Bipolar4LifeSupport

“Recognizing Warning Signs and How to Cope:”

Most people believe that mental disorders are rare and “happen to someone else.” In fact, mental disorders are common and widespread. An estimated 54 million Americans suffer from some form of mental disorder in a given year.

Most families are not prepared to cope with learning their loved one has a mental illness. It can be physically and emotionally trying, and can make us feel vulnerable to the opinions and judgments of others.

If you think you or someone you know may have a mental or emotional problem, it is important to remember there is hope and help.

What is mental illness?

A mental illness is a disease that causes mild to severe disturbances in thought and/or behavior, resulting in an inability to cope with life’s ordinary demands and routines.

There are more than 200 classified forms of mental illness. Some of the more common disorders are depression, bipolar disorder, dementia, schizophrenia and anxiety disorders. Symptoms may include changes in mood, personality, personal habits and/or social withdrawal.

Mental health problems may be related to excessive stress due to a particular situation or series of events. As with cancer, diabetes and heart disease, mental illnesses are often physical as well as emotional and psychological. Mental illnesses may be caused by a reaction to environmental stresses, genetic factors, biochemical imbalances, or a combination of these. With proper care and treatment many individuals learn to cope or recover from a mental illness or emotional disorder.

How to cope day-to-day

Accept your feelings

Despite the different symptoms and types of mental illnesses, many families who have a loved one with mental illness, share similar experiences. You may find yourself denying the warning signs, worrying what other people will think because of the stigma, or wondering what caused your loved one to become ill. Accept that these feelings are normal and common among families going through similar situations. Find out all you can about your loved one’s illness by reading and talking with mental health professionals. Share what you have learned with others.

Handling unusual behavior

The outward signs of a mental illness are often behavioral. A person may be extremely quiet or withdrawn. Conversely, he or she may burst into tears, have great anxiety or have outbursts of anger.

Even after treatment has started, some individuals with a mental illness can exhibit anti-social behaviors. When in public, these behaviors can be disruptive and difficult to accept. The next time you and your family member visit your doctor or mental health professional, discuss these behaviors and develop a strategy for coping.

Your family member’s behavior may be as dismaying to them as it is to you. Ask questions, listen with an open mind and be there to support them.

Establishing a support network

Whenever possible, seek support from friends and family members. If you feel you cannot discuss your situation with friends or other family members, find a self-help or support group. These groups provide an opportunity for you to talk to other people who are experiencing the same type of problems. They can listen and offer valuable advice.

Seeking counseling

Therapy can be beneficial for both the individual with mental illness and other family members. A mental health professional can suggest ways to cope and better understand your loved one’s illness.

When looking for a therapist, be patient and talk to a few professionals so you can choose the person that is right for you and your family. It may take time until you are comfortable, but in the long run you will be glad you sought help.

Taking time out

It is common for the person with the mental illness to become the focus of family life. When this happens, other members of the family may feel ignored or resentful. Some may find it difficult to pursue their own interests.

If you are the caregiver, you need some time for yourself. Schedule time away to prevent becoming frustrated or angry. If you schedule time for yourself it will help you to keep things in perspective and you may have more patience and compassion for coping or helping your loved one. Being physically and emotionally healthy helps you to help others.

“Many families who have a loved one with mental illness share similar experiences”

It is important to remember that there is hope for recovery and that with treatment many people with mental illness return to a productive and fulfilling life.

Warning Signs and Symptoms

The following are signs that your loved one may want to speak to a medical or mental health professional.

In adults:

Confused thinking

Prolonged depression (sadness or irritability)

Feelings of extreme highs and lows

Excessive fears, worries and anxieties

Social withdrawal

Dramatic changes in eating or sleeping habits

Strong feelings of anger

Delusions or hallucinations

Growing inability to cope with daily problems and activities

Suicidal thoughts

Denial of obvious problems

Numerous unexplained physical ailments

Substance abuse

In older children and pre-adolescents:

Substance abuse

Inability to cope with problems and daily activities

Changes in sleeping and/or eating habits

Excessive complaints of physical ailments

Defiance of authority, truancy, theft, and/or vandalism

Intense fear of weight gain

Prolonged negative mood, often accompanied by poor appetite or thoughts of death

Frequent outbursts of anger

In younger children:

Changes in school performance

Poor grades despite strong efforts

Excessive worry or anxiety (i.e. refusing to go to bed or school)

Hyperactivity

Persistent nightmares

Persistent disobedience or aggression

Frequent temper tantrums………..

