is the perfect time to start incorporating this list into your day-to-day routine.  For more information, go to http://www.liveyourlifewell.org/ . 

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Posted in: anxiety,balance,coping,depression,exercise,faith,Felicia Wong MD,getting help,happiness,health,healthy eating,mental health,mood,sleep,therapy,worry

Lessons Learned in the Wake of Tragedy

By Gina Newsome Duncan, M.D.





Dr. Molly McVoy recently blogged about the horrific shootings of Representative Gabrielle Giffords and others on Saturday, January 8, 2011. This tragic incident has sparked widespread national debate about all aspects of the case, including mental health treatment in this country and links between violence and mental illness.



The fact is that most people with mental illness are not violent, and that violence is most often caused by those who are not mentally ill. However, this incident does provide an opportunity for us as a nation, to seriously consider the state of our mental health services. If we examine it carefully, we can possibly prevent further acts of violence, and also think about how we help those who are in need of mental health treatment.



It is an unfortunate reality that mental illness remains largely shrouded in stigma, and tragic events such as this often help to only deepen that stigma in the minds of the public. As a result of this stigma, many people live with unnecessary shame and suffering, not seeking the help that they need. Most often, the primary victim is the person living with the illness, and by extension, their loved ones. Very rarely, however, untreated illness can lead to tragic consequences that reach far beyond the person with the illness and his or her family.



Like physical illness, mental illness has the best outcome when recognized and treated early. We should let this tragedy be a call to become more proactive in addressing issues of mental illness in our communities.

There are several important steps that can be taken:



1) As a public, we can become more informed about the signs, symptoms and treatment of mental illness.



2) We can all work to  destigmatize mental illness. The American Psychiatric Association’s Council on Communications is actively involved using this blog and with other activities.



3) Educate yourself on how mental health is funded in your community and let your vote count when issues of mental health funding are on the ballot.





It is true that there are rare situations in which a person with a severe mental illness may become violent. In most cases, this violence will be self-directed in the form of suicidal acts, but in rare instances, it may be directed toward others as well. What can be done in those situations?



1) If you are personally experiencing a mental illness and are having thoughts of harming yourself or others, it is important that you seek help from a doctor, therapist, or 911 immediately.



2) If you are the friend or family member of a person experiencing a severe mental illness and you are concerned due to actions or statements they have made that they may be a danger to themselves or others, it is important that you seek help from a doctor, therapist, or by calling 911 immediately.



a. Be as detailed about your concerns as possible.



b. Do not let your concern go unheard, put it in writing.



c. Firearms and weapons should be kept sealed and locked, or ideally, removed from the home.



d. Unfortunately, many communities do not have adequate crisis prevention resources. Familiarize yourself with the procedures your community does have for involuntary hospitalization. You can get this information by calling your local health department, hospital department of psychiatry, emergency room, community mental health center, family physician, or police department.

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Posted in: crisis,getting help,Gina Duncan MD,mental health,mental illness,stigma,violence

Mental Health - maybe some one has been listening

Natural Mental Health

MIND Reviews: What is Mental Illness?

By Ferris Jabr  | December 31, 2010 |

http://www.scientificamerican.com/article.cfm?id=mind-reviews-what-is-mental-illness

