Mental Health Matters
Todd Weatherly, Therapeutic Consultant and mental health professional hosts #MentalHealthMatters. Interviewing doctors and therapists, treatment professionals, organizational leaders, and other members of the mental health community about the importance of mental health awareness, treatment and the future of addressing mental health in the US. Discussing how to support mental health in our communities from hospitals to the dinner table and what to do when crisis arises.
Mental Health Matters
Navigating Crisis and Recovery with Todd Weatherly
What truly defines resilience in the face of a crisis? Join me in dissecting the subtle difference between crisis and trauma, illustrating how unresolved trauma can impede healing and recovery after disasters like Hurricane Helene that struck the Western North Carolina community.
Emotional wellness often takes a back seat until a crisis forces us to confront it head-on. In our journey through emotional recovery, we touch on the significance of seeking support during vulnerable times. Personal experiences, like those related to anniversaries of loss, highlight how unprocessed emotions can disrupt our daily lives. The importance of proactive mental health practices, compassionate workplace policies, and learning from the COVID-19 pandemic's impact on mental well-being are key points of reflection.
The complex landscape of mental health issues unfolds as we examine psychosis, mood disorders, and the critical nature of understanding and treatment. From the generational shifts in mental health awareness to the necessity of personalized care, we stress the significance of early assessments for effective management. With resources like All Souls Counseling and The Aegis Center in Asheville, listeners are encouraged to prioritize mental health and utilize available support systems for stability and recovery. Remember, your mental health matters, and taking the first step toward support can pave the way for long-term wellness.
Hello folks and welcome once again to Mental Health Matters. This is Todd Weatherly, your host on WPPM 1037, the voice of Asheville, therapeutic consultant and behavioral health professional. We had a bit of a run lately. Helene kind of knocked us out for a minute. A couple of weeks without power, a minute, a couple of weeks without power. Myself and my family are among very fortunate. Our home was not severely damaged. We had a little bit, but nothing like what you see anywhere else, nothing like what you see on the news.
Speaker 1:But when you are virtually based and you do all your stuff and recording on a computer or talking with your clients on a phone, spending anywhere from six to 10 days without signal and without power makes things a little challenging. Most of us, to get anything done, had to go out of the area in order to just get some work done. So that was, that was something. It was a. It was a challenging time and the community is getting through it. So things are getting repaired and things are coming around. Some people will never see their homes again and they're just going to have to either move out of the area or rebuild, find a place to live. Many people are finding temporary housing somewhere nearby. Some close friends of mine are temporarily housing in neighboring communities Brevard, weaverville or Hendersonville, where the damage was not as bad. So to those families and to the people who suffered the greatest loss. Our hearts go out to them and you know it's if you've got an opportunity.
Speaker 1:There are lots of good organizations to donate to. Eplen Charities is one. I'm personally connected to them. Beloved Asheville is another. They've been stars in responding with water and food and just emergency supplies and things like that. You've got Homeward Bound. I would also consider looking at Habitat for Humanity. There are lots of ways to respond to crisis and you know I got to attend. All Souls Counseling is one. I got to attend a presentation that Meredith Switzer, the executive director of All Souls Counseling here in Asheville, got to put on. Who's going to be a guest later on this week? Many of the guests we had to reschedule, so that's why we've been a little bit offline late and my apologies, but they were talking about the difference in this presentation between crisis and trauma.
Speaker 1:Crisis is the thing that happens to you. So you're in a flood and a storm has happened and there's a crisis and you're just trying to survive, trying to get your things out, or you're trying to get to safety, or you're just enduring whatever's going on. And after the fact are the things that occur. It might be a continuation of the crisis. If you're without power and water and your house is damaged and you've got to find a place to go or live and those kinds of things. You're kind of in the midst of just finding a way to survive and those kinds of things you're kind of in the midst of just finding a way to survive.
