And how #behavioral treatment, along with medicine, improves outcomes

Writer: Caroline Miller

Clinical Expert: Jill Emanuele, PhD

What You'll Learn

- What is bipolar disorder?

- Why is bipolar disorder hard to diagnose, especially in teens?

- How is bipolar disorder treated in adolescents?

- Quick Read

- Full Article

- What does onset of bipolar disorder look like?

- How is bipolar disorder diagnosed?

- Treatment

A person with bipolar disorder has very extreme mood swings, from feeling very low or depressed to high or “manic.” They may have psychotic episodes, which means they hear or see things that aren’t real.

#Bipolardisorder is usually diagnosed in adolescence, though it can also be diagnosed in children and older #adults.  Since teens are known for being moody, those who develop bipolar disorder often wind up getting the wrong diagnosis or none at all.

Bipolar disorder usually shows up first as bad depression. Symptoms include not only sadness but feeling like a failure, feeling confused, and being very tired. A teen may even think about suicide. Since a manic episode may not appear for months or even years, this is often treated just as depression, so they miss out on treatment for bipolar that could help them.

Bipolar disorder can also show up as either a big manic episode or a milder one called “hypomania.” A teen may seem way too happy for no reason. They also may think and speak very fast, do dangerous things and need very little sleep. This can be mistaken as the impulsiveness or hyperactivity of ADHD.

Sometimes the first episode of either mania or depression can include breaks from reality, such as hallucinations or delusions. When this happens, it can be misdiagnosed as schizophrenia.

It takes an expert to figure out if a teen has bipolar disorder. Doctors rely on family members to describe the teen’s moods and symptoms over time. Getting the diagnosis right is important because the longer someone has symptoms, the higher their risk of suicide.

The best treatment for bipolar disorder in teens is medications called mood stabilizers combined with specialized therapy. There are three kinds of therapy that have been shown to work well for #bipolardisorder in #adolescence. Family-focused therapy gets everyone at home involved and is aimed at lowering the #stress level at home. #Cognitivebehavioraltherapy (#CBT) is aimed at changing negative ways of thinking. #Interpersonalandsocialrhythmtherapy (#IPSRP) focuses on what are called “social rhythms,” and it helps a #teen reduce #stress by keeping a regular schedule for things like eating and sleeping, going to school or work, and seeing friends. For more information about these therapies, see the full article below.

Bipolar disorder is a #mooddisorder characterized by dramatic highs and lows — periods of depression alternating with mania, or extremely elevated mood.

Bipolar disorder is most often diagnosed in #adolescence or early #adulthood, though it can be diagnosed in childhood or in later adulthood. The mean age of onset is 18, and between 15 and 19 is the most common period of onset. But the disorder’s first signs are very often overlooked or mischaracterized. At the outset, bipolar symptoms are commonly mistaken for #ADHD, #depression, #anxiety, #borderlinepersonalitydisorder and, in its more severe manifestations, as #schizophrenia.

That’s because the first symptoms of this disorder are unusually varied. Only over time does the pattern of alternating high and low moods become clear, meaning that in many cases people with #bipolardisorder are left waiting months, or even years, for an accurate diagnosis. And that waiting can have serious consequences, including treatment that’s not effective.

What does onset of bipolar disorder look like?

In some #patients, the first sign of bipolar disorder is what appears to be a major depressive episode.   Others experience full-blown mania or hypomania — a less extreme form of mania. Still others experience a confusing combination of symptoms called a “mixed episode,” which has elements of both depression and mania.

Here is a closer look at what a first episode might look like:

Depression: When the first episode of bipolar disorder is depression, symptoms can develop slowly, reports Michael Strober, PhD, who is Distinguished Professor of Psychiatry, and Senior Consultant to the Youth Mood Disorders Treatment and Research Program at the David Geffen School of Medicine at UCLA. Bipolar depression usually includes not only the sadness or irritability we associate with depression, but delusions of failure, exaggerated feelings of guilt, #mental confusion and profound physical slowness.