by Richard J. McNally. Belknap Press of Harvard University Press, 2011
When a breakup is one-sided, the rejected party’s behavior and mental state often change dramatically. A veil falls upon the world. Sleep becomes elusive. Food and sex are suddenly strangers to pleasure. Concentration dwindles to a rare resource. Intrusive memories and spiraling pessimism worm their way into every moment of consciousness.
These changes are an expected response to loss. Sometimes, however, they are also symptoms of major depression. In his new book, What Is Mental Illness?, experimental psychopathologist Richard J. McNally explores how to identify the line that separates an appropriate response to loss from a dysfunctional one. In other words, how do we distinguish mental distress from mental disorder? “There is a fuzzy boundary, but mental illness has properties that mental distress does not have,” McNally says.
Although McNally asks a direct and important question, he never gives a straightforward answer. Instead of clearly outlining exactly how mental illness and mental distress differ, he swims through eight chapters in which he tries to answer a series of new and daunting questions. For instance, the chapter “Are We Pathologizing Everyday Life?” asks whether we misdiagnose our reactions to stressful events, such as going through a breakup or getting a speeding ticket, as more grave than they actually are. And in the chapter “Is It in Our Genes?” McNally tries to parse out to what extent our biology dictates our mental health. When we arrive at the final chapter, “So What Is Mental Illness Anyway?” we can only conclude that the most succinct and accurate response is, “Well, it depends.”
In the end, that is actually McNally’s main point. Understanding mental illness requires context, and when making a diagnosis, we cannot simply tick off criteria on a checklist. We need to consider the symptoms and the causes as well as our biology, genes and culture.
If you are looking for definitive answers to complex questions, this is not the book for you. If you want to delve into the complexities of mental illness, however, then join McNally in grappling with some of the toughest issues facing psychology today.

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Posted in: mental health,natural mental health

Coping with Stress in America

By Adair Parr, M.D.

A survey by the American Psychological Association highlighted the negative impact that stress can have on families and children. This is an extremely important topic that affects many family caregivers, who are under a great deal of stress taking care of loved ones. More and more Americans are affected by stress. The survey indicates that many Americans feel that they are experiencing unhealthy amounts of stress. The economy is one of the main reasons. Fewer are satisfied with the ways that their employer helps employees balance work and non-work demands and many are concerned about job stability.

In addition, stress impacts the entire family. Children recognize when their parents are stressed and that could make them feel sad and worried. Nevertheless, parents frequently underestimate the impact that their own stress has on their children.



Stress affects both our mental and physical health. Some people manage stress by smoking, drinking or over-eating. That can lead to bigger problems. The study shows that Americans understand the importance of healthy behaviors like getting enough sleep, exercising and eating healthy. However, lack of time and motivation gets in the way of following through on these goals. Willpower was identified as a barrier to many healthy behaviors, even when they are recommended by a health care provider.

Managing your stress is extremely important. Stress does affect the family members you care for. There are healthy ways to manage your stress. Some suggestions are: exercising or playing sports; listening to music; spending time with friends and family; going to religious services; journaling; and practicing yoga / meditation. 





If you find that you are overwhelmed or suffering physical symptoms from stress like headache, poor appetite and insomnia, or if you are feeling depressed or suffering from chronic irritability and crying spells, you may need to see a mental health provider. The Healthy Minds website has brochures about dozens of mental health issues including early warning signs of mental illness.

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Posted in: Adair Parr MD,anxiety,caregivers,children,coping,family,mental health,stress

Finding Meaning in Modern Life - Part 2

By Roberto Blanco, M.D.

Last month, I wrote about Viktor Frankl’s book “Man’s Search For Meaning” and how some of the principles in his book could be applied to modern life. In response to the blog, one of the readers, Mukesh Samani, asked what it was in Dr. Frankl’s book that touched me the most. I would like to take this opportunity to thank Mr. Samani for his question and to respond.

What touched me the most from Dr. Frankl’s work was his motivation to live, share his experience, and teach something positive. As a psychiatrist during a time when any type of self-revelation was taboo and frowned upon, he showed great courage in revealing some of the darkest, innermost details of his life to the entire world. He did this so others could learn from his experience.

As a Psychiatrist, I work with many people who may be down on their luck or are the victims of unfortunate situations. Like Dr. Frankl, the ones who are able to discuss their situation, find some meaning from it, and continue to move forward, generally do the best.

Mr. Samani also asked what is special or specific in Dr. Frankl’s model of psychotherapy known as Logotherapy. Mr. Samani, I would refer you back to Dr. Frankl’s book which has a nice summary on Logotherapy. I am not an expert on Logotherapy. However, in short, it is a therapy which focuses on man’s desire to find meaning as the main motivating force in life.

