There oughta be a law! (Ron Otto)

On Saturday, June 5th, more than 50 mental health consumers filled the living room at Thresholds’ Dincin Center for Recovery to hear a presentation on psychiatric advance directives (PADs). The 1 1/2 hour educational session was given by Laurel Spahn, a staff attorney for the Guardianship & Advocacy Commission’s Legal Advocacy Service, and Alex Magnus, a mental health consumer.

Most people with a psychiatric illness live in fear of being involuntarily committed to a hospital. This fear is based on the total loss of control they will have in directing their treatment. They will be locked up and then left out of the treatment decision-making process.

PADs are legal documents that help return control to the psychiatric patient and promote their participation in treatment decision-making. These documents allow a competent person to make decisions in advance about mental health treatment preferences in areas including psychotropic medication, electroconvulsive therapy, short-term admission to a treatment facility, and the appointment of a “proxy” decision-maker.

Research has shown a strong interest among mental health consumers in PADs, but only a small percentage of people complete them unless they are given help with the documents. Illinois recognizes two types of PADs – (1) a declaration for mental health treatment and (2) a power of attorney for health care – and it can be difficult to understand their different features and signing requirements without professional assistance.

Laurel and Alex are part of an ongoing recovery initiative at Thresholds to provide education and professional support around advance directives. Laurel and her legal services team will be back at Thresholds to conduct a clinic for people who attended the educational session and wish to complete advance directives.

Tools supporting self-directed care, such as advance directives, are fundamental to mental health recovery. If you would like more information about PADs, the National Resource Center on Psychiatric Advance Directives, www.nrc-pad.org, is the place to start. If you would like help in completing an Illinois advance directive form, you may contact the Illinois Guardianship and Advocacy Commission at the toll free number: 866/274-8023.

A Labor of Joy (Ron Otto)

Why is physical exercise so often viewed as a joyless experience? It’s almost as if thinking about it reminds people of the story of Sisyphus, the mythological king who deceived the Gods and was punished by having to roll a huge boulder up a hill only to have it roll back down, and cursed to repeat this futile labor through eternity.

Like many people I’ve struggled with getting into the habit of regular physical exercise, but now it feels very natural and the joys of exercise are very real. I include among these joys:

1. reduced stress, anxiety, depression and irritability – the joy of being in a good mood
2. a mental break from overthinking, worries and ruminative thinking patterns – the joy of taking a mental break and having a fresh mind
3. setting a goal of 2 ½ hours of moderate to vigorous weekly exercise and often reaching this goal – the joy of achievement
4. focusing on the immediate (the pattern of my breath and the rhythm of my steps) and not the distant past or uncertain future – the joy of being in the present moment
5. enjoying the sensory and soothing qualities of nature – the joy of nature and the outdoors
6. breaking the cycle of inactivity and being actively involved in the healing process – the joy of active, productive participation
7. experiencing normal fatigue and improved sleep quality – the joy of a good night’s sleep
8. improved energy and motivation – the joy of positive energy
9. less negative expression (criticizing and complaining) and the clearing of suppressed emotions – the joy of relating to self and others in positive ways

Physical exercise has enormous benefits for mental health and well-being. And as we look to develop a more integrated and holistic health care system, exercise-based interventions may become standard care. After all, what harm is there in prescribing joy?

For additional reading on exercise and mental health, check out “Exercise for Mood and Anxiety Disorders: Therapist Guide” by Jasper A. J. Smits and Michael W. Otto.

Recommended Reading

Last year I facilitated a wellness and recovery group for persons with mental illness at a Chicago nursing home. A major focus of the group was on the wellness tools and strategies that people use to stay healthy and well.

One of the group’s participants, a woman who always seemed to have a pleasant attitude, made regular entries in a gratitude journal. This seemed like a great idea, but I didn’t give much thought to the value of a gratitude journal until I recently started keeping one myself.

Maintaining the journal has been a transformative experience for me in several important ways. Instead of focusing on the 1 – 2% of things that either annoy me or seem to go wrong in my life, I’m now far more aware of and attentive to the 98% of things that are actually turning out well. My apartment has hot and cold running water, the electricity rarely fails, and now that I’m on the telemarketing no call list, life isn’t too bad.