“INPATIENT what to ASK”

Of the 5.4 million people who sought mental health treatment in 1990, less than 7% required hospitalization. More than half of those who needed inpatient-care had schizophrenia, one of the most severe forms of mental illness. If you or someone you know may have a mental illness, the chances are that you will not need hospitalization. But, if you do, the following information will help assure you of the best care possible.

Questions To Ask:

■Has the person been professionally evaluated? By whom? Do I understand the diagnosis?

■If the patient has not been evaluated, why am I seeking admission for the person?
a) A doctor’s recommendation?
b) Need to have patient removed from family situation? Why? Because of behavioral problems?
c) What are they? Because family cannot care for him or her? Why?
d) What symptoms is the patient exhibiting which cause concern?

The Hospital/Treatment Center At Check-In:

■Does your facility treat patients only for this specific diagnosis?

■If the patient has other health or emotional problems will he/she receive treatment for these problems also?

■Does your facility require tests when admitted? If so, what are they?

■Who will perform these tests?

■Who will evaluate the patient when he/she is admitted?

■What are the person’s qualifications/ title?

■Will this person continue to treat the patient?

■Will the patient be seen by this professional on a regular basis?

■When will the initial evaluation take place?

During the Patient’s Stay:

■When can I (or another family member) talk to the therapist or doctor?

■Will we be able to discuss treatment with the doctor or therapist? When? How often?

■When can family members visit? For how long?

■Will the patient be allowed to receive phone calls?

■Will the patient have a daily schedule of activities or treatments?

■If so, what activities will the patient be involved in?

■Is therapy group or private and is it part of the treatment plan?

■What clothes should the patient bring?

■How long will the patient be at the facility?

■Who makes this decision?

■Will the family be advised of changes in treatment?

■Who will make the evaluation for discharging the patient? When will this happen?

Leaving The Hospital:

■Will someone advise the patient and family about adjustment concerns such as the need for further counseling or a medication schedule?

■What can we expect when the patient is discharged?

■Will he/she be on medications? Which ones?

■How will these medications help? Are they habit-forming? What are the side effects? What is the dosage?

■How long will the patient have to take this medication?

■If the patient leaves the hospital without permission how will the hospital handle this?

■If this occurs, what is the parent or family’s responsibility?

■Will the patient be able to continue school work while in the hospital? Or how soon after he or she is discharged?

■If classes are offered to patients, what are they and who teaches them?

■What follow-up treatment or support group options should the family and patient consider?

Financial And Insurance Issues:
Ask the treatment center and/or insurance company the following questions:

■Does the hospital accept this type of insurance? If not, what are the alternatives? If it does, what is covered?

■Can coverage be reviewed with a member of the staff?

■Are there separate charges and how much are they for physicians, therapists or caretakers? What may these separate charges be?

■How are fees assessed?

■When will billing occur?

■If insurance only covers part of the cost, what other arrangements can be made for payments?

■Is there other assistance available? Will the facility accept partial payments or payments on a schedule?

Ask The Therapist:
What can the patient and family expect during the treatment process?

■What can be the expected reactions/behaviors of the patient?

■How should the family respond?

■How can the patient and family prepare for unexpected behavior and possible setbacks?

SEASONAL AFFECTIVE DISORDER :

Some people suffer from symptoms of depression during the winter months, with symptoms subsiding during the spring and summer months. These symptoms may be a sign of seasonal affective disorder (SAD). SAD is a mood disorder associated with depression and related to seasonal variations of light. SAD affects half a million people every winter between September and April, peaking in December, January, and February. The “Winter Blues,” a milder form of SAD, may affect even more people.

Prevalence:
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Three out of four SAD sufferers are women.

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The main age of onset of SAD is between 18 and 30 years of age.

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SAD occurs in both the northern and southern hemispheres, but is extremely rare in those living within 30 degrees latitude of the equator.

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The severity of SAD depends both on a person’s vulnerability to the disorder and his or her geographical location.

Symptoms:

A diagnosis of SAD can be made after three consecutive winters of the following symptoms if they are also followed by complete remission of symptoms in the spring and summer months:
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Depression: misery, guilt, loss of self-esteem, hopelessness, despair, and apathy

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Anxiety: tension and inability to tolerate stress

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Mood changes: extremes of mood and, in some, periods of mania in spring and summer

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Sleep problems: desire to oversleep and difficulty staying awake or, sometimes, disturbed sleep and early morning waking

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Lethargy: feeling of fatigue and inability to carry out normal routine

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Overeating: craving for starchy and sweet foods resulting in weight gain

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Social problems: irritability and desire to avoid social contact

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Sexual problems: loss of libido and decreased interest in physical contact

Causes
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As sunlight has affected the seasonal activities of animals (i.e., reproductive cycles and hibernation), SAD may be an effect of this seasonal light variation in humans. As seasons change, there is a shift in our “biological internal clocks” or circadian rhythm, due partly to these changes in sunlight patterns. This can cause our biological clocks to be out of “step” with our daily schedules.

