IBPF Consumer Track Meeting

Yesterday I attended the IBPF (International Bipolar Foundation) Annual West Coast Meeting – Consumer Track. The one-day consumer track meeting covered quite a bit which I outline here, providing links to more information.


David J. Miklowitz, PhD

Professor of Psychiatry, Division of Child and Adolescent Psychiatry, UCLA Semel Institute, David Geffen School of Medicine at UCLA, and Department of Psychiatry, Oxford University

Coping with Bipolar Disorder: Eight Practical Strategies for Enhancing Wellness

The 8 Self-Care Principles

  1. Monitor your moods daily/know your early warning signs
  2. Recognize and manage stress triggers
  3. Stabilize your sleep/wake rhythms
  4. Know your position on medications
  5. Develop a mania prevention plan
  6. Work on communication with your family/partner
  7. Obtain reasonable accommodations at work or school
  8. Get regular therapy or join a support group

Eric Arauz, MLER

Adjunct Faculty Instructor, Rutgers/Robert Wood Johnson Medical School, Psychiatry.

Conscious Storytelling: Integrating somatic, cognitive, and emotional lucidity in oral storytelling as a recovery tool for serious mental illness, trauma, addiction, and suicidality.

  • Trauma-Informed Recovery
    1. Trauma-Informed Storytelling
    2. Relational Reconstruction
  • Fluencies of Self: Physiological, Cognitive, Spiritual, Social, and Emotional
  • Narrative Identity Processing: “…well-being is associated with the capacity to construct a coherently structured story about a difficult experience.” (Pals, J. L. (2006), Narrative Identity Processing of Difficult Life Experiences: Pathways of Personality Development and Positive Self-Transformation in Adulthood. Journal of Personality, 74: 1079–1110. doi: 10.1111/j.1467-6494.2006.00403.x)
  • Read, Write, Speak
  • Polyvagal Theory: TherapeuticDyad
    • Autonomic Nervous System
    • Social Engagement System
    • Neuroception: Pro-social, Fight or Flight, Freezing/Imminent Death
    • Interventions: Heart to Face, Heart to Voice, Heart to Eyes
    • (Porges, SW, The polyvagal theory: phylogenetic substrates of a social nervous system. International Journal of Psychophysiology, 2001 Oct; 42(2):123-46.)
  • Conscious Storytelling — Speak — “What is Shareable is Bearable.” (Dan Siegel, MD, author of Mindsight)

Genevieve GreenLynn Hart Muto

A Perspective from a Patient and Caregiver

Genevieve Green, 20-year-old mental health activist and public speaker, and Lynn Hart Muto, IBPF Board Secretary and one of IBPF’s founders, gave their perspectives as consumer and caregiver and answered questions.


Maricela Estrada

Hope: The Beginning of my Beautiful Life

Maricela Estrada has written Bipolar Girl: My Psychotic Self, is publishing Beautiful Bipolar Bisexual, and blogs at mentalhealthinspiration.blogspot.com. She was a patient of the Los Angeles County Department of Mental Health for ten years. Now she works as a Medical Case Worker helping patients with Prevention and Early Intervention.

Los Angeles Department of Mental Health Access Line (24/7): 1 (800) 854-7771

Milestones of Recovery Scale (MORS): Mental health recovery is non-linear.


Thomas S. Jensen, MD

Medical Director of IBPF and psychiatrist in private practice in San Diego. He specializes in general and neuropsychiatry treating children, adolescents and adults, but is especially esteemed for his work with patients with bipolar disorder.

Medication Treatment: A 4-Phased Approach

  • Phase 1: Rapidly stabilize mania or mixed state to help assure safety
  • Phase 2: Introduce agents that dampen cycles and lengthen the frequency of cycles, rather than just dampening the mania
  • Phase 3: Address residual depression
  • Phase 4: Address coexisting conditions

Dr. Jennifer Bahr, ND

Dr. Jennifer Bahr is a licensed naturopathic doctor who specializes in natural treatments for mental illness and endocrine disorders. For more information about her practice in San Diego, visit drjenniferbahr.com.

Healthy Living: A Natural Approach to Living Well with Bipolar Disorder

Focus on Right/Healthful Decisions

  • CBT/Mindfulness
  • Sleep
  • Exercise
  • Support
  • Resilience is Health

Acceptance – Not perfect all the time


Jake Roberts and Kayte Roberts

All in the Family: Overcoming Addiction and Bipolar Disorder Together

Panel discussion led by siblings Jake Roberts and Kayte Roberts addressed addiction and recovery from addiction, co-occurrence of mental illness and addiction, and genetic roots of addiction and mental illness.

Choices, Choices

Peering over my glasses as I ponder my choices
Peering over my glasses as I ponder my choices

 

Okay, so maybe this isn’t the proper forum to be weighing pros and cons of volunteer opportunities. So far I’ve shadowed two MHA (Mental Health Association of Orange County) Hearing Advocates to three different hospitals over two Fridays. Last Friday I was sick, and the Hearing Advocate I had hoped to shadow never called.

(I’m using the term patient, not consumer, in this post since I’m talking about hospitals. I consider myself both a consumer of mental health services and a patient of my mental health providers.)