Keeping the journal has lowered my stress and, at the same time, strengthened my sense of mental and emotional well-being. And although I always felt that my temperament couldn’t be changed too much, I now feel this gentle pull to be more positive and optimistic about life.

The nursing home resident made another suggestion (for which I’m also grateful): when you’re feeling down, read your journal.

Excellent advice!

Check out Oprah’s interview here.

Collaborative Support Programs of New Jersey

Check out the latest newsletter of the Collaborative Support Programs of NJ here: http://cspnj.org/recovery_newsletter.php

Cooking with Mom: Pizza and Salad (Cathy Batscha)

Friday April 9^th on a beautiful  spring afternoon, people met at the Thresholds Mothers’ Project for the first community kitchen.   Lenna Ingram organized the cooking, preparing  pesto chicken and three sauces in addition to other delicious toppings for moms to choose from.   Music and conversation kept it lively as we turned out sixteen pizzas and twenty-five salads in three hours.

By the end of the afternoon, even the oven was tired.  But it was a good tired!   Moms left with pizzas (in actual pizza boxes) and salads for them and their children.  We’re planning to meet again next month with suggestions for soul food, tacos, or submarine sandwiches.

Why Not Call it Brain Building? (Ron Otto)

I’m all for calling a spade a spade, yet this may not always be the most rewarding practice. For example, what sounds more appealing to you: “physical exercise” or “brain building?” After watching a recent Public Television Special called “Change Your Brain, Change Your Body” with Dr. Daniel Amen, I decided I’d rather be actively engaged in brain building.

Dr. Amen and a fair number of research studies have convinced me that when it comes to overall health and quality of life, no single activity is more important for both your brain and your body than physical exercise.

The benefits of regular physical exercise go far beyond weight control, physical strength and endurance. They extend to protecting the brain and enhancing its performance by increasing the rate of neurogenesis (the formation of new nerve cells and neuronal connections). Mental exercise also benefits the brain, but its role is more limited to ensuring the survival of the new neurons. Good nutrition and stress management are also key components of brain health.

Recovery from serious mental illness is a matter of developing health and wellness routines that increase one’s mental and physical strength and resilience.

Physical exercise, as it turns out, is exercising the brain. So, call it what you will. Still, when I get off work in the evening the whole idea of physical exercise seems much less appealing than heading off to the gym to do some serious brain building. At least my brain thinks so…and you have to start somewhere!

Watch Dr. Amen on Rachel Ray’s show:

Alfalfa to Omega-3 (Shirley Helm)

Here’s some news from the world of alternative treatments for psychiatric symptoms . . . but then, how alternative is something that’s reported in the Archives of General Psychiatry?

We all know that exercise and omega-3 fatty acids are good for our bodies ‘below the neck,’ right? (To quote the American Heart Association’s website, “Omega-3 fatty acids benefit the heart of healthy people, and those at high risk of — or who have — cardiovascular disease,” and, “Whether it’s included in a structured exercise program or part of your daily routine, all physical activity adds up to a healthier heart.”) Now we have even more evidence that they’re also good for our brains and our minds.

• “Hippocampal Plasticity in Response to Exercise in Schizophrenia” describes a three-month-long randomized, controlled study of aerobic exercise (cycling) in which the volume of the hippocampus (the part of the brain associated most with memory) and aerobic fitness increased in both patients with schizophrenia and in healthy controls, and improvement in short-term memory was correlated with increased hippocampal volume in the group of people with schizophrenia.
• “Long–Chain Omega-3 Fatty Acids for Indicated Prevention of Psychotic Disorders” reports on a randomized, double-blind, placebo-controlled trial involving 81 individuals at “ultra-high risk of psychotic disorder.” At the end of the 12-month study, 2 of the 41 (4.9%) individuals in the group receiving omega-3 fatty acids had developed a psychotic disorder, while 11 of 40 (27.5%) in the placebo group had developed such a disorder. Omega-3 fatty acids also significantly reduced positive and negative symptoms and improved functioning, compared with placebo.