Speaker 1:And then, once you get to a place, if we look at Maslow's hierarchy, it looks like a cone and at the bottom of that cone is shelter and safety and food and the ability to just take care of your basic needs. You've got to have that. And then there's relationships and there's love and acceptance and there's actuation. You've got to have a lot in place in order to be working on your self-actualization. To be honest with you, you've got to have a stable living environment. You've got to have community. You've got to be loved and supported. You've got to have a lot of things in place before you can start working on the final level at the top of the cone. In this case, people were working on their safety. You can't do a lot of personal work when you're trying to just be safe, and so after you get past that stage, you found safety, maybe you found refuge, you've pulled together food and resources and other kinds of things and you get a minute to rest and you get a minute to reflect on what's just happened to you.
Speaker 1:That's when you have trauma. That's when trauma sets in. I mean, you see a lot of things that happen for people. You know there's a lot of people, a lot of people, especially the people who are out there and already homeless. They're those people who did not survive the storm. Or there are people that were teetering on homelessness and the storm just caused a lot of the resources to go away and they became homeless as a result. Or they had resources but they couldn't reach them. They were out there, they could not be reached. There was no cell phone. Maybe their cell phones got damaged or destroyed or something like that. There was no signal in the first place. You could barely get a text out for about a week here in the Western North Carolina area, several parts of it. And so you know, when a person can't find resources, they are stuck with what they've got in front of them. So you know, once you get settled, suddenly trauma starts to happen and then trauma can build on continued crisis, but trauma. What you'll find is that homelessness rates go up, people get divorced because of major and significant trauma, relationships experience a lot of duress. There are a great number of things that happen in the midst of trauma, and so we're grateful for people like All Souls Counseling, and I think that we dismiss how important mental health is.
Speaker 1:People don't, especially if you live a life where you don't really think about it a lot. You know you just go about your business and you paint by numbers and you go to work, school. You know, go to work, do whatever it is you do during the course of your day and your week and your year. Go to where, do whatever it is you do during the course of your day and your week and your year. And then, all of a sudden, something happens and you're not used to seeking help for for your emotional state. And then, all of a sudden, you're having an emotional state because you're you're in the throes of experiencing trauma as a result of experiencing crisis and you don't turn to anyone or you don't know how to turn to someone. And then all these feelings, they they stir up and they have a tendency to come out of you, whether you like it or not and in ways that are not the most comfortable, not the most, seemly not the most productive Anxiety and fear and depression and all the things that come along with traumatic events. They bring about the worst in us sometimes.
Speaker 1:Um, and so you know if you're, if you're not, if you're not finding a release valve for that stuff to go live somewhere. Um, a good friend of mine, therapist, suzanne Flynn, talks about like just you got to have some practices, man. You got to have some practices in your life that help you sustain just being above board, just being above water In this case, literally above water and if you're not emotionally above water, it compromises your ability to operate in the world. You don't make good decisions, you miss opportunities for for doing even basic levels of self-care, and that includes just like getting showers and baths and things like that, finding someone who can help. There's a lot of people who just don't know how to ask for help. Fortunately, there's a lot of people giving help, so help was readily available. And so you know, there's a lot of people giving help, so help was readily available, and so you know there's a thing that happens to folks after these events transpire.
Speaker 1:Long term is that you not only experience trauma immediately after the event. Maybe you get help, maybe you don't, maybe you don't know what to do about it and maybe you can put it away for a while. But anytime a person experiences traumatic events anniversaries, you know, if you've had a parent pass in your life, for example, or even a child, god bless it. Just having a child pass Every time you reach the anniversary, or a spouse, any time you reach the anniversary of when that happens, you'll probably have the feelings for the rest of your life, most likely at different levels and in different ways. But my father passed 20 years ago, and when the day that he passed passes by, you know my family, we all text one another and we say things about dad and we. You know we have feelings. They're a little further removed from the actual event, but they don't go away. They don't go away, and so being able to do something about them and being able to kind of process those feelings with someone that is able to help you, put it in appropriate containers, is a good way to keep it from having an undue influence on the rest of your life.