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Melatonin, a sleep-related hormone secreted by the pineal gland in the brain, has been linked to SAD. This hormone, which may cause symptoms of depression, is produced at increased levels in the dark. Therefore, when the days are shorter and darker the production of this hormone increases.

Treatments for Seasonal Affective Disorder
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Phototherapy or bright light therapy has been shown to suppress the brain’s secretion of melatonin. Although, there have been no research findings to definitely link this therapy with an antidepressant effect, light therapy has been shown to be effective in up to 85 percent of diagnosed cases. Patients remain in light up to ten times the intensity of normal domestic lighting up to four hours a day, but may carry on normal activities such as eating or reading while undergoing treatment. The device most often used today is a bank of white fluorescent lights on a metal reflector and shield with a plastic screen.

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For mild symptoms, spending time outdoors during the day or arranging homes and workplaces to receive more sunlight may be helpful. One study found that an hour’s walk in winter sunlight was as effective as two and a half hours under bright artificial light.

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If phototherapy does not work, an antidepressant drug may prove effective in reducing or eliminating SAD symptoms, but there may be unwanted side effects to consider. Discuss your symptoms thoroughly with your family doctor and/or mental health professional.

“HOW SLEEPING HELPS:”

Sleep may seem like a waste of time. You could instead be answering e-mail, doing the dishes, repairing the deck or decking the halls. But research shows that you’re more likely to succeed at your tasks—and enjoy greater well-being—if you get some serious shuteye.
Of course, it’s not easy to sleep when you’re feeling overwhelmed. In fact, nearly two-thirds of Americans say they lose sleep because of stress. That’s especially unfortunate because sleep combats some of the fallout of stress, and poor sleep has been linked to significant problems, including:

•greater risk of depression and anxiety
•increased risk of heart disease and cancer
•impaired memory
•reduced immune system functioning
•weight gain
•greater likelihood of accidents

Creating Good Nights

Are You Getting Enough Rest?
Experts suggest that adults get seven to nine hours of sleep a night. Everyone is different, though, and you may need more after a few days of burning the midnight (or 2 a.m.) oil.
To assess your sleep deficit, ask yourself:

•Am I often tired?
•Am I using caffeine to get through the day?
•Do I sleep well?
•Do I wake up feeling refreshed?
•Do I get drowsy while driving or watching TV?

Tips for Upping Your Sleep
To sleep longer—and better—consider these suggestions:

•Set a regular bedtime. Your body craves consistency, plus you’re more likely to get enough sleep if you schedule rest like your other important tasks.
•De-caffeinate yourself. Drinking caffeine to stay awake during the day can keep you up at night. Try resisting the coffee and colas starting six to eight hours before bed.
•De-stress yourself. Relax by taking a hot bath, meditating or envisioning a soothing scene while lying in bed. Turn off daytime worries by finishing any next-day preparations about an hour before bed.
•Exercise. Working out can improve sleep in lots of ways, including by relieving muscle tension. Don’t work out right before bed, though, since exercise may make you more alert. If you like, try gentle upper-body stretches to help transition into sleep.
•Make your bed a sleep haven. No paying bills or writing reports in bed. Also, if you can’t fall asleep after 15 minutes you can try some soothing music, but if you remain alert experts recommend getting up until you feel more tired.
For additional sleep guidelines, see the National Sleep Foundation’s website. (But no computer right before bedtime!)

More Sleep Aids

If you’re considering sleep medication, you can buy one of several over-the-counter products, which generally can be used safely for a few days. As for prescription medications, the National Sleep Foundation suggests a limit of four weeks—and simultaneously working on one’s sleep habits. Never combine sleep medications with alcohol or other potentially sedating medicines, and be sure to allow at least 8 hours between taking a sleep medication and driving.
If you’re wondering about the hormone melatonin, there is evidence of its usefulness in improving sleep and helping to regulate an off-kilter sleep cycle. Still, some experts urge caution, arguing that more research is needed to determine correct dosing and timing for taking a melatonin supplement.
If you’re having serious sleep problems, see your doctor, especially if you have trouble more than three nights a week for a month. Your doctor can check whether your sleep issues are caused by some underlying health problem, like depression or a thyroid disorder, and can help with a treatment plan or referral to a sleep specialist.