I see following role models, like Dr. Frankl, as a way to find meaning in life. Looking back on your own life, is it clear which people affected you the most in positive ways? What was it about these people that moved or affected you? Did they have some special characteristic that set them apart from others or allowed them to connect with you? If so, finding out what that is and trying to reproduce it with others can give your life more meaning.

I have a lot of admiration for Dr. Frankl’s work and I appreciate the comment from “Mary” about a new documentary coming out on his life titled “Viktor and I.” I’ll be interested to see how he used his experiences in his professional life and what he was like on a personal level from the perspective of his close friends, family and colleagues. Thank you for your comments and questions.

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Posted in: happiness,health,mental health,Roberto Blanco MD,role models

National Family Caregivers Month: Self-Care for Caregivers

By Felicia Wong, MD

I love helping others. That is why I became a doctor, and why I love my job as a psychiatrist. But when I was a pre-medical student in college, my mom shared the following words of wisdom with me:  “In order to take care of others, you need to take care of yourself first.”

It took me a moment to understand the importance of the point she was making. I had taken a break from my community service projects due to a sports injury, and was eager to return to them. However, at that time, I was not fully recovered and was often in pain, and would tire easily. My mom encouraged me to take some more time off in order to focus on my own recovery and healing. Initially, I felt guilty taking the time out for myself. But in the end, I realized mom was right. Once I became strong and well again, I had so much more to offer to others.

Caregivers tend to be selfless, and expect a lot of themselves without recognizing their own need for self-care. Studies have found that caregivers have higher levels of depression and stress than non-caregivers. Sometimes caregivers are so committed to helping others that they forget to take care of themselves. They fail to recognize that if they drive themselves to exhaustion or sickness, they may not be able to help at all.

Warning signs of caregiver burnout from the non-profit Helpguide.org include:

• You have much less energy than you used to


• It seems like you catch every cold or flu that’s going around


• You’re constantly exhausted, even after sleeping or taking a break


• You neglect your own needs, either because you’re too busy or you don’t care anymore


• Your life revolves around caregiving, but it gives you little satisfaction


• You have trouble relaxing, even when help is available


• You’re increasingly impatient and irritable with the person you’re caring for


• You feel overwhelmed, helpless, and hopeless

Key strategies to prevent burnout include getting the help you need, seeking emotional support, and taking time out to care for yourself.

• Learn and use stress-reduction techniques.


• Attend to your own healthcare needs.


• Get proper rest and nutrition.


• Exercise regularly.


• Take time off without feeling guilty.


• Participate in pleasant, nurturing activities.


• Seek and accept the support of others.


• Seek supportive counseling when you need it, or talk to a trusted counselor or friend.


• Identify and acknowledge your feelings.


• Change the negative ways you view situations.


• Set goals.

For additional strategies for self-care for caregivers, visit the Family Caregiver Alliance, and watch for my next post on caring for someone with Alzheimer's. 

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Posted in: caregivers,depression,family,Felicia Wong MD,mental health,stress

Finding Meaning in Modern Life

By Roberto Blanco, M.D.

During recent travels, I visited the Yad Vashem Holocaust Museum in Jerusalem and came across Man’s Search for Meaning at the bookstore. It is written by Dr. Viktor Frankl, a Viennese professor and psychiatrist before World War II, who became a holocaust survivor. Dr. Frankl narrates his experiences and observations in different concentration camps and describes how, against all odds, he survived.

Dr. Frankl, however, did not intend the book to be solely a tale about survival. As he explained in his preface to the 1984 edition, he wrote the book so that others could see concretely that life, even in the most hopeless and miserable conditions, holds meaning. He wanted to show how having meaning in one’s life is the most important aspect to living fulfilling lives. In the book, Dr. Frankl proposed that he was able to survive because of luck and because his faith that his survival had some great meaning was unshakeable. During years spent in brutal conditions in concentration camps, Dr. Frankl was able to endure by finding some goodness to hold on to, even if sometimes this goodness could only be found in his head. He also observed how those who eventually lost motivation and hope usually did not survive much longer.



