Reminder about Recovery

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Just a reminder as we start the New Year:

Recovery doesn’t mean the elimination or even absence of symptoms. It means the management of symptoms – using whatever system you have.

My symptoms will be here. Some intermittently, others permanently. Sometimes they’re really bad. Sometimes I don’t notice them at all.

But the important thing is to keep going and use the supports I have.

Realistically: sometimes, nothing seems to help, and one must endure until it does pass. Never forget to use whatever treatment, coping skills, support, and perseverance you have, and the dark times will always pass.

Merry Christmas and Happy Holidays!

Mental Health Association Hope & Courage Award

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Hello readers,

I won an award! Specifically, the Mental Health Association Hope & Courage Award in the Client category, which goes to the most impactful mental health advocate in Orange County who has received mental health services. Huge honor!

I didn’t expect to win, and apparently I sat there looking shocked for a few seconds. People had to tell me to stand up and walk onto the stage.

I also didn’t prepare much for a speech, which ended up with some Hufsa babbling (which is always awkward but very genuine too).

From my memory, my speech went something like this:

I didn’t prepare a speech because I didn’t think I would win, but I am honored to receive this award. This award really goes out to the people who have helped me in my recovery. This isn’t the Oscars, so I won’t list them, but I will say my mom is here in this room. (10 second ovation for my mother)

This award also goes out to the other nominees and to the people here. Everyone in this room helps individuals with mental health conditions find recovery and I am so thankful for all of you.

(turning to CEO) Do I have to talk more?

And then I was ushered off stage in my shocked state.

Pictures!

Never been so honored and complimented, so I revamped the website. Changed pictures, included new information, made sections more concise, and made the site MUCH more mobile friendly. Yay for Photoshop trials!

Words to Prepare Me for the Next Presidency 

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My dearest friends, I began this post with something that many people, including myself, don’t want to hear: that things are going to be okay.

With one addition: Only as long as we remain vigilant and active.

I’ve watched my groups be affected. Islamophobia has spiked, is rampant, and will not decline anytime soon. Finding out that two mosques were burned down across the country in one week almost broke me, if I’m going to be honest. When my people get terrorized, who is there to say something about it? The room is quiet but a few whispers.

And then there is the future of mental health. With the repeal of ACA, I don’t know how many people I serve will lose their access to mental health treatment, and that kills me. I’m brought to tears every time I think about it. What happens to those with mental health conditions who need new insurance without the protections of ACA? As it stands, that could mean that they will lose access to desperately needed treatment. Which, honestly, could mean that people will die.

For me to fixate on these things — without doing anything about them — means that I would lose sight of the bigger picture. I know that I am one of the few, or only, mental health advocates and Muslim people that many people know. I need to remain strong, to be that example, to show that my groups are strong people. My fellow Muslims, mentally ill, and women are all far stronger than me, and I must represent them to the greatest of my ability.

So with that I just focus on what I can do now. Continue to advocate. Try my best to stay updated on politics. Take some time at least once per month to just sit down and make calls or write emails. Write a blog post every once in awhile (no promises though). Do not divide myself from people I care about because of political differences; seek to understand and work together. The list goes on.

I have to stay strong and know that it’s not over. Is it not so encouraging to see how many people are speaking up and becoming politically active? We cannot deny that if we look back in history and note that regardless of what’s happening, we have in fact made progress, and we will never regress to the point where we have slaves, segregation, and complete inequality for women ever again. Never.

Remember, we always have the opportunity to make history.

I love you all. Whether you are feeling dismayed, sad, depressed, horrified, angry, the same, better, or worse as me, apathetic, ambivalent, or hopeful — I support you. I swear to myself, that in the end, it WILL be okay.

Suicide Hotline: A Lifeline as Important as 9-1-1

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Can you imagine a world where Robin Williams was still alive, and spoke as openly about his depression as his alcoholism, where he declared the importance of reaching out for help in direst of times: when one is suicidal?