Speaker 1:You know, if you're not emotionally well, that will touch every other aspect of your life. It'll touch the way that you relate to people, the way that you talk to people, the way that you, you know, have a relationship with your partner or with your children, or with other members of your community, friends and family. They'll notice, most likely, if you've got something that's really big, that's stirring inside of you and the people who are closest to you will notice that something's off, um, like hey, are you okay? And um, I think that there's an immediate, there's an immediate response for people who are not used to receiving help, for emotional help, that, um, they deny it. You know it's like I'm fine, you know. You know, look, fine, look up the definition of fine per Elizabeth Kubler-Ross and you know what fine stands for Frustrated, being the F for one, and it goes from there. But I'll let you search that out. I'll put a link in when I post the show so you can do a little bit of research and read about Elizabeth Kubler-Ross and her work on grief.
Speaker 1:At any rate, if you're not getting support and you're not giving emotions a place to go, they find a place to go. It's like a sieve it leaks all over everything. If you're not putting it in its own container and you're not processing it. And you're not putting it in its own container and you're not processing it, you're not doing those things. You could be looking at having that stuff leak out in places you don't want it to at work, you know, all of a sudden you just you got to leave the building. You can't be here anymore. You're having a day. Everybody's had those days and I think that you know one of the practices that my wife and I you know in being in management and being in you know directors and founders of programs and things like that my experience, my wife's experience as well.
Speaker 1:One of the things that I've tried to implement as I go along is that you get mental health days. You know you used to have to claim to be sick in order to get a mental health day. In order to get a day you just couldn't take being at work anymore. Now I think that COVID did a lot because, even being sick, there are a lot of employers who are not compassionate and they want you there. They don't have good practices around employment. They're not good partners to their community. I could name a few, I won't name any, but they're here in our community and just like they are in every community and I think that COVID gave us.
Speaker 1:You know, you could say that you were sick and people like whoa, I don't want that anywhere near here, and you could legitimately be sick. So that was one thing. But we're still not at the place where a person can have a mental health day. But in my practices you get a mental health day. If you call me up, it's like, look, I need a mental health day. That's as legitimate as saying you're sick and I think in our communities these days we still don't have that equivalency. The person cannot have a mental health day. They can't have a day where they just need to not be at work and they need to not be responsible for anything.
Speaker 1:Today They've had something happen. I mean the US practices for you know, hr practices in employment are, when it comes to grief, are deplorable. You know, if you have a spouse die or a parent die, kind of standard practice you get three days in the US. In Europe you get two weeks. They're deplorable. They're deplorable around child care. I mean we're not good to our employees and not especially supportive to our communities and our practices, honestly. So that's something that I think an awareness about mental health can change, because the truth is that you get more out of emotionally healthy employees than you get out of emotionally unwell employees. They may be at work, but they're not operating, they're not functioning, they're not performing. So those are some things to think about. Those are some things that came up for me during this entire time. We've got some guests we're going to be able to interview this week, which is great. I'm excited about that.
Speaker 1:But today's a solo run and I just wanted to name a few things because we didn't stop, because, you know, in our work, just because we had a crisis didn't mean other people didn't have a crisis as well. So some of the crisis that was happening was stuff that was local and we tried to provide support as much as we could. Uh, while we were here, two of my team live in the area and and we were fortunate ones and not not as impacted by the storm as many others, but we still had to keep going and still had to support our clients who are in other areas, because we we work with clients around the united states and, um, they were in the middle of what they were going through and it wasn't stopping. And that's the other thing about mental health conditions is that they will at a certain point, if they get big enough, they're going to come, whether you like them to come or not, and it won't be at a good time. It's never at a good time. Not, and it won't be at a good time. It's never at a good time.
Speaker 1:You know, if you ask somebody who suffers from panic attacks if they could think of a good, if they could think of a time when a panic attack came at a at like, kind of just the right time huh, this was an okay time for me to have a panic attack I doubt you'd get very many positive responses to that. Um, you know the, the, and then there's the, the threshold. What I'm talking about right now is more or less up to what I would call this line of what is commonly referred to and forgive the term, the worried. Well, people who are more or less able to function in the world and have traumatic events and have things happen to them and have stuff that's terrible or disconcerting, or anxiety-producing or depressing, and then they suffer from the emotional conditions that come along with such events, but they are able to keep going. They show back up at work, they're able to kind of pull themselves up by the bootstraps and keep going. They're able to kind of pull themselves up by the bootstraps and keep going.