It is difficult not to be inspired by Dr. Frankl’s story, but it makes me think about how difficult it can be to feel fulfilled in our modern world. How can a man who had everything in his life taken away from him, find more meaning in his life than many who have all of the freedoms and material possessions they could want? I think that the answer lies in slowing down to appreciate the little things in life and to appreciate the meaning of it all. Every day should serve as a challenge to find a meaning, even if it is a small one.

The ways in which people find meaning depend on their age, current role in life, and developmental stage. Some people are motivated by special people in their lives; the relationships that provide meaning often change as people become independent of parents, find partners, and then have children of their own. Others develop a relationship with a higher power, which also can change as they grow and change themselves. And finally, having a mission, vocation, or cause often gives people meaning to their lives. These often change, as well, as people change careers, go back to school, or have other new experiences.

On a day-to-day basis, here are some things that you can do to answer the challenge of the day:

1. Be kind to another person.

2. Strike up a conversation with a friendly stranger.

3. Re-connect with an old friend.

4. Reminisce about that special memory that brings back positive feelings.

5. Further your cause or mission in some way.

6. Participate in a favorite hobby, sport, or special interest.

7. Pray.

8. Go for a walk.

9. Tell that special someone how you feel about them.

I’m interested to hear, what is it that brings meaning to your life?

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Posted in: happiness,mental health,Roberto Blanco MD

Concluding the Mental Health Checkup: Personal Statement

By Gina Duncan, M.D.





Over the last several days, I provided a list of nine topics to reflect upon as you consider how you’re taking care of your mental health. Finally, to complete our mental health checkup, does the following statement apply to you:



“I am pleased with myself and where I am in my life. I acknowledge my past mistakes, but do not feel overburdened by them or unable to move forward. I am self-aware. I cannot always control my external circumstances, but I feel good about the way in which I am meeting the challenges I face, and I feel confident in my ability to succeed. I don’t expect myself to be perfect, but I do know that I am a person of worth who has something to offer this world. I have relationships that are meaningful, I contribute to others in ways that are fulfilling, and I feel in tune with myself and in sync with my surroundings.”



I want to encourage all of us to not just strive to “cope” with the stresses of everyday life, but to thrive.



What does mental health mean to you?

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Posted in: Gina Duncan MD,mental health

Mental Health Checkup: Mood, Concentration, Balance, Energy

By Gina Duncan, M.D.

I’m rounding out my list of topics to consider in a personal mental health checkup. Keep in mind, this list is not exhaustive. It’s meant to provide a starting point to help you examine how you’re doing emotionally and mentally.



Mood — Do your moods feel pretty stable, or are you experiencing significant mood swings (either highs or lows)? Are you crying more than usual? Feeling persistently depressed for two weeks or more and any thoughts of suicide could indicate clinical depression.



Concentration — Are you able to focus on the task at hand, whether at work or at home, and get it done in a timely manner? Or, do you find yourself overrun with missed deadlines and undone chores? Often the first sign that our concentration is waning is when our productivity goes down. Poor concentration is a hallmark of attention deficit hyperactivity disorder (ADHD) but it can also be a symptom of depression and anxiety and should not be overlooked.

Balance — Is there an appropriate balance between your home life and your work life? Between family time with your kids and “date nights” for you and your spouse? Are you getting in some “me-time”, including physical exercise and spiritual pursuits? Achieving perfect balance in your life is probably not possible, but that doesn’t mean it’s not worth striving for! Juggling too many responsibilities is a prime way to end up stressed out and unhealthy.



Energy — Do you feel that you have the energy to do the things you need and want to do? Fatigue can be a sign of depression, anxiety and other mental illnesses, but it can also be a symptom of many physical illnesses including cancer, diabetes and sleep apnea. If you find that you are feeling unusually fatigued or have other concerning symptoms, it is important that you contact your doctor right away.



