Mental Illness:  Bipolar and Schizophrenia

Five years ago, I was browsing the Internet and discovered that Finland had an 85% success rate for mental illness.  It was seen as acute rather than chronic.  They stumbled on an approach that was helpful by having a planning meeting where everyone who cared about the person who was suffering got together and had a dialogue.  In Sweden there are healing homes where were successful and that the countries who used the least medicine had the best success rates.  In fact it is pretty sad to say, but that the medication may actually increases the likelihood that this will become a chronic illness.  There are studies in countries where medication is not widely used and the have the highest rates of recovery.  There are studies known as the "relapse studies" where when people are taken off the medication their symptoms return.  

The book, "The Anatomy of an Epidemic" by Robert Whitaker is a good place to start.  It is purchasable on Amazon.  You can also see some of his videos on YouTube and some of his videos are farther down this page.
Anatomy of an Epidemic Summary of Findings - Robert Whitaker (concise summary - when reading it is hard to belief these facts as it flies in the face of what we have been told.)

Another book, "Rethinking Madness, by Paris Williams, Ph.D offers a alternative way to treating mental illness than what is typically done in America.  In this book, it repeats some of Robert Whitaker's findings, but discussed mental illness from a broader perspective and discussed how people have overcome mental illness.  Generally, the pattern seems to be those who have suffered once getting off the medication the healing began.  It seemed to be an average of 2 years or longer and sometimes these same individuals became therapists and helped others.

  

Open Dialogue

About 5 years ago, I was browsing the Internet and discovered that Finland had an 85% success rate for mental illness.  I watched the following video which inspired me to look further into this.  Jaakko Seikkula, PhD and Tom Anderson, PhD were working in Finland and Norway and had better rates of recovery by far than what could be seen in the US.  Mental Illness was seen as acute rather than chronic.  30 years of research an there was type of conversation that was effective with less medication.  Typically, 'the person of concern' (or client) experiences psychotic symptoms (delusions, auditory hallucinations, mania, etc) there is a response from a teach of caring people within 24-48 hours.  They often come to the home and may meeting for 1-1.5 hours a day sometimes 10 days in a row.  A psychiatric may nurse may come to the home to stay for the first week and if a medication is prescribed it is a benzodiazepine (a minor tranquilizer vs. a major tranquilizer).   They stumbled on an approach that was helpful by having a planning meeting where everyone who cared about the person who was suffering got together and had a dialogue.  There is a specific way the meeting was conducted.  I had the opportunity in May 2016 to receive my first training (5 Days in New York) in Open Dialogue (OD) with Mary Olson, Ph.D.and Nazlim Hagmann, MD.  It was probably one of the most powerful and influential trainings I have experience in my 28 year history of being a therapist.  I can see why it works.  It has helped me with any of my clients and I would highly recommend exploring this work. 

A video on Open Dialogue by Daniel Mackler


Healing Homes in Sweden - another good video I watched that a client had purchased.  I am glad these are online so I can refer people to them.  Here they believe that putting people in a hospital further exacerbates the crisis.  Putting them in a safe, structured and stable home seems to aid in the healing.  We are not sure whether the agricultural environment is part of the healing.  Studies are still trying to prove effectiveness outside of Sweden.
 

Take These Broken Wings: Recovery from Schizophrenia without Medication by Daniel Mackler.  (I encourage you to support his cause.  I am buying his videos.  Without seeing this I would never have known another way.)  Dr. Daniel Dorman, (author of Dante's Cure) works with a woman Catherine Penny who was catatonic and for some weeks he saw her every day and she would just rock.  After her recovery she works as a psychiatric nurse helping others.  When I worked in involuntary commitment, I didn't see people get less catatonic overall, but up and down. This was amazing and very hopeful.

Another look at the Studies of Effectiveness for Schizophrenia and Bipolar Disorder

All

Robert Whitaker - Anatomy of an Epidemic

Somewhere in all this, a book was given to my one Christmas.  Anatomy of an Epidemic by Robert Whitaker.  This book was quite enlightening.  A summary is presented in these two videos.  The research indicates that those who have been on medication have less of a chance of recovery than those who did not.  This causes us to question the current conventional thinking in "treating psychosis."  This is not saying the medication doesn't have its place, but that overall, it is not that effective.  This validated my experience working in Seattle with people who were crisis in a psychiatric hospital (involuntary commitment) and years of working with people in private practice.

Robert Whitaker - An Anatomy of an Epidemic - Part 1


 Robert Whitaker - An Anatomy of an Epidemic - Part 2

More videos on Open Dialogue

7 Principles to Open Dialogue for treating Mental Illness - Jaako Seikkula - Finland (English Subtitles) - Worth viewing and reading

Video from the Open Dialogue or Trialogue approach in Ireland - Trialogue - Healing the mentally ill in Ireland

Resources for Healing Mental Illness

Resources for Open Dialogue and other approaches for healing through mental crisis

Open Dialogue Training in America - Mary Olson, PhD. 

Open Dialogue Training in Finland

Trialogue - Ireland

Therapists and Resources

Will Hall MA - a therapist who was originally diagnosed with schizophrenia, recovered and is now helping others.  Practices in Santa Rosa, CA.  He does phone work as well. 