Unfortunately, he is gone (and may he rest in peace). But I am trying to do these things in his stead. September is National Suicide Prevention Awareness Month and today I only have one message to convey: the Suicide Crisis Line number.

800-273-TALK (8255)
Open 24/7 and is free
Chat is also available on their website here

Any amount of suicidal thoughts merits a call.

Please, save this number in your phone. You never know if you or someone you know needs it. The number has saved the lives of many people I know, and from the account of one of my friends:

It was 4:30am when I went downstairs to get a glass of water. I cried as I walked up the stairs, because I was going to overdose on my medication. After typing up a suicide note, before I clicked send, something stopped me. I don’t know what made me do it, but I started looking through my contacts. I found the number for the Suicide Prevention Lifeline. I spoke with a guy named Andrew who talked me about my current problems and options. Before I hung up with him, he asked me if I would call back if I felt the urge to commit suicide again, and I promised I would.

The next day I saw my therapist. Eventually I did check myself into a psychiatric unit voluntarily, but if I didn’t speak to Andrew, I wouldn’t be here today.

The Suicide Prevention Lifeline saved my life, and I know I’m not the only one.

-J.L.

I hope that none of you ever has to call that number. But it is there if you need it.

Lastly, know that you can call 9-1-1 in case of a psychiatric emergency as well.

Cognitive Distortions Are Not Limited to People with Mental Illness, So Let’s All Learn about Cognitive Behavioral Therapy (CBT)

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People with mental illness are taught about the cognitive distortions we have, which ranges from black and white thinking (a.k.a polarized thinking), to overgeneralization, to catastrophizing. However, after learning about and practicing Cognitive Behavioral Therapy techniques for 6 weeks, people can dramatically change the way they think, feel, and behave.

Cognitive behavioral therapy (CBT) is a short-term, goal-oriented psychotherapy treatment that takes a hands-on, practical approach to problem-solving. Its goal is to change patterns of thinking or behavior that are behind people’s difficulties, and so change the way they feel.

– PsychCentral article, In-Depth: Cognitive Behavioral Therapy

CBT 15 distorted thinking

Source: https://counselingcenter.gwu.edu/sites/counselingcenter.gwu.edu/files/downloads/15%20STYLES%20OF%20DISTORTING%20THINKING.pdf

These are the 15 styles of distorted thinking I learned about. Filtering is an awful problem, where people might only focus on their mistakes and not their accomplishments. People who are depressed will frequently only notice and react to the things that contribute to their depression. Polarized Thinking (a.k.a. Black and White thinking), means that people will see a person, circumstance, or the world as one thing: “I am all bad,” “I am a failure,” “I can’t do anything.”

Self-talk is very powerful in combating these thoughts. For example:

Hey, me! You’re having polarized thinking again! Remember, nothing is all good or all bad, and everyone has successes and un-successes! -Good CBT practice

It’s funny, though, because as I have started getting back into reading news and social media, I’m noticing that society as a whole has distorted thinking patterns. Seriously, (almost) everyone needs to be taught CBT. One class on Distorted Thinking in schools may do wonders for society.

To walk you through an example, I’m going to reference comments made about mentally ill individuals.