In my next blog entry, the last in this series, I’ll provide a statement to help you consider whether you are thriving or just coping.

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Posted in: ADHD,balance,Gina Duncan MD,happiness,mental health,mood

Mental Health Checkup: Avoidance, Eating Habits

By Gina Duncan, M.D.

I am continuing my list of topics to consider in a mental health checkup. Remember, if any of these issues raise red flags for you, your family doctor, family member or clergy may be a good place to get advice about next steps.

Avoidance — Do you feel like you’re avoiding yourself? It may seem like a funny question, but if you find yourself going out of your way to keep from being by yourself, then that could indicate that there is something you are trying to avoid emotionally. Many people find that their feelings of anxiety or worry are intensified when they are alone, and so they find ways to distract themselves by staying busy. We can often be unaware of this subconscious strategy to protect ourselves from painful feelings. If you think that this describes you, when you have a moment, go to a quiet place where you will be uninterrupted and sit quietly for a few minutes. How do you feel? Take a moment to write it down. If you find that even the thought of spending quiet time by yourself makes you tense, write that down as well. The goal is not to avoid your problems, but to find effective ways to deal with them.

Eating Habits — Has your appetite changed? Are you eating too much or too little? And what are you eating? If you find that you’re craving foods that are high in carbohydrates (sugar) and fat, or that you’re eating larger quantities than usual, it could be a sign of emotional eating as a response to stress. While temporarily satisfying, high sugar and fatty foods ultimately zap your energy and leave you feeling lower. Not to mention that the added pounds can become an additional source of stress.

Tomorrow I’ll round out my topics for a mental health checkup by discussing mood, concentration, balance and energy.

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Posted in: avoidance,Gina Duncan MD,healthy eating,mental health

Mental Health Checkup: Tension, Anxiety and Tuning In

By Gina Duncan, M.D.



Continuing my Mental Health Checkup series, here are some additional factors to consider as you evaluate your mental health:

Tension and Anxiety — Are you feeling tense and wound up all the time? How about nervous and anxious? Is it hard for you to unwind at the end of the day? We live in a fast-paced society and stress has become a common part of our everyday lives. If, however, you are finding that you’re unable to take mental breaks during the day where you can feel totally relaxed and worry-free even for a few moments, then that could indicate that your stress is approaching dangerous levels. Relaxation is a skill that many of us have to learn and practice. There have been some great previous posts with relaxation tips as well as ways to cope with anxiety and stress.

Writing in ajournal is one way

to stay "in touch" with yourself.

Tuned In — In general, how “in touch” do you feel with yourself? Do you feel like you’re experiencing emotions and you don’t know why, like being angry or crying “for no reason”? It’s not uncommon to get so busy that you don’t have time to process everything that is happening on an emotional level in real time. However, taking some time to write in a journal or talk to a friend can be critically important to good mental and emotional health, particularly when you find yourself in periods of great transition or change. The danger of being out of touch with yourself emotionally is that you may respond to difficult situations in ways that you later regret (such as impulsively sending off an angry email to your boss, or taking out your frustration on your kids). It is also difficult to advocate for yourself and your needs when you don’t know what those needs are. Being able to take a moment and identify that “I feel angry because _____.” or “I am hurt because _____.” can take you a long way in staying in touch with yourself.



Tomorrow I will write about avoidance and eating habits.

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Posted in: anxiety,Gina Duncan MD,mental health,stress

Nine Topics to Consider in a Mental Health Checkup

By Gina Duncan, M.D.

Yesterday, I wrote about the concept of a mental health checkup. Over the next few days I’ll provide a list of nine topics to consider when thinking about the state of your own mental health. While not exhaustive, the topics on this list are meant to provide a starting point to help you examine how you’re doing emotionally and mentally. If any of these items raise a red flag for you, be sure to talk with your doctor. If you are concerned that you may have anxiety, depression, or another mental illness, or if you need help finding a professional to talk to, see my previous post on finding a therapist for tips.