Despite these differences, Dr. Strober notes that symptoms of bipolar depression are often misdiagnosed as major depressive disorder early on, because alternating periods of mania (or hypomania) may not appear until months or years later.

Mania: Unlike the gradual descent into #depression, when the initial episode is mania the onset can be “like a thunderclap,” says Wendy Nash, MD, a #child and #adolescent #psychiatrist. An initial manic episode might be characterized by grandiose thinking, risk-taking, accelerated speech and thought, and euphoria or irritability.

It’s not unusual for the #behavior to be so extreme that the #patient ends up hospitalized — or even arrested. Dr. Nash gives an example of a college student who inexplicably shifts from normal #behavior to overdrive: Suddenly they’re up all night, hyper-talkative, loud, and combative, maybe even getting into fights, acting so rashly and erratically that police are called.

In younger #children, mania may be misinterpreted as the hyperactivity and impulsivity of #ADHD.

Hypomania: Sometimes the initial episode of bipolar disorder is the less extreme form of mania called hypomania, and these episodes are often missed, Dr. Nash notes. The person may be talkative, grandiose, highly productive, a little moody and irritable, but the symptoms aren’t as disruptive or dangerous as in full-blown mania, and patients themselves don’t perceive themselves as disordered.

“Hypomania is trickier to diagnose,” adds Jill Emanuele, PhD, Senior Director of the #MoodDisorders Center at the #ChildMindInstitute. “Adolescents with hypomania aren’t as flagrantly out of control as those with full-fledged mania, who can be dangerously impulsive and reckless.”

Mixed episode: Finally, some people with bipolar disorder experience what’s called a mixed episode, which includes characteristics of both depression and mania. In a mixed episode, a patient has a depressed mood but racing thoughts and speech, agitation, and anxious preoccupations — what one patient describes as being over-caffeinated and tired at the same time.

In a mixed episode, obsessive negative thoughts can be misdiagnosed as #anxiety, notes Dr. Strober.

Psychosis: Some first episodes of either mania or depression can be so severe they include psychotic symptoms — breaks from reality such as hallucinations or delusions. When this happens, it can be misdiagnosed as #schizophrenia.

How is bipolar disorder diagnosed?

A diagnosis of bipolar disorder is based on a detailed history that tracks changes in mood over time; as one expert puts it, think of it as a movie, not a snapshot.

“You need to get the timeline of mood shifts,” notes Dr. Emanuele, “and that takes a very careful diagnostic assessment.” Without treatment, bipolar episodes usually last from several weeks to several months. Periods in between episodes, without symptoms of either mania or depression, can last weeks, months or years.

Interviewing family members or friends can be important, since #patients themselves may not recognize manic or hypomanic symptoms as harmful or disordered. Eliciting a family history is also important because bipolar disorder is more common in people who have first-degree relatives (a #parent or sibling) with the disorder.

To determine whether elevated or depressed moods meet the criteria for #bipolardisorder, a clinician looks for these criteria:

 Signs of mania:

- Drastic personality changes

- Excitability

- Irritability

- Inflated self-confidence

- Extremely energetic

- Grandiose/delusional thinking

- Recklessness

- Decreased need for sleep

- Increased talkativeness

- Racing thoughts

- Scattered attention

- Psychotic episodes, or breaks from reality

Signs of #depression:

- Depressed or irritable mood

- Loss of interest or pleasure in things once enjoyed

- Marked weight loss or gain

- Decreased or increased need for sleep

- Prolonged sadness

- Restlessness

- Lethargy

- Fatigue

- Feelings of #hopelessness, helplessness, worthlessness

- Excessive or inappropriate guilt

- #School avoidance

- Avoids friends

- Cloudy or indecisive thinking

- Preoccupation with death, plans of #suicide or an actual #suicideattempt

- Psychotic episodes — breaks from reality

These criteria describe the most severe form of the disorder, called #bipolarIdisorder. People may also be diagnosed with #bipolarIIdisorder, in which less severe episodes of hypomania replace manic episodes.

