Over a period of months, the world watched Britney Spears spiral into a mental health abyss all too familiar to this parent’s eyes. The vultures and tabloids heaped blame, shame, ridicule and humiliation on her young shoulders, despite the fact that she was clearly sick. She needed medical care and proper treatment; she needed help. Fortunately, her father stepped in to demand that help and she seems to be on the road to recovery. Facing down the hoopla surrounding her illness and its distressing symptoms, Ms. Spears valiantly offers living-large proof that treatment works. With a good doctor and family support, she is on the mend.

Check out this audio clip of her upcoming release.

In 2006, Lauren Greenfield unveiled the HBO documentary THIN to rave reviews at Robert Redford’s Sundance Film Festival.  Revealing the inner world of anoretics, bulemics and treatment at the Renfrew Center Foundation, THIN brought eating disorders and the battle to overcome them to the forefront of modern consciousness.

Now, two years later, production company Tijuana Entertainment hopes to bring the same focus and understanding to the treatment of Obsessive Compulsive Disorder, commonly referred to as OCD, and its related disorders.

As Tijuana Ent. gears up to create the new documentary series in Los Angeles, they’re searching for people  in need of help. The non-exploitive documentary will aim to improve the participants’ lives through sessions with licensed therapists including John Tsilimparis, MFT and Karen Pickett, MFT.  Cognitive Behavioral Therapy will be provided free of charge to the chosen applicants during production and filming.

If this opportunity is of interest to you, contact Alicia Kincaid, Casting Coordinator, at therapycasting@yahoo.com.

I knew in my gut that my son Michael’s pot smoking was both symptomatic and causal regarding his mental health. We talked time and again about the damage he could be inflicting on his brain and about his doctor’s inability to treat his bipolar disorder correctly when he continued to use.

Deaf ears. No need to say more. But we have to get the word out. We have to share the facts. And the facts are now indisputable.

Marijuana, in addition to being a gateway drug (it is for most and it certainly was for Michael) has now been proven to accelerate the onset of psychosis in those whose genetic makeup predisposes them to serious mental illness.

Shouldn’t that information be enough to keep young people from experimenting?

Here are the facts:

Earlier this year a team of Spanish researchers found a strong and independent link between marijuana use and the onset of psychosis at a younger age. The possibility of chance has been factored out, as have gender and the use of other drugs. The amount of cannabis used, however, is a significant variable.

“The clinical importance of this finding is potentially high,” Dr. Ana Gonzalez-Pinto from Santiago Apostol Hospital in Vitoria,”given that cannabis use is extremely prevalent among young people.”

The researchers also discovered that “estimates of the attributable risk suggest that the use of cannabis accounts for about 10 percent of cases of psychosis.”

The findings are based on 131 patients ages 15 to 65 years who needed inpatient care for a first psychotic episode during a 2-year period. The results showed a significant gradual reduction in the age at which psychosis began that correlated with an increased dependence on cannabis. Compared with nonusers, age at onset was reduced by 7, 8.5, and 12 years among users, abusers and dependents, respectively, the researchers report.

These results “point to cannabis as a dangerous drug in young people at risk of developing psychosis,” Gonzalez-Pinto and colleagues conclude.

Spread the word. Share the facts. Save a life.

I recently wrote this article for Caring and Sharing, a publication for mental health consumers and their families, put out by the National Alliance on Mental Illness. It shares a small glimmer of hope in the world of mental health research.

Schizophrenia is a serious mental illness affecting 1 in every 100 people at some point during their lives. Genetic factors are thought to account for more than 70% of all cases, and scientists have long sought to identify those genetic markers in an effort to predict who is predisposed to the disease so that they can avoid triggers and perhaps onset. Recently, two-large scale, multi-national collaborations netted results that brought the medical community closer to that goal by identifying sections of the human genome that, when deleted, can elevate the risk of developing schizophrenia 15-fold, as compared to the general population.

The International Schizophrenia Consortium (ISC)1, a collaboration of researchers from 12 institutions in Europe, the United States and Australia, studied the genomes of 3,391 patients with schizophrenia, looking for a specific type of genetic error called a copy number variation, in which a section of the genome is deleted or duplicated.

The SGENE consortium2, made up of 18 institutions across Europe, the United States and China, catalogued all the copy number variations between 15,000 parents and their children, and then looked for matches to these variations in nearly 5000 schizophrenia patients.