Speaker 1:And there are a lot of people out there who are just they're living with something that they don't know what to do with. They're living with something that they don't are unable to process, but they keep going anyway. And you get a lot of people who they do that for years, maybe their entire lives. And then my father was one of them. He was an abused child and the great gift that he gave to us was he did not carry that over into his family, he just wanted to be a loving father and everything else. But he ended up suffering from. He suffered from depression all of his life and as he got older and his health got worse, his depression became more prominent and it became something that really was impacting him terribly and, you know, as he got into his 60s, died at 65, as he got into his 60s, you know he was just living, as we say, a half-life, because he had finally tried to put it away without getting help around it for so long that he couldn't put it away anymore.
Speaker 1:And I think that there are a lot of people, especially in the boom, um, you know, in the boomers and silent generation and you know the older folks, you didn't, you just put your stuff away and you kept going. You ducked your head, you know, keep going, carry on, kind of way. Um, and these days we're a lot more aware. I think mental health gets a lot more attention and we're a lot more aware of what's going on. But there's still a divide, because the other side of what I'm talking about is that most people don't know about is when you cross this threshold, like I'm talking about. My father crossed it. Major depression took hold of him and he he would have been, if he had done an, an assessment, he would have been diagnosed with major depression, probably getting medications. They would have suggested treatment of some kind. He would have gotten trauma care of some kind if he had done it right or if he had gotten support that he needs. So he did not do that.
Speaker 1:And then you cross over this threshold and there are people who have been suffering with either severe depression and comes with suicidal ideation. They may struggle with bipolar disorder. They may struggle with schizophrenia. People are like well, schizophrenia, what are you talking about? You'd be surprised the number of people that are out there that struggle with thought disorder, psychotic features. You've got individuals in the throes of substance use disorder, SUD, and some of those individuals are at risk or have experienced a psychotic break as a result of their substance use, so substance induced psychosis. So I was working with a family and you know they were struggling with some of these things with their family member and the thing that came as a result was me talking about, in this particular instance, the difference between psychoses. So this is kind of a lay person's explanation.
Speaker 1:I think that if you are a person who finds yourself struggling with, if you have a family member who's struggling with very severe emotional, psychological kinds of conditions, then one of the first things that we recommend is to get an assessment, to get a true neuropsychological assessment, you know and don't. That includes testing that looks at a person's cognitive capabilities, because both psychosis and severe mental health conditions can impair a person's cognitive capacities. But I've also had older adults who are now suffering from severe mental health conditions and they've been to the hospital and they're trying to figure out what's going on and one of the things they discover is they discover dementia. They discover cognitive decline conditions that go along with the emotional is. They discover dementia. They discover cognitive decline conditions that go along with the emotional conditions they're experiencing. So sometimes an MRI is important or a neurocognitive evaluation is important for a person. If you're over the age of 50, neurocognitive evaluations MRIs or go to a neurologist is is going to be an important thing for you to do if you start experiencing things like severe depression or suicidal ideation or any of these other things. Make that part of the thing that you investigate.
Speaker 1:But psychosis is actually. I look at it and I see three different ways in which psychosis can come along. And you know there's substance-induced psychosis is out there and the levels. And you know I wrote an article about this on my LinkedIn page and I posted a blog, but I even had someone comment, dr Karen Flannery and she talked about the increasing frequency of high-potency THC and stimuli, at least particularly in early adulthood, when schizophrenia and bipolar disorder have their and psychotic breaks have their like 18 to 21. Early adulthood young adulthood, as we call it, up to 28 years of age is kind of that prime time when you know if you are going to experience things like thought disorder and a psychotic break as a result of suffering from bipolar disorder or schizophrenia or schizoaffective disorder or any of those, you're going to see that typically not always, but typically somewhere between 18 and 24. So if you blend that in with a mix of that's also when you know late teen teenagers and early 20s individuals that go to college or they're graduating from high school and they're experimenting with alcohol and marijuana and other substances that they're getting hands on, including benzodiazepines, which includes Xanax and Vicodin, and all those kinds of things. Some of these are addictive, predictive. If you are a person at risk of suffering from psychotic conditions and you start taking these substances, especially the high-dose THC stuff, then you are putting yourself at risk for a psychotic break.