One of the most concerning things about bipolar disorder is that the lifetime #suicide risk is 15 times that of the general population. Factors which elevate this risk for individuals include the severity and persistence of depression and the presence of mixed episodes, which combine depressive symptoms and the activation of mania.

Treatment

While medication has for many years been the first-line treatment for bipolar disorder, over the last several decades specialized forms of psychotherapy have been developed to work alongside medication. Research shows that the most effective treatment for bipolar disorder combines medication and psychotherapy.

Medication: The go-to treatment for bipolar disorder is usually a group of medications called mood stabilizers, including lithium and some drugs called anticonvulsants. Mood stabilizers are generally effective at treating manic symptoms and lowering the frequency and severity of both manic and depressive episodes. But the depression is tougher to treat than the mania, and antidepressants are sometimes added to treat bipolar depression. Given alone, antidepressants can trigger manic symptoms, so they need to be prescribed with great care.

Atypical antipsychotics are also used, especially in #adolescents, Dr. Nash reports. While mood stabilizers are very effective in #adults, she says, in #adolescents an a typical antipsychotic is often more effective.

Many people with bipolar disorder take more than one medication and the drugs can have complex interactions, leading to significant side effects if they are not effectively monitored by an experienced clinician.

Therapy: Several forms of psychotherapy adapted for bipolar disorder have been shown to speed recovery from an acute episode of mania or depression, delay recurring episodes, decrease #suicideattempts, and increase medication adherence.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

www.celebratingyourgiftoflife.com

“A major challenge to treatment is compliance with medication,” notes Dr. Emanuele, and psychotherapy increases compliance. It also helps people make changes in their lives to avoid triggering symptoms. “Psycho-education helps people manage their lives with the disorder, and psychotherapy helps them deal with thoughts and feelings.”

An NIMH-funded study of bipolar #patients found that treatment with one of three psychotherapies along with medication “significantly enhance a person’s chances for recovering from depression and staying healthy over the long term.”

The three therapies are:

- #Familyfocusedtherapy (#FFT): #FFT engages #parents and other family members in keeping track of symptoms and improving communication and problem-solving in the home, to avoid spikes in family #stress, which can lead to episodes.

- #Cognitivebehavioraltherapy (#CBT): #CBT focuses on helping the #patient understand distortions in thinking and activity, and learn new ways of coping with the illness

- #Interpersonalandsocialrhythmtherapy (#IPSRT): #IPSRT focuses on helping the #patient stabilize daily routines and sleep/wake cycles, and solve key relationship problems, to avoid triggering an episode.

IPSRP, the most recent of these therapies, is based on the concept that a healthy person has regular social rhythms — when you get up, eat meals, go to #school or work, see other people, sleep, etc. — and #bipolardisorder may be caused by those rhythms being destabilized.

IPSRT focuses on helping patients reduce interpersonal stressors and disruptions to a stable lifestyle, in order to forestall new episodes of mania or #depression. #Patients learn to improve relationship skills and keep regular patterns of eating, socializing and sleeping.

While IPSRT was developed for #adults, it has been adapted for #adolescents and is especially suited to the latter, notes Ellen Frank, an expert in #mooddisorders treatment at the University of Pittsburgh who, with colleagues, developed the therapy. Adolescence is a particularly sensitive period for interpersonal turmoil, and #adolescents are prone to chronic sleep deprivation and radical shifts in sleep patterns, she writes. “They often have very dysregulated sleep and social routines that would be especially harmful for a #teenager with BD.”

Contrary to earlier thinking, research shows that the course of the disorder is no different whether it develops before or after age 18, Dr. Strober reports.