Steven Dill, MA - Edmonds, WA - I have referred families to him for years who need help with mental health issues.  He previously worked in the mental health system at a local hospital.  Now in private practice he is able to offer personalized care.

EASA- Early Assessment and Support Alliance - early intervention is key to higher recovery rates.  Patrick McGorry

Foundation for Excellence in Mental Health Care

Initiating Open Dialogue Treatment in America Open Dialogue Treatment in America - University of Massachusetts Medical School

About Brain Chemistry and Medication

Alternative to Meds Center, Sedona, Arizona video on Brain Chemistry, Medication and Supplements.  I had the opportunity to visit the Alternative to Meds Center in Sedona and saw how they work with others.  It was a great experience to see people put their lives back together. 

This video is incredibly well done.  It is well organized into sections and gives a well balanced view of what is going on in the brain.  At Alternative to Med's Center, Sedona Arizona, they help people with psychosis wean off the medication and put their lives back in order.  Watch their other videos.  What they say and do makes a lot of sense to me.

 

Alternative to Meds Center's Blog on Medication.  Great resource to look up the article on the medication you want information about. 

Here is a video, by Will Hall, MS who I have a lot of respect for.  I have consulted with him and find him very helpful.  This video is on Harm Reduction for Coming off of Medications - What I like in listening to him is even apart from his discussed about medications is his peaceful spirit about what it was like being diagnosed schizophrenia and now being a therapist/consultant helping others.

 

 

Bipolar Disorder

Robert Whitaker's list of Research Articles on Bipolar.    He is the author of Anatomy of an Epidemic.  He cites 24 studies that show how the medication will lower rates of recovery for those with this disorder.  Recovery rates were higher before the era of pharmacological treatment of bipolar.

Schizophrenia

 

 

Professional Journey towards philosophy:

 I prefer to think about people who are suffering from what is called Schizophrenia or Bipolar Disorder as going through a "mental crisis."  This might seem naive to some, but I didn't always think this way.  Twenty five years ago I was working with the chronically mentally ill and was trained to think that it was a chronic disease and the medication management was the best form of treatment. I worked in a hospital in Seattle and then eventually in a group home setting for a few years.  The people who lived there all seemed to suffer from some kind of trauma in addition to the trauma of having psychotic experiences.  When one is in a manic episode or hearing voices or catatonic, it is easy to focus on these symptoms rather than look at what could be the causes.  They also seemed to be very perceptive and had a sensitivity that other's didn't seem to have.  But, it would only be later that I would

The medical profession tends to use medication, surgery and ECT and has moved away from the concept that the brain's chemistry might be responding to some social, psychological or external factors.  Taking a snap shot of the brain and seeing what is going on is a start, but people are too complex for this approach.  If a couple were have an argument and the brain chemistry was measured, this thinking suggests that it is the chemistry causing the argument.  We should give people medication for the "imbalance" and this could cause people to not have the fights with their loved ones.  I was surprised when I was working with someone and was working through the issues after have severely abused several family issues.  There were prescribed an anti-seizure medication to help them with the "intermittent explosive disorder."  According to the client, it worked in that it slowed his brain down.  It is an interesting idea that perhaps anger is associated with mini seizure activity in the brain. This has yet to be proven.  Using one form of treatment over another limits the effectiveness that could be provided to clients suffering from Bipolar Disorder, Schizo-Affective Disorder, Major Depression or Schizophrenia.   It may appear that I am anti-medication.  I am really not as long as there is good solid research to justify using it and the benefits outweigh the negative side effects.  The problem appears today in American there there is an imbalance of the use of medication rates of mental illness are actually getting much worse and not better.  It is common knowledge that America is over medicated. (I will provide stats soon)

A little personal and professional history.  A while ago, I started seeing more people with bipolar disorder that was triggered by substance abuse, mainly marijuana.  I am sorry, but this was my experience.  Clients would have a psychotic break with reality during use, end up in the hospital and then they were diagnosed with Bipolar Disorder, even the the DSM-III, DSM IV, DSM IV-TR would state that you would have to rule out substance abuse causes.  I also met with people who had a manic episode after using Prozac.  At that time, people were told not to take an SSRI if they were predisposed to have Bipolar Disorder.  Today, I see people all the time put on Prozac with mania. 

Worked with a gentleman who had suffered a lot of trauma in his life and then believed the county was after him and he tore up the house looking from microphones.  I worked with him for a year and got him stabilized. I had a client who was really successful in managing her schizophrenia and dealing with the voices.  We worked with a technique called reality testing, where we help her stay focused on logic.  If the voices were sexual in nature and the people she thought were standing farther than 50 feet we saw this as a hallucination and she ignored them.  By the end of therapy, she created new ways of thinking about this. 

I then worked with a lady had been in mental institutions, received shock treatment and had been on medication for years.  She did well with someone listening to her story, taking her serious and helping her solve problems.  This reminds me of a story Dr. Peter Breggin, MD, who shared while he was in his residency at a psychiatric hospital, there was 10 of the most chronic psychiatric patients there assigned to 10 grad students for therapy.  Just doing therapy, 9 out of the 10 moved out of the hospital and started to live functional lives.