Speaker 1:But the thing is that most people don't know it. What you'll have is a kid that did fairly well. They went in high school and everything else. They graduated without much of a problem. They go off to their first year at college and something happens and all of a sudden you get the report back from the first semester and it's all Fs, or they're on academic probation or something else has occurred and they come home and they're a disastrous mess and what they've been doing is partying, and then partying led to something else, or maybe they've been isolating in their room. If anybody's ever seen the movie A Beautiful Mind, which is based on a true story, the doc in that story talked about a roommate that he had all through his initial years in college. But his roommate was an hallucination and I mean he spent a number of years talking about stories that he did with this roommate who was a hallucination Because he suffered from pretty severe schizophrenia. So you've got substance-induced psychosis.
Speaker 1:Now, if it's truly substance-induced psychosis, then the person is going to. If they stop taking that substance and probably, to be fair, substances in general they're not going to have a psychotic break. They're not going to have psychosis. It goes away if they're not using the substance. And that's true substance-induced psychosis, that is as a condition. Psychosis can be substance-induced and trigger a psychotic break that a person was probably going to have anyway at some point in time. And then there's substance-induced psychosis, where it triggers a psychotic break and the psychotic break happened as a result of the substance and once the substance goes away they no longer have that problem.
Speaker 1:So kind of two different camps there, and anybody who suffers from psychotic features to their mental health condition needs to stay away from marijuana and psychedelics. Probably a good idea for them not to drink. They need to find some other way to calm their mood, because the use of either recreational or illegal substances or even the misuse of prescribed substances like Adderall, attention meds or benzodiazepines like Vicodin or Xanax, is pretty much a no-no Because they are either prone to addiction, alcohol, for example. I know people who suffer from a bipolar disorder and alcohol becomes way too close a friend and they just can't play with it and they can't experiment with it. They can't experiment with it and any other substance is just as, and of course it's a bit of a gateway. Alcohol just leads you right into. Well, that feels good. Maybe I'll do something else to make me feel good.
Speaker 1:And the truth is is that you do feel better as a result of use of these drugs? A person who suffers from bipolar disorder that's having anxiety and they smoke pot, they feel better? Absolutely, they feel better. It's an immediate solution. It's great Until it isn't, until you have a psychotic break because you weren't paying attention. The other people who suffer from bipolar disorder and schizophrenia is they start to feel good because they're on the proper medications and as soon as they feel good they feel like they don't need to take those meds anymore they fall right off that shelf. So you know to talk about. We've got mood disorder. Bipolar is a mood disorder. Depression is a mood disorder. Severe anxiety either goes along with mood disorder or it can be a disorder in and of itself.
Speaker 1:We won't get into diagnostic profiles Again. If you want to get into the nitty-gritty of something like this and you find that you've got a family member who suffers from these conditions, what you need to do is get in front of a clinical psychologist who does assessments for a living. We've got wonderful ones in our community, several that do them here, and you can find them most anywhere and most of the people who do clinical assessments will travel. And then you've also got assessment and stabilization centers. That are also part. I'm going to have as a guest soon the CEO of Lender Center for Hope, dr Michael Brote soon, and they are an assessment stabilization center. They focus on being able to diagnose very definitively what's going on with an individual, including medical health conditions.
Speaker 1:You might be suffering from psychosis, and this is rare but it happens. But it's actually a thyroid-based malady. If thyroid's out of whack for some reason, it's doing something to you neurologically. If you get the thyroid under control, you stop having symptoms. So it's important to check medical stuff as well. But when we're talking about mood disorder, there are lots of mood disorders that can come along with psychotic features. You can have depression bad enough that you have depression, depression, psychosis, people who get so far in the throes of psychosis, or so far in the throes of depression that they end up in if so far in the throes of of depression that they end up in a psychotic break, or even catatonia. If you're a person who suffers from catatonia, ect might be a treatment that's important for you. Or severe depression that doesn't seem to go away what they call treatment resistant um depression then then that's where uh, ect can be a saver for you. It saved many people. It's not something it would do lightly, but there are people that need that level of care.