#Bipolardisorder is a chronic disorder, but with a combination of medications, psychotherapy, #stress-management, a regular schedule and early identification of symptoms, many people live very well with the diagnosis.
https://standingabovethecrowd.com/2023/07/jamesdonaldson-on-mentalhealth-bipolardisorder-why-its-often-misdiagnosed/

#JamesDonaldson On #MentalHealth – #BipolarDisorder: Why It’s Often Misdiagnosed

And how #behavioral treatment, along with medicine, improves outcomes

Writer: Caroline Miller

Clinical Expert: Jill Emanuele, PhD

What You'll Learn

- What is bipolar disorder?

- Why is bipolar disorder hard to diagnose, especially in teens?

- How is bipolar disorder treated in adolescents?

- Quick Read

- Full Article

- What does onset of bipolar disorder look like?

- How is bipolar disorder diagnosed?

- Treatment

A person with bipolar disorder has very extreme mood swings, from feeling very low or depressed to high or “manic.” They may have psychotic episodes, which means they hear or see things that aren’t real.

#Bipolardisorder is usually diagnosed in adolescence, though it can also be diagnosed in children and older #adults.  Since teens are known for being moody, those who develop bipolar disorder often wind up getting the wrong diagnosis or none at all.

Bipolar disorder usually shows up first as bad depression. Symptoms include not only sadness but feeling like a failure, feeling confused, and being very tired. A teen may even think about suicide. Since a manic episode may not appear for months or even years, this is often treated just as depression, so they miss out on treatment for bipolar that could help them.

Bipolar disorder can also show up as either a big manic episode or a milder one called “hypomania.” A teen may seem way too happy for no reason. They also may think and speak very fast, do dangerous things and need very little sleep. This can be mistaken as the impulsiveness or hyperactivity of ADHD.

Sometimes the first episode of either mania or depression can include breaks from reality, such as hallucinations or delusions. When this happens, it can be misdiagnosed as schizophrenia.

It takes an expert to figure out if a teen has bipolar disorder. Doctors rely on family members to describe the teen’s moods and symptoms over time. Getting the diagnosis right is important because the longer someone has symptoms, the higher their risk of suicide.

The best treatment for bipolar disorder in teens is medications called mood stabilizers combined with specialized therapy. There are three kinds of therapy that have been shown to work well for #bipolardisorder in #adolescence. Family-focused therapy gets everyone at home involved and is aimed at lowering the #stress level at home. #Cognitivebehavioraltherapy (#CBT) is aimed at changing negative ways of thinking. #Interpersonalandsocialrhythmtherapy (#IPSRP) focuses on what are called “social rhythms,” and it helps a #teen reduce #stress by keeping a regular schedule for things like eating and sleeping, going to school or work, and seeing friends. For more information about these therapies, see the full article below.

Bipolar disorder is a #mooddisorder characterized by dramatic highs and lows — periods of depression alternating with mania, or extremely elevated mood.

Bipolar disorder is most often diagnosed in #adolescence or early #adulthood, though it can be diagnosed in childhood or in later adulthood. The mean age of onset is 18, and between 15 and 19 is the most common period of onset. But the disorder’s first signs are very often overlooked or mischaracterized. At the outset, bipolar symptoms are commonly mistaken for #ADHD, #depression, #anxiety, #borderlinepersonalitydisorder and, in its more severe manifestations, as #schizophrenia.

That’s because the first symptoms of this disorder are unusually varied. Only over time does the pattern of alternating high and low moods become clear, meaning that in many cases people with #bipolardisorder are left waiting months, or even years, for an accurate diagnosis. And that waiting can have serious consequences, including treatment that’s not effective.

What does onset of bipolar disorder look like?

In some #patients, the first sign of bipolar disorder is what appears to be a major depressive episode.   Others experience full-blown mania or hypomania — a less extreme form of mania. Still others experience a confusing combination of symptoms called a “mixed episode,” which has elements of both depression and mania.