Both groups documented genetic deletions associated with schizophrenia in the same three locations: Two new discoveries on chromosomes 1 and 15, and confirmation of the previously connected chromosome 22. The SGENE collaboration located an additional deletion on chromosome 15, and the ISC determined that people with schizophrenia are more likely to carry rare chromosomal structure changes than are those without the disease. Both groups also verified that these deletions confer a greatly increased risk of schizophrenia (somewhere between 3 and 15 times greater for different deletions), but that each occurs in only around 1% of the population.

Although these findings don’t completely explain the genetic basis of schizophrenia, the replication of the findings in two distinctly separate studies is important. “The fact that there are two independent studies that come at the problem from different angles and using different methodologies is fantastic for psychiatric genetics,” says Pamela Sklar of Harvard Medical School in Cambridge, Massachusetts, part of the ISC study.

Jonathan Flint, who studies the genetic basis of psychiatric diseases at the Wellcome Trust Centre for Human Genetics at the University of Oxford, agrees that the results are a major advance, but points out that converting these findings into a better understanding of the biology of schizophrenia will take a lot more work. “The genetic changes on chromosome 22 have been known for some time,” he says, “but the exact genes that cause the increase in risk still remain unclear.”

Nevertheless, these are the first deletions associated with schizophrenia to be identified in such a large sample across several populations. Since schizophrenia is a disorder affecting thoughts and emotions, it is a devastating disease that is little understood and is difficult to diagnose. These findings shed light on its causes and provide a first component to a molecular test to aid in clinical diagnosis and intervention.

A friend of mine found the perfect residential treatment facility for her dually-diagnosed twenty year-old daughter. Unfortunately, this perfect place is in another state, eight hours away by car. As we talked, she shared her fears about placing her very sick girl in the care of strangers, and asked me how she could be certain her safety was guaranteed.

Of course, this concerned and engaged mom had already done her homework and knew that this particular facility treated both the mental illness and substance abuse with which her daughter was dealing. In addition to those facts, certain policies and methods of communication are vital.

Listed below  are some of the rights that youth and families possess in order to prevent abuse or neglect in a residential setting. If any of these are disregarded or unavailable, I’d look for a new placement.

RIGHTS OF YOUTH AND FAMILIES TO PREVENT ABUSE AND NEGLECT

• Your child should have reasonable access to a telephone to make uncensored calls.
• You and your child should be provided with direct, 24-hour telephone numbers for use if rights are being violated or they are being mistreated.
• You should always be notified if their child is sick or injured.
• You should always be notified within 24 hours about medication changes and missed dosages.
• You should always be notified within 48 hours of any on-site investigations or reports of child abuse and neglect, violation of health and safety standards, or violations of state licensing standards.
• Your child should never be subject to abusive disciplinary methods, such as seclusion, restraint, corporal punishment, fear tactics, humiliation, forced labor, medicinal sedation, or the withholding of food, water, clothing, shelter, or medical care.
• You should never be approached with funding incentives to relinquish custody of your child.

Fellow writer Jane Devin wrote a profound and provocative post in the form of a letter to Vincent Van Gogh. Feeling a deep connection to Jane and her soul-baring words, and having a long-held attachment to Van Gogh, I responded with the comments below:

Our Dear Jane,

Despair not. Although it seems the earth is harshly and radically shifting, in reality she has never been quiescent. It is we who have lost our balance.

Some of us grew shaky, drunkenly falling for false promises made during intoxicating, prosperous times. From some, balance was stolen, as darkness cloaked the thief; or the dusk wooed us into thinking wonder was ahead, and we believed. And some of us simply failed to take good care and let balance slip away, like a lamb left unguarded in the dark of night.

And darkness came.

In the dark, we feel and fear the grasping hands, the pointing fingers, the greed and lack of warmth. It is frightening.

But darkness lasts only so long, and then light destroys it for a time.

In the light, with clear eyes, we see that, like greed and politics and power-brokering brutes, the drafts girls and potato eaters and coffee pourers have always been here. We’ve been overlooked, not recognized by others and ourselves, and in some hearts, judged “less than,” but we’ve been here. And now we must assert what we know to be right and good, we must restore balance.

We are the source of the light and the warmth. It is not them. It is we. We need not buy their false hope and skewed reality. We must join our frail lights together to illuminate a path of change and then follow it. We create hope and possibilities.