Check out the abstracts (links above in blue) and tell me what you think!

Ready, set, cook! (Cathy Batscha)

Lenna and Marshelia

We’re starting. The community kitchen is going to happen. And soon. Here’s the plan.

We are meeting at the mother’s project once a month to cook healthy, delicious meals which we will then distribute. Lenna, the chef at the mother’s program is organizing the process of cooking, I’ll do menus, Kristin is getting containers, and Marshelia, Kristin and I are delivering to different sites when we have everything packed up. Marshelia is doing the advertising. Flyers to invite people to come and join in the fun.

I’m overwhelmed with the idea of cooking for 20 mothers and that many kids (Lena, on the other hand, says this is not such a big deal). We’re starting with pizza (square) and a salad with homemade dressing. I’ll let you know how it goes!

Taking a Time(less) Out (Ron Otto)

The journey toward recovery from serious mental illness can take a person far beyond the world of psychiatric medications and talk therapy. The struggle for mental peace and emotional well-being often leads to an inner search for meaning, purpose and joy. For some, the practice of meditation becomes a part of this search.

Even without my mental illness, I’m prone to worry, anxiety and stress. So, I’ve tried meditation and found it helpful. Recently, however, when a friend asked me how to meditate I didn’t know where to start. I decided to dust off a meditation CD I hadn’t used for awhile and hoped that playing it would suffice.

The CD, “Inner Renewal” by Master Del Pe, uses breathing techniques, visualizations and positive affirmations to help free the listener of “negativities and discomforts” and bring about a sense of peace and harmony at several levels – physical, emotional, mental, as well as the interpersonal. The listener begins by imagining the most beautiful ocean they’ve ever seen. Master Del Pe’s soothing voice then guides them through a series of affirmations that help release anger, guilt and a host of other distressing thoughts and emotions into the ocean. After listening to “Inner Renewal” it felt like my mind and emotions had gone through the wash and come out cleaner, purer and fresher.

Meditation can’t replace medications and other essential forms of treatment, but it can be an effective way of alleviating some of the stress and strain that accompany mental illness. And this can make it a lot easier for health and happiness to follow.

I don’t recommend any particular style of meditation, but if you’d like to learn more about Master Del Pe, go to www.mdpglobal.com. He’s the one who looks like Mr. Clean.

Kankakee Roadtrip Anyone? (Kristin Davis)

I had been planning on devoting an entire post to describing a terrific wellness program in New Jersey, run by a fabulous researcher- practitioner, named Peggy Swarbick, who if we’re lucky, will contribute a blog post sometime soon on what her program is up to. In the meantime, you can read about some of their activities here.

But between writing that post and now, I visited a Thresholds’ run program in Kankakee, which blew me away! Don’t get me wrong, I know that there are many, many good things going on across Thresholds’ programs, and we know about some of them through various internal publications, but these can’t capture everything . . . especially the atmosphere and spirit of a program.

Boy, do I wish you could all go Kankakee to experience it. While the staff and members mourn their old space from which they had to move a year ago, space which included a beloved garden and a beautiful older building that had originally been a school house, they’re in the process of recreating much of what they had to leave, despite being surrounded by an asphalt parking lot. The indoor space is not only adorned with gorgeous paintings, oil-based and watercolor both, but also shows the beginning of what the Program Director, refers to as “the greening of the inside”—seedlings, plants, and flowers. Of course, bricks, mortar, and paintings a program does not make.

It is indeed much more. The membership and staff are participating in walking and smoking cessation groups, and garden both winter and summer to produce food for their two residences. Many members mentioned how much they appreciate living in a rural environment and, I have to say, that Kankakee River is surprisingly gorgeous. This is not to suggest all is a pastoral ideal south of Chicago, many members expressed frustration with how tired they feel on a regular basis and with how hard it is to lose weight. Others indicated they wished they knew how to ask their medical doctors the right kinds of questions. Suggestions welcome.

Luckily, many of these same members have offered to photograph their ideas of wellness and health for this blog as a way to share their vision of what it means to be well and to help shape the Wellness Campaign I had gone to Kankakee to launch, a campaign I now realize will merely supplement what’s already going on!