Here is a closer look at what a first episode might look like:

Depression: When the first episode of bipolar disorder is depression, symptoms can develop slowly, reports Michael Strober, PhD, who is Distinguished Professor of Psychiatry, and Senior Consultant to the Youth Mood Disorders Treatment and Research Program at the David Geffen School of Medicine at UCLA. Bipolar depression usually includes not only the sadness or irritability we associate with depression, but delusions of failure, exaggerated feelings of guilt, #mental confusion and profound physical slowness.

Despite these differences, Dr. Strober notes that symptoms of bipolar depression are often misdiagnosed as major depressive disorder early on, because alternating periods of mania (or hypomania) may not appear until months or years later.

Mania: Unlike the gradual descent into #depression, when the initial episode is mania the onset can be “like a thunderclap,” says Wendy Nash, MD, a #child and #adolescent #psychiatrist. An initial manic episode might be characterized by grandiose thinking, risk-taking, accelerated speech and thought, and euphoria or irritability.

It’s not unusual for the #behavior to be so extreme that the #patient ends up hospitalized — or even arrested. Dr. Nash gives an example of a college student who inexplicably shifts from normal #behavior to overdrive: Suddenly they’re up all night, hyper-talkative, loud, and combative, maybe even getting into fights, acting so rashly and erratically that police are called.

In younger #children, mania may be misinterpreted as the hyperactivity and impulsivity of #ADHD.

Hypomania: Sometimes the initial episode of bipolar disorder is the less extreme form of mania called hypomania, and these episodes are often missed, Dr. Nash notes. The person may be talkative, grandiose, highly productive, a little moody and irritable, but the symptoms aren’t as disruptive or dangerous as in full-blown mania, and patients themselves don’t perceive themselves as disordered.

“Hypomania is trickier to diagnose,” adds Jill Emanuele, PhD, Senior Director of the #MoodDisorders Center at the #ChildMindInstitute. “Adolescents with hypomania aren’t as flagrantly out of control as those with full-fledged mania, who can be dangerously impulsive and reckless.”

Mixed episode: Finally, some people with bipolar disorder experience what’s called a mixed episode, which includes characteristics of both depression and mania. In a mixed episode, a patient has a depressed mood but racing thoughts and speech, agitation, and anxious preoccupations — what one patient describes as being over-caffeinated and tired at the same time.

In a mixed episode, obsessive negative thoughts can be misdiagnosed as #anxiety, notes Dr. Strober.

Psychosis: Some first episodes of either mania or depression can be so severe they include psychotic symptoms — breaks from reality such as hallucinations or delusions. When this happens, it can be misdiagnosed as #schizophrenia.

How is bipolar disorder diagnosed?

A diagnosis of bipolar disorder is based on a detailed history that tracks changes in mood over time; as one expert puts it, think of it as a movie, not a snapshot.

“You need to get the timeline of mood shifts,” notes Dr. Emanuele, “and that takes a very careful diagnostic assessment.” Without treatment, bipolar episodes usually last from several weeks to several months. Periods in between episodes, without symptoms of either mania or depression, can last weeks, months or years.

Interviewing family members or friends can be important, since #patients themselves may not recognize manic or hypomanic symptoms as harmful or disordered. Eliciting a family history is also important because bipolar disorder is more common in people who have first-degree relatives (a #parent or sibling) with the disorder.

To determine whether elevated or depressed moods meet the criteria for #bipolardisorder, a clinician looks for these criteria:

 Signs of mania:

- Drastic personality changes

- Excitability

- Irritability

- Inflated self-confidence

- Extremely energetic

- Grandiose/delusional thinking

- Recklessness

- Decreased need for sleep

- Increased talkativeness

- Racing thoughts

- Scattered attention

- Psychotic episodes, or breaks from reality

Signs of #depression:

- Depressed or irritable mood

- Loss of interest or pleasure in things once enjoyed

- Marked weight loss or gain

- Decreased or increased need for sleep

- Prolonged sadness

- Restlessness

- Lethargy

- Fatigue

- Feelings of #hopelessness, helplessness, worthlessness

- Excessive or inappropriate guilt

- #School avoidance

- Avoids friends

- Cloudy or indecisive thinking

- Preoccupation with death, plans of #suicide or an actual #suicideattempt

- Psychotic episodes — breaks from reality

These criteria describe the most severe form of the disorder, called #bipolarIdisorder. People may also be diagnosed with #bipolarIIdisorder, in which less severe episodes of hypomania replace manic episodes.