Speaker 1:And ECT is not what it was. It's a lot more sophisticated these days than it had. We're not still in the throes of, not in the days of one flew over the cuckoo's nest. You know that is not what ECT looks like anymore, but mood disorders. If you think of here's what mood disorder is, everybody has ups and downs. You know you have good days and bad days. You feel a little down one day, you feel a little up another. You had something that happened. It was a great thing and you feel great today and that lasts for a little while and then something else happened and you feel a little down today and you get over it. But you know, and there's this kind of there's kind of this middle and the ups and downs they follow. They don't go over a certain mark and they don't go below a certain mark and you have this wave. Now some folks don't even need an event, they are.
Speaker 1:What we're finding about a lot of these conditions is that they are epigenetically related. I mean, you could have had a mother, a grandmother or a grandfather who suffered from depression and no one in the immediate family moms and dads and siblings don't seem to have any problem with it. But you, for some reason, are suffering from major depression and even though you feel like your life was pretty okay and everything else like depression. The emotional conditions can be genetic in nature. They can follow a family line, but a lot of times these things are also traumatic events that are associated with why a person suffers from a specific condition, a specific condition, right? So at any rate, when the highs and lows go above kind of one standard deviation above the normal threshold or below the normal threshold then you're throwing the system off and the system feels like it needs to accommodate all the levels it's ever experienced. And it is so.
Speaker 1:When you're talking about personality disorder. A person who suffers from personality disorder is probably suffered from a mood disorder for a lengthy period of time and they have lived kind of out of whack. Instead of a line that looks like this, that's got regular ups and downs, you've got a line that looks like a squiggly, it's got high ups and way low downs, and maybe it goes to normal and maybe it goes back down and maybe it goes way up, and so you see an arrhythmia to the mood line that you draw for a person. And if you spend long enough in that kind of way, you're going to struggle with relationships, you're going to struggle with having stability in any aspect of your life, and that will inevitably lead to suffering from personality disorder. It's almost a guarantee, because it's hard to trust what the next moment's going to look like and makes it hard to trust relationship, trust yourself, trust your judgment, all those things. It's a very difficult condition to live with. It's a very difficult condition to treat. So back to mood disorder though.
Speaker 1:When you have mood disorder that has too much of a high and too much of a low, or both Bipolar disorder, you've got various forms. There are people who experience mania. If you experience mania, you're going to experience depression. Basically, what goes up must come down. It works both ways, really. Really, whatever major mood whether it's high or low that you experience, there's a recovery. If it's depression, you'll come back out of it. You may spend a long time in depression, but eventually there is a time when you'll come back out of it. That's what makes people very anxious, because they know the low point's coming again. Or, if you go very high, you have a manic episode. Eventually you're going to come off of it, and when you fall, you fall hard and it feels terrible. People in mania feel great. There are people who experience mania at levels that they'll kind of do anything to go have a manic episode because they feel great. I mean, you feel great and then you don't in the worst possible way. You feel awful. After that mania subsides and goes away. And if you're a person who knows that you experience mania and, as a result of mania, experience very low depression, you'll see people get very anxious when they're not feeling either. One of those like which one's coming next.
Speaker 1:So why medications help? There are people who experience psychosis regardless of mood, like psychosis is part of their profile. If they are not on antipsychotics, they will have psychotic breaks. There are some who suffer from mood disorder and medications help regulate mood. You got lots of different mood regulators that are out there. Sleep is a big piece of this. When people don't get sleep, that goes nowhere. Good, if they regulate their mood and they're on a mood regulator that keeps those highs and lows from going too high or too low, then what they're going to have, then they have a tendency to avoid having psychotic episodes. They only have psychotic episodes when they break past that threshold of too high or too low and psychosis is part of what they experience as a result of mania or as a result of depression. And if you regulate the mood, they don't have psychotic features to their condition as a result of the mood being regulated and they can often go without being on an antipsychotic. You've got other people that even if you regulate the mood, they have psychosis as part of their profile. They need to be on an antipsychotic so that they can not have those. And psychosis is terrible for the brain. It's like setting the brain on fire. Every time you have one you do more damage, not to say that you don't have a tremendous. The brain has tremendous resiliency as well.