The hospital nearest my home also happens to be the nicest of the three at which I trained. I mean, how many hospital psych wards have ocean views? I do not know if the program is as good as it was a decade ago when I was voluntarily admitted. I was inpatient for two weeks and partially hospitalized for a few months until the program got repetitive. Back then the hospital was under different ownership and their program was highly respected and highly structured. Patients were not allowed to mill about and loiter. You were in group, actively participating, or you were to stay in your room. During breaks and in the evening, we could enjoy the break room, watch TV, and “walk the circuit” since the bedrooms were arranged in a semi-circle with offices in the center. The layout enabled fluid movement, as opposed to walking up and down halls with locked doors at either end, which results in rather unsettling and caged pacing.

I do not know the details of the programs at the three hospitals where I trained. I do know that I felt uncomfortable at the two I visited on my last Friday of shadowing. Patients seemed like they were wandering about without much structure. Perhaps it was too close to lunch time, but many of the patients seemed either too symptomatic or unresponsive to participate in structured group activities. I sensed that at any time, someone could go off and chaos would ensue. (Actually, I witnessed chaos at both hospitals in response to decisions made by the Hearing Officer. Decisions that were clearly well-founded.) Needless to say, I didn’t feel particularly safe, nor did I feel welcome. There, I said it. A couple of patients saw us as part of the system that “imprisoned” them. Honestly, I was at a loss. The Hearing Officer does not want to release someone if they might turn around and kill themselves or hurt someone else. The decisions Hearing Officers make are difficult. They must balance the right to personal freedom against the need to protect. When we (those of us living with serious mental illness) are dangerously symptomatic, we cannot think clearly, and we do not always behave in our best interest, or in the best interest of others.

My other volunteer options rest with NAMI Orange County where I interviewed this morning. They have several volunteer opportunities I may enjoy and for which I may be well suited. I could be trained to be a Peer teacher for their Peer-to-Peer Recovery Education Course. I could be trained to be an In Our Own Voice speaker. I could volunteer at special events by sitting at their table, handing out information, and answering questions. I could even volunteer in their office doing clerical work. I would NOT do all of these activities. That would be WAY too much. Both the Peer-to-Peer Recovery Educator and In Our Own Voice public speaking require training, which I greatly appreciate and need. I am impressed with NAMI’s structured training programs.

I NEED structure. Perceived risk of chaos and danger trigger me. I do not need that in my life. In writing this, I’m pretty sure I have made up my mind. I cannot handle being a Hearing Advocate right now. Truth be told, I respect people who are highly motivated to seek treatment and am at a loss about how to best help those with serious mental illnesses (brain disorders) who refuse help, whether due to their symptoms, or because they reject the medical model outright. I do understand not wanting to stay in a hospital in which your personal freedom is severely limited and in which you feel punished rather than healed. I am 100% behind improving our mental health system, including making psychiatric hospitals hospitable, healing and safe for patients, their visitors, their advocates, and their mental health providers.

In Our Own Voice Interview

This week I’m feeling much better than I was on Friday and over the weekend. Spending so many days in bed or slouched on the couch did a number on my lower back and hip flexors. I was in extreme pain this morning. Walking around while doing errands seems to have loosened them up again. This morning I got my hair cut and went clothes shopping to prepare for my interview tomorrow at NAMI – Orange County for their In Our Own Voice program. Here is how NAMI describes the program:

NAMI In Our Own Voice

Presentations by those who are recovering from mental illness are designed to raise awareness and reduce stigma by providing a dialogue on the issues related to recovery from severe mental illness.

In Our Own Voice: Living with Mental Illness is a recovery education presentation given by trained consumer presenters for other consumers, family members, friends, professionals, and lay audiences.

A brief, yet comprehensive interactive presentation about mental illness–including video, personal testimony, and discussion–enriches the audience’s understanding of how people with these serious disorders cope with the reality of their illnesses while recovering and reclaiming productive lives.

I love public speaking, but have had little opportunity to do so. My whole life, I loved being on stage and the center of attention. Yes, I was a drama geek, and can be theatrical.

Wish me luck. I’m nervous (and excited)!

NAMI Target Exercise

Blank Target: MUST, MIGHT, CAN, WANT
© NAMI Peer-to-Peer

 

Target Exercise: Relapse Prevention Planning

© NAMI Peer-to-Peer Recovery Education Course Week Seven Class Handouts (Rev. 2006) included the Target Exercise shown above, the text of which I’ve summarized below.

  • In the bull’s-eye, we put what we MUST do, or MUST not do, to live well with mental illness.
    • I MUST take my medicine, sleep, and not overdo it.
  • In the next ring, we include what we MIGHT do to improve our health. These we suspect prevent or trigger relapses, and we may move these items into thebull’s-eyeasMUSTS.
    • I MIGHT walk, exercise, and eat healthier.
  • The third ring represents what we CAN do. These we can do without risk to our health and that we can do to improve our life now. These include things we are already doing to stay well.
    • I CAN (and do) read, write, blog, take part in groups, and meditate.
  • Outside the target, we put what we WANT to do ~ dreams, goals, and desires for the future.
    • My WANTS include volunteer for NAMI, take classes to further my training as a California licensed Marriage and Family Therapist (perhaps Dialectical Behavioral Therapy training), become an expert public speaker, and travel internationally. Here I got ambitious, and it felt good to once again be ambitious, for I’ve felt hobbled by bipolar disorder for far too long.

© NAMI Peer-to-Peer Recovery Education Course Week Seven Class Handouts, Rev. 2006