15 Styles of Distorted Thinking from Everyday People on the Topic of People with Mental Illness

  1. Filtering: The news only shows instances of mentally ill people being violent and dangerous.
  2. Polarized Thinking: “All of the mentally ill are incapable of holding jobs and fellow residents.”
  3. Overgeneralization: The news shows us the worst of mentally ill people, so average people believe that all of us are like that.
  4. Mind Reading: “Everyone feels the same way as me about the mentally ill.”
  5. Catastrophizing: “What if we allow the mentally ill into our neighborhoods through public/affordable housing? What if we have a homeless shelter near our neighborhood? Our children will be assaulted and traumatized!”
  6. Personalization: “My son gets so agitated. I do not know what I’m doing wrong.”
  7. Control Fallacies: “I feel like the government is controlling us by expanding Medicaid. Why won’t they listen to us that we shouldn’t waste our government money on insurance for those people?”
  8. Fallacy of Fairness: “It’s not fair that we don’t want the mentally ill in our backyard and the government is not listening to us.”
  9. Blaming: “I don’t understand why depressed people can’t get out of bed. They are so lazy.”
  10. Shoulds: “People shouldn’t have to take meds to feel better. People shouldn’t have to live off welfare. People should be able to get jobs and take care of themselves.”
  11. Emotional Reasoning: “I feel like mentally ill people are scary so they must be bad for our society.”
  12. Fallacy of Change: “If I tell my friend that he is not depressed, he will get out of bed.”
  13. Global Labeling: “Mentally ill people are violent and disturbing.”
  14. Being Right: The people who spam Twitter saying that psychiatry is BS and that mental illness is not real.
  15. Heaven’s Reward Fallacy: “We have been putting all of our efforts to point out what BS mental health is. It’s not real. The world should understand.”

To be fair, I think a lot of these distortions have been taught to us and extremely, extremely, extremely exacerbated by negative influences like the media and previous societal norms.

IDEA: Regardless of who you are and what you fight for, I encourage you to make a post pointing out any of the Distorted Thinking patterns related to the general public’s perception your issue, whether it’s related to religion, abortion, gun control, consent, etc. Let’s show the world how messed up our thinking is so we can fix it! And if you feel like you don’t know CBT well enough, just pick the one you find most applicable and understandable – Polarized/Black and White Thinking, Overgeneralization, and Catastrophizing I’d say are pretty easy to understand.

P.S. If I remember correctly, Cognitive Distortions has been renamed to Unhelpful Thinking Styles in more recent therapeutic worksheets.

Will Framing Mental Illnesses as Brain Disorders Reduce Stigma, or Make Things Worse?

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I posted on Facebook about the director of the National Institute of Mental Health, Thomas Insel, pushing towards society referring to mental health disorders (also referred to as behavioral disorders) as “brain disorders” (you can see the video here: http://www.ted.com/talks/thomas_insel_toward_a_new_understanding_of_mental_illness). The question I posed after posting the video was, how do you think referring to mental illnesses as “brain disorders” will impact the stigma towards these conditions?

Thankfully, I found an answer. Patrick Corrigan, the king of stigma research, has already researched this topic and produced a paper, “At Issue: Stop the Stigma: Call Mental Illness a Brain Disease” (http://schizophreniabulletin.oxfordjournals.org/content/30/3/477.full.pdf). In the paper, he writes that explaining that mental illness is biological and genetic does reduce the public’s view that mental health conditions are the fault of the individuals with the condition. However, it has a reverse reaction as well: it causes people to believe that individuals with MI are then different than others, provokes a negative attitude towards these individuals, and reinforces stereotypes like the belief that people with mental illness are dangerous since the illness is “ingrained” in them and they are not able to control it.

Corrigan writes that psychosocial explanations for mental illness have decreased stigma, as it frames mental health conditions as “understandable reactions to life events,” such as child abuse, difficult life transitions, drug use, and trauma. However, we cannot just refer to mental illnesses as psychosocial, because not everyone who experiences a traumatic or life-changing event will develop a mental health condition—which could increase self-stigma, as one who develops mental illness might think they are weaker because they developed the illness when someone in similar circumstances did not.

The last issue is that while people can learn that mental health disorders are biological, genetic, and a reaction to life events, there is a lack of understanding that recovery is possible. To address this, Corrigan has shown that education about recovery, and even more powerful, contact with a person with mental illness, provides a balance to the public’s understanding: mental illness has biological and psychosocial components, recovery is possible, and there are numerous individuals with mental illness living successfully in recovery.

So what is the solution? Do we refer to mental illnesses as brain disorders?

Brain disorders will certainly be on my list of “words that mean mental illness that I can use so I don’t say mental illness 50 times in one post.” However, I don’t think we can switch over the term without teaching the public that recovery is possible and without more individuals in recovery coming out about their mental health challenges.