Speaker 1:One thing I like to tell people is that recovery is possible. You'll go into hospitals. Unfortunately, hospitals don't know about treatment. Largely they don't know about treatment. They largely they do not know about treatment. They don't know about residential treatment. They don't know about the appropriate placement for a person who's just been hospitalized for a psychiatric event, and what they do is they send you out to the street, put you. You know if you no longer meet criterion, you no longer endanger yourself or others. You know you're now eligible for discharge and what you can do is visit your local doctor or the IOP, neither of which are appropriate for a person who's just had a psychotic episode and had to go to the hospital as a result for drugs or psychosis or severe depression or any of those things. If you ended up in the hospital, you probably need to do at least a PHP, which is a partial hospitalization, a very intensive level of care with some supported housing I would say residential treatment. But if you can get to a PHP with supported housing, I think that can be a good intermediary that will support you in a way that you need supported.
Speaker 1:But here's the thing, and that I run into this as a result of working with people who suffer from these conditions like, do I really have to go away somewhere? Do I really have to? It's like, look, if you're going to go work on stuff that's been impacting your life, you know now for the whatever your entire life is, if you're in your early twenties or maybe you're in your thirties, I recently had a client who had their first psychotic break in their forties. Client who had their first psychotic break in their 40s. If you're a person who's dealing with something like this, don't play around. If you had a heart attack and you went to the hospital, you wouldn't play around with your care. I hope you wouldn't. I hope you'd be like that's pretty serious. I need to take care of that. What do I need to do If you've been to the hospital as a result of severe depression or psychosis or suicidal ideation or any of these other conditions that make you hospital or substance use that's gone so far out of line that you need detoxing and everything else.
Speaker 1:You need help and the chances are very good you need residential help, so get someone to help you find it. You can work with a therapeutic consultant. Most people don't know what those are and they wouldn't have to know until they experience something like this. Therapeutic consultants can help you navigate that kind of stuff, so that's great. Sometimes you'll get hold of a good discharge planner at the hospital or a good doc who knows their way around and can refer you to someone who knows about programs or knows about some programs his or herself. Get help, don't skip getting help. You may have feelings about medications. Use medications, just use them. Don't play around.
Speaker 1:If you can get off of medications or you can do medications at a reduced or minimized level, great. Do that after you've stabilized, after a year of being stable, of having no episodes more or less being, you know, in that regular kind of mood. You know you got good days and bad days, but nothing horrible, right, um, and if you can experience a year of that, you can start looking at medications I would. However, the warning is is that hospitals are not seeing you long enough to really tell you what medications you should be on. They're giving you stuff that's going to cause you to calm down. If I give you Thorazine and Haldol, trust me, it doesn't matter who you are. You're going to be a cool cucumber. You're not going to be doing much or saying much, but you're not going to be a danger to yourself or others and it's like great job done. It's like no, it's not.
Speaker 1:I wouldn't leave anyone on either one of those medications for a long period of time if I had a choice. They're hammers to the system, they are terrible for the body and they work in the moment. You know Haldol is one of the old meds. A person in psychosis could get Haldol and they would stop being in psychosis and that would work. Call it a velvet hammer, but you know you need a person who's looking at you and your responses to medications. Ideally, you'd get genomic testing to see what your absorption levels are for certain psychiatric meds and work with it closely with a psychiatrist for certain psychiatric meds and work with it closely with a psychiatrist and even a therapist or a psychologist in tandem with one another largely clinical environments, treatment environments where you find that kind of arrangement, where people are working in a team but, if you can put it together, make sure you're taking the right medications, the ones that are right for you.
Speaker 1:You know you don't need to be on a anti-psychotic, don't be on one. But you need to find that out. Sometimes finding that out can be very hard and sometimes finding it out needs to happen in a residential care environment. It just does. Because, if you think about it, if you've gone through all this kind of intense treatment during the day, talked about your trauma, and you get a lot of think about it, if you've gone through all this kind of intense treatment during the day, talked about your trauma, and you get a lot of information about your diagnosis and what's happening to you and you're kind of taking this re-identity formation on board and there's all this stuff going on for you.