With boldness and courage, our barkers cry out the truth when the emperor has no clothes. The drafts girls and icons of change imagine, create and inspire for a better truth. The laborers work the plan, the coffee pourers and potato farmers provide sustenance, the shepherdesses gently lead the young and frightened out of the darkness and into the light, and the dreamers weave the fabric the will protect us when the cold darkness comes again. Because it will. But we will be ready.

Yes, Jane, it is we. It is you and me and all the others who feel right from wrong, recognize basic decency and the lack thereof, and know in our souls that we can be better.

And we can.

Yes. We can.

As a woman, wife, mother, teacher and writer, I’ve mastered the art of loving others. Intuitive, I often feel what others need and am compelled to meet the need whenever possible. I recognize voids and work to fill them.

One problem. A big one.

I have not turned my insight inward. I have not looked at my own needs, the voids in my inner world.

It is as if I give them no merit.

I speak to caregivers on a regular basis and I always tell them, “The key to being the best caregiver possible is to first give yourself the best care.”

Do I listen to my own mantra? I’m a case study for the adage, “Physician, heal thyself.”

No More!

I will address my own needs.

I will embrace my own wonder.

I will love my essence.

I will celebrate my value.

I will offer grace unto myself

I am the Beloved.

Join me. You are too.

Today I spoke to a group of dedicated professionals who care for some of the youngest, most vulnerable members of American society. Sunshine Residential Group Homes house and care for abused, abandoned or neglected children who require out-of-home placement. Twenty two homes, each housing 10 children between the ages of 5 and 18, make up the Sunshine network. Five of those homes care for girls, the other 17 provide services for boys.

It makes sense that many of these children have mental illness diagnoses. Families break down and fall apart when parents are incapable of caring for themselves, much less for their children. Since a large percentage of people diagnosed with serious mental illness are not receiving treatment, many of their family’s suffer. Their children become displaced. The go to places like Sunshine.

At Sunshine, and thousands of similar programs across the country, compassionate people pull together to provide a loving, supportive and nurturing environment for kids who may never have had that experience. They work in shifts, twenty-four hours a day, seven days a week, to create stability, structure and safety for children unfamiliar with those things most of us take for granted.

Here is the philosophy by which the Sunshine Residential Homes are driven, as stated by Director Simon Kottoor:

“Today’s youth are on the threshold of unprecedented risk. The future of our country depends upon the condition of our children and the quality and strength of their families. Many children in our country are deprived of strong families, quality care, support, life-skill training, and proper guidance.

Many children are constantly subjected to abuse, neglect, and abandonment. Our system of intervention must be strong and consistent to ensure a safe and productive future for these children.

Sunshine Residential Homes is dedicated to helping our children reach their greatest potential. Our emphasis is on providing quality care and love. Our children have an opportunity to experience a stable foundation on which to build a wholesome and healthy life.

Sunshine children are encouraged to participate in a series of individual and group activities that promote self-discovery, self-esteem, and self-confidence.”

I was impressed by Mr. Kottoor’s staff. They were eager to learn more about the children in their charge, and even more eager to learn the skills that will enable them to better serve the needs of those children. They asked vital questions, shared on-point personal anecdotes and showed deep concern and affection for their charges.

I am grateful that, despite the obvious challenges they’ve already endured, the children living in Sunshine homes are surrounded by adults who have their wellness and best interests at heart. I wish them all well.

Below is an excerpt from my book, Mommy I’m Still in Here: One family’s journey with bipolar disorder. As you will see, this occurred five and a half years ago, but in some ways feels like yesterday. I share it now to encourage others to maintain patience, love, appreciation and hope. Time is not the best measure of progress or success. Often, we must look deeper, into our hearts and into the hearts of others.

March 2003

“Learning how to appreciate both pleasant and even seemingly unpleasant experiences is a key to increased fulfillment.”

-Mother Theresa

Not long after Michael got out of the hospital, I watched through our family room window as a metalworker, who did several jobs on our new house, spent a few minutes chatting with him. I took Michael to school, and then returned home. When I went out to see how the work was going, this kind man turned off his welder and asked if he could sit in the shade and talk to me for a few minutes. Having seen Michael occasionally during the preceding twelve months, he seemed to understand what we were going through.