Also contact your doctor if you suspect a sleep disorder, like sleep apnea, which involves snoring and gaps in breathing, or restless leg syndrome, which causes sudden urges to move your body, or if you are experiencing any unusual nighttime behaviors. It’s also reasonable to see a health care professional if you still feel tired despite getting enough sleep.
If you want help learning to cope better with sleep problems, try to locate a therapist who offers cognitive-behavioral therapy for insomnia. This treatment works by changing sleep-related beliefs and behaviors. You might, for example, rethink your notion that the whole night is ruined if you’re not asleep by 10. A sleep clinic may be able to help you locate such a therapist…..

HELP PAYING FOR MEDICATION:

The ongoing cost of prescription medications can be a challenge, especially if you are taking more than one prescribed medication. Some pharmaceutical companies offer prescription assistance programs to individuals and families with financial needs. These programs typically require a doctor’s consent and proof of your financial status. They may also require that you have either no health insurance or no prescription drug benefit through your health insurance.

In addition, there are county, state, and national prescription programs for which you may qualify and special drug discount cards offered by some pharmaceutical companies.

The following organizations may be able to help qualifying patients without prescription drug coverage get the medicines they need:
■The Partnership for Prescription Assistance can help qualifying patients without prescription drug coverage get the medicines they need through the program that is right for them. Many will get their medications free or nearly free. For more information, call 1-888-477-2669.
■Together Rx Access can help qualifying patients without prescription drug coverage save on hundreds of name-brand and generic products and connect patients to resources about coverage options. For more information, call 1-800-444-4106.

Your local and/or state Mental Health America office is a resource for information about state and local prescription assistance programs.

Your state Medicaid office may offer information about prescription assistance and drug discount programs available in your state.

Medicare Rights Center offers information about state and national prescription assistance programs, drug discount cards, mail order and internet discount pharmacies, and prescription drug price comparison web sites. This information is not only for Medicare Part D plan participants but for anyone needing information about help paying for their prescription drugs. Use the “Help Paying for Prescription Drugs” option on the left-hand side of the page to access this information.

RX Hope has program descriptions and downloadable applications for prescription assistance programs for specific medications including psychotropic medications.

RX Assist offers a patient assistance program directory along with information about a variety of programs including drug discount cards, prescription assistance programs for generic medications, programs that help with medication co-pays, programs that provide free and low cost health care, as well as information for Medicare Part D beneficiaries.

Needy Meds has a searchable list of disease-specific assistance programs (primarily for other medical conditions) with program description and contact information (Use link under “Additional Programs” on left-hand side of home page.) Some of these programs provide a broad range of financial assistance including help with other necessary expenses such as utility bills. They also have a list of state sponsored programs which can be accessed from the link under “Government Programs” also on the left-hand side of the home page. Once you have identified programs, you can contact the Partnership for Prescription Assistance at 1-888-477-2669 for free assistance in applying for these programs.

Cutting Costs

Discuss with your doctor if switching to generic drugs or less expensive brand-name prescription drugs is a safe option for you. It is important to let your doctor know if you cannot afford your prescriptions. He or she may be able to give you free samples of your medications.

Compare the prices of your prescription drugs at different retail pharmacies. Many retail pharmacies list their prices for commonly prescribed drugs online, or you can call local pharmacies to request prices for your medications.

Check out Destination Rx at http://www.destinationrx.com/ to compare pricing of your prescription medications.

Medicare Part D

Medicare prescription drug coverage, also referred to as Part D, is a program that helps individuals who receive Medicare benefits pay for prescription drugs. This program covers both brand name and generic prescription drugs at participating pharmacies in your area. Everyone on Medicare is eligible, regardless of income, health status, or current prescription expenses.

There are two types of insurance plans that vary in cost and drugs covered. They are:
1.Medicare Prescription Drug Plans, sometimes called “PDPs” only offer the Medicare drug benefit.
2.Medicare Advantage Plans, sometimes called “MA-PDs,” are managed care plans (like HMOs and PPOs) that offer more comprehensive health care coverage, to which the drug benefit will be added.

Extra Help is a program that helps eligible people with Medicare pay for some or most of their prescription drug costs.

Visit Medicare.gov to find and compare Medicare plans or to enroll