Speaker 1:Let me tell you that is disconcerting. I mean it's going to throw you off. You're going to feel not like yourself for quite some time until you forge this new identity around who you are. For a person in their early 20s it's very difficult. They were already forging this half-baked idea about who they are and who they want to be and everything else. It's a time when you explore your identification. You throw severe mental illness, bipolar disorder, psychosis, schizophrenia into that mix. That makes that next to impossible to do without help not do well anyway. So get the help.
Speaker 1:If you're receiving all this care during the day and all of a sudden you go home at night and you think you're not going to have feelings when you try to go to sleep that night, when you have racing thoughts, when you, you know, uncovered some bit about your history that you found traumatic and you didn't realize that it was traumatic for you. But it's kind of a new memory Like you're going to have all this stuff going on If you don't have support in that environment. I know people think they can go home alone or they can go home to family. Those are not environments that are going to support this kind of stuff. You need professionals involved, you need medications and you need professionals. Sorry, that's what you need.
Speaker 1:There are programs out there that talk about being able to do it without medications. If you can do it without medications, you need to do it without. You need to try that, after you've been stable for a while, use the medications, use them as a crutch, find your way to stability and then start working on bringing the dose down, eliminating medications, those kinds of things I would also. My other argument is you will also find docs, hospitals, other folks, other professionals out there that will put you on way too many medications. They will give you a mood regulator, they give you an antipsychotic. They give you a sleep med, they give you an anti-anxiety. You've got people wearing 5, 6, 7, 10 medications. It's too many. It's too many. Every time you have a symptom, they give you a medication to manage the symptom. There are lots of different ways to manage symptoms. So not only is medication a very effective way to help manage some of these conditions, but, like healthy lifestyle, healthy eating, good sleep hygiene, good personal self-care, etc.
Speaker 1:All of these are other ways to manage mood, to manage mental health conditions, and if you're a person who's not over this threshold where you're experiencing these kind of major psychological conditions, you find yourself close to the line. And after an event like a flood, like we just had, many people do find themselves pretty close to the line. You need to get outside, you need to walk. You need to exercise, you need to eat right. No more like, stay away from the fast food, eat some salads. You know what I mean. Like, try to take care of yourself and you'll find that has a tremendous impact on your mental well-being your mental well-being.
Speaker 1:So, kind of going through this and giving this explanation was helpful for families when I've been talking to them and they were able to kind of get a grip on the levels of a person's psychological and emotional experience as a result of being diagnosed with a severe and persistent mental health condition. We call that SMI and they, you know I wrote it up in an article on LinkedIn. I'm trying to talk about it so that people have it out there and I want it to be information that people use as something that's reliable. And if you're uncertain about where you might fall on the scale because you've been experiencing things that have been a little weird and different than anything you've experienced in your life, get some help, call someone, call us, call your therapist. If you've got a psychiatrist, call them. If you've got a medical doctor, they'll refer you.
Speaker 1:Find help If you feel like you can't afford any of these things and you need to talk to someone and you need a therapist. All Souls Counseling is a local resource that provides a sliding scale and even free therapy and counseling for people who need it. They can do it virtually. They can do it in an office. Sometimes I think their offices are actually back in operation these days. I know that they were there when I talked to them, but I think they're probably in full operation again. I'll ask Meredith about all that when I interview her later this week.
Speaker 1:But reach out to a local resource. If you're a person who suffered from a psychotic break, there's the Aegis Center in town, in town, and they are able to give you a doc and a therapist and prescribe psychiatric meds if those are what you need. They're the first episode center, the Aegis Center here in Asheville as well. So there are resources around, and so access those as much as you can Call and get help. Take it seriously. Your mental health is important. Thanks, folks. This has been Todd Weatherly. Once again, mental Health Matters on WPVM 1037, the voice of Asheville. I'll look forward to being with you next time. Be safe out there, be well. Talk to you soon you.