The debate on what term to use other than mental illness – mental health issue, mental health challenge, mental health disorder, behavioral health disorder, and more – shall continue. There will always be debate (and if anything, I’m happy there’s a variety of terms to choose from in my posts!), but what is most certain is that we need individuals with lived experience with mental health at the forefront of making that decision – and in collaboration with those who do not. 

“Nothing about us without us!”

Why Saying Donald Trump Has Narcissistic Personality Disorder (NPD) is Unnecessary, Unethical, and Harmful to People with Mental Health Conditions

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All over the Internet, you see articles along the lines of “Therapists agree that Donald Trump has Narcissistic Personality Disorder (NPD),” or “A Neuroscientist Explains…” or therapists saying they will be using clips of Donald Trump in their classes.

This needs to stop!

First, I need to preface this by saying this is not an argument whether Trump has NPD or not. It is an argument that we should not even be discussing his diagnosis, because:

1. Donald Trump should not be President because of his words, actions, and views. That is absolutely enough reason to be against him. We do not need to diagnose him with something to create a new reason why we should not vote for him. (There is undoubtedly enough solid evidence already!)

(Really, you could stop reading here. That’s my biggest point, and it doesn’t need any further explanation. But if you’re interested, there are a few other reasons.)

2. Associating Donald Trump with NPD means that people with NPD will be associated with Donald Trump. (I certainly wouldn’t wish that upon anyone.) It is increasing the stigma of not just NPD, but also other mental health conditions. And why should one stop at NPD? I fear that this argument would be extended to other mental health conditions and other important positions. For example:
“We can’t elect Senator Patrick Kennedy to be a President because he has bipolar disorder, and his mood swings would destroy our international relations.”

3. Diagnosing someone who is not your patient and sharing their diagnosis without their consent is unethical, as stated in the code of ethics for psychiatrists, psychologists, and therapists. In order to diagnose, you must be trained on and fully knowledgeable of the DSM. Psychiatrists, psychologists, and therapists typically take AT LEAST one full hour to assess a new patient’s mental health history in order to properly diagnose them.

The American Psychiatric Association states “When a personal examination has not been performed and when a psychiatrist is asked for a professional opinion about a person in light of public attention, a general discussion of relevant psychiatric topics — rather than offering opinions about that specific person — is the best means of facilitating public education” (https://www.psychiatry.org/psychiatrists/practice/ethics). The American Association for Marriage and Family Therapists warn against the impact of public statements (https://www.aamft.org/iMIS15/AAMFT/Content/legal_ethics/code_of_ethics.aspx), and the American Psychological Association states “psychologists provide opinions of the psychological characteristics of individuals only after they have conducted an examination of the individuals adequate to support their statements or conclusions” (Section 9.01, http://www.apa.org/ethics/code/index.aspx).

4. This is something often forgotten by nearly all, including numerous clinicians: people diagnosed with personality disorders are, first and foremost, people—people who have treatable illnesses. Not everyone with a PD or mental illness is the same and not everyone with NPD is a “horrible person.”
Burnt out or old school clinicians and medical professionals have told me that people with PDs are “too hard to deal with.” Some have even gone so far to say that they are “untreatable.” But there is hope. I’ve seen people with PDs move on to graduate from the clinics where I worked, gain meaningful roles and activities, and have strong relationships.

5. Yes, I have in fact worked very closely with many people with NPD and other PDs as a case manager at an intensive outpatient mental health clinic and other jobs in mental health. It can be very hard, but they are not evil people. Just because someone has a diagnosis does not mean they are a bad person!

Note: There is typically a distinction between mental illness and personality disorders. However, I’m considering both them under the umbrella of “mental health conditions,” because the general public does not know the difference, as well as similarity of symptoms, comorbidity, and the need to be knowledgeable of both to make a diagnosis.

So please, world, start saying that Donald Trump should not be President because of who and what he is—and then stop before bringing mental health into this. You have more than enough evidence already.