“I hope you don’t think me too bold, but I need to share my thoughts with you. I want you to know how glad I am that you continued to love and support Michael even though he continued to defy you and disrespect himself. My family is rife with addiction and mental illness and I know how hard it is to keep working toward a solution with someone who doesn’t even think there’s a problem. It’s a lot easier to give up and tell them to get out. I’ve seen that happen too many times.

“Every Saturday my wife makes sandwiches and I take my boys downtown and we feed the homeless. I try to spend time with the youth, and I’m always saddened and surprised by how many there are. Nearly all of them tell a similar story. They went through the same distress your family has gone through and their parents were either unwilling or unable to continue to care for them. Some of them were beaten and abused, and fled the violence. Some were stubborn, refused to live by the rules, and left. Others just drifted away and no one tried to reel them back in. No matter how it happened, they’re on the street, where their addictions grow, their health deteriorates, and they feel alone and unloved.

“As hard as it’s been for you, I have no doubt that you saved your son’s life. I know people see the surface of things and judge harshly, and you and Mark have probably gotten more than your share of that. I want you to know that people recognize and value what you’ve done. I’m glad you continued to love and support Michael, and when some time has passed, he’ll be glad too.”

Grateful, I thanked him, went back into the house, and wept. I wept for what we’d lost, as well as what we’d gained. I wept with joy for what we had, and with gratitude that we’d learned to appreciate it.

Addiction sucks.

For the addict.

For the people who love the addict.

During the past six years, my son Michael has participated in nearly every type of rehabilitation program available, yet clean and sober living remains unattainable for more than a few weeks. I have often said, “My job is to keep him alive until his brain matures completely and medical treatments for bipolar disorder are more effective.”

Well, he’s still alive;  but at age 23 he’s abused almost every drug, gone through cold-turkey opiate detox no fewer than six times, nearly died of a heroin overdose and participated in activities too dangerous and distressing to write about here.  Every statistic and study I’ve read clearly points to the most likely scenario of a drug-related death before age 30. So 30 has been my goal. Let’s just get him to 30.

Sometimes that seems attainable.

Other times, not so much.

On a single day last week I got three phone calls and a piece of mail expecting me to pay debts Michael had incurred. I’d suspected he was using again. The calls and mail proved it. Money goes missing and bills go unpaid when an addict is back at it.

Even though Michael is doing better than many times in the past…he’s going to school, working part time and recently got married…he’s still not in a good place, not healthy. As the years have passed and the doors to a number of opportunities have closed forever, Michael has learned small lessons. He nearly died of an IV heroin overdose just over a year ago. Since then, he hasn’t relapsed using IV drugs because “That stuff will kill me.” Instead, when he relapses he smokes black tar heroin and abuses prescription opiates. That stuff won’t kill?

Come on, Michael…you know better.

He continues to cling to a sense, no matter how false, of control.

I saw Michael over the weekend. His wife gave him an ultimatum. If he cannot get clean and stay clean, she will leave. Now he’s scared. And detoxing cold turkey. Again.

He shivers and shakes and has diarrhea. He vomits and twitches and feels unbearably anxious. He cannot sleep. He cannot eat. His eyes dart from place to place. He has a hard time sitting still or looking anybody in the eye. He’s paranoid and frightened and wants this to be over. Problem is, the last time he detoxed the symptoms persisted. At the two week point he broke down and started using again.

“Just a little, totally controlled.” “Just enough” to keep him from getting sick, so he could still go to school and stabilize on the meds the doc prescribed for the bipolar disorder.

In no time a little turns into a little more, and then more, and then a lot, and then he’s lost.

He ponders that; and although he feels committed to seeing it through to the end this time, I wonder if he has what it takes. I hope so.

I hope.

It takes a lot.

Addiction sucks.

And so for now I can give nothing more than unconditional love to my son. Money and salable goods are a temptation. Too much support and he takes advantage. I can provide actual food, but even grocery store gift cards (I learned the hard way) are hot commodities when sold below face value. I have to consider every gesture before it is made.

My husband Mark and I love Michael. And he loves us. Despite his addictions and sordid activities, he treats us kindly and lovingly. He is gentle and sweet in our presence. He is precious. I smile when I think about my son. I smell the wonder of his special scent on the day he was born. I hear his shouting “I coming mommy” after calling out for his two-year-old self in our half-acre backyard. I see him standing at the podium, in his 6th grade glory, as student council president and top academic boy.  Michael has filled my life with joy. And heartbreak.  But I will focus on the joy. I will hold out hope. I will love my son.