Sleep — How are you sleeping at night? Is it restful, or does it leave something to be desired? Poor sleep can often be the first sign that there is something troubling you emotionally. When under stress or dealing with a more serious mental illness, many people find that they cannot fall asleep as quickly as they used to because of excessive worry or a feeling of not being able to “turn off” their mind, and others find themselves waking up frequently throughout the night. For some, insomnia can be put to rest with simple sleep hygiene measures such as limiting caffeine in the evening and creating a bedtime ritual. For others, common over-the-counter (OTC) sleep aids such as Tylenol PM, Benadryl, and herbal medicines like melatonin can be helpful if used in limited quantities and for a limited amount of time. [Note: although they are advertised under many different brands, most OTC sleep medicines have diphenhydramine (generic Benadryl) as their active ingredient. Make sure to read the labels so you don’t take medicines you don’t need and to decrease your risk of unsafe combinations.] It’s always a good idea to first check with your doctor before beginning any OTC sleep regimen to make sure there are no harmful interactions with other medicines you’re taking.

Tomorrow, I’ll continue the checkup with information about evaluating tension and anxiety and being tuned in to your emotions.

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Posted in: Gina Duncan MD,mental health,sleep

Time for a Checkup: Lack of Illness vs. Health

By Gina Duncan, M.D.

I recently spoke with a reporter from a Boston community newspaper who is planning an article spotlighting the concept of a “mental health checkup.” I think that this is a great idea, and something that is very much needed. Given that September is a time for new beginnings with many people going back to school and work, what better time than now to do a mental health checkup.

 

Many people go through their entire lives never encountering a mental health professional. That doesn’t mean, however, that they are mentally healthy, for the absence of illness does not necessarily equal health. Unfortunately, in our society we place a lot of emphasis on treating illness and much less on what it takes to stay healthy.



What is mental health? You can probably find many different definitions, but I would like to suggest one characteristic which I think is critical to the foundation of good mental health: knowing yourself, ie. being self-aware. I often tell my patients with depression and anxiety that they are in a position to be some of the most mentally healthy people around, because their illness has forced them to grapple with unhealthy patterns and learn new skills to cope with the stresses of everyday life. And in the process, they have come to know themselves much better. One of my professional goals is to bring the same skills that we as psychiatrists use in the office to people who would never come through our doors because they are not identified as being "mentally ill." They may be functioning and getting by, however, they are missing out on living life at the level of their "best self."



Over the next several days, I will post about important topics to consider as you do your own mental health checkup.

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Posted in: Gina Duncan MD,mental health

Talking about Mental Health

By R. Scott Benson, M.D.

In May a few years ago I was asked to give a talk to the seniors who exercised at the mall in the early morning hours. The timing was right for a mental health talk, since May is Mental Health Month.



The focus of my talk was new understanding of the brain and changing thoughts on the cause and treatment of mental illness. The audience was attentive but asked few questions. But after the talk an elderly man approached to clarify some comments I had made about schizophrenia. He called his wife over and they shared the painful story of their adult son’s deterioration as he developed unmistakable signs of this tragic disease.



This couple had been told by the treatment team that their parenting had caused their son’s condition and they needed to leave him alone so that he could recover. And they had carried a burden of guilt for years, viewing themselves as somehow toxic. I was able to answer a few of their questions and then I was encouraged them to join other families involved with our local chapters of Mental Health America and the National Alliance on Mental Illness.



The positive impact of these brave families sharing their stories was reinforced in a new survey from the American Psychiatric Association. And the results of this survey are a cause for celebration telling us how far we have come. More than a third said that stigma has declined, and openness about personal experiences by friends, family and public figures was influential.



The internet has become a valued source of information and was cited by 75% of those surveyed as at least moderately influential in reducing stigma associated with mental illness.



In addition to HealthyMinds, what are the reliable sources of information that have been useful to you? Where have you heard patient and family stories that have reduced stigma in your community?

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Posted in: family,mental health,NAMI,parenting,R Scott Benson MD,schizophrenia,stigma