One of the most concerning things about bipolar disorder is that the lifetime #suicide risk is 15 times that of the general population. Factors which elevate this risk for individuals include the severity and persistence of depression and the presence of mixed episodes, which combine depressive symptoms and the activation of mania.

Treatment

While medication has for many years been the first-line treatment for bipolar disorder, over the last several decades specialized forms of psychotherapy have been developed to work alongside medication. Research shows that the most effective treatment for bipolar disorder combines medication and psychotherapy.

Medication: The go-to treatment for bipolar disorder is usually a group of medications called mood stabilizers, including lithium and some drugs called anticonvulsants. Mood stabilizers are generally effective at treating manic symptoms and lowering the frequency and severity of both manic and depressive episodes. But the depression is tougher to treat than the mania, and antidepressants are sometimes added to treat bipolar depression. Given alone, antidepressants can trigger manic symptoms, so they need to be prescribed with great care.

Atypical antipsychotics are also used, especially in #adolescents, Dr. Nash reports. While mood stabilizers are very effective in #adults, she says, in #adolescents an a typical antipsychotic is often more effective.

Many people with bipolar disorder take more than one medication and the drugs can have complex interactions, leading to significant side effects if they are not effectively monitored by an experienced clinician.

Therapy: Several forms of psychotherapy adapted for bipolar disorder have been shown to speed recovery from an acute episode of mania or depression, delay recurring episodes, decrease #suicideattempts, and increase medication adherence.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy



www.celebratingyourgiftoflife.com

“A major challenge to treatment is compliance with medication,” notes Dr. Emanuele, and psychotherapy increases compliance. It also helps people make changes in their lives to avoid triggering symptoms. “Psycho-education helps people manage their lives with the disorder, and psychotherapy helps them deal with thoughts and feelings.”

An NIMH-funded study of bipolar #patients found that treatment with one of three psychotherapies along with medication “significantly enhance a person’s chances for recovering from depression and staying healthy over the long term.”

The three therapies are:

- #Familyfocusedtherapy (#FFT): #FFT engages #parents and other family members in keeping track of symptoms and improving communication and problem-solving in the home, to avoid spikes in family #stress, which can lead to episodes.

- #Cognitivebehavioraltherapy (#CBT): #CBT focuses on helping the #patient understand distortions in thinking and activity, and learn new ways of coping with the illness

- #Interpersonalandsocialrhythmtherapy (#IPSRT): #IPSRT focuses on helping the #patient stabilize daily routines and sleep/wake cycles, and solve key relationship problems, to avoid triggering an episode.

IPSRP, the most recent of these therapies, is based on the concept that a healthy person has regular social rhythms — when you get up, eat meals, go to #school or work, see other people, sleep, etc. — and #bipolardisorder may be caused by those rhythms being destabilized.

IPSRT focuses on helping patients reduce interpersonal stressors and disruptions to a stable lifestyle, in order to forestall new episodes of mania or #depression. #Patients learn to improve relationship skills and keep regular patterns of eating, socializing and sleeping.

While IPSRT was developed for #adults, it has been adapted for #adolescents and is especially suited to the latter, notes Ellen Frank, an expert in #mooddisorders treatment at the University of Pittsburgh who, with colleagues, developed the therapy. Adolescence is a particularly sensitive period for interpersonal turmoil, and #adolescents are prone to chronic sleep deprivation and radical shifts in sleep patterns, she writes. “They often have very dysregulated sleep and social routines that would be especially harmful for a #teenager with BD.”

Contrary to earlier thinking, research shows that the course of the disorder is no different whether it develops before or after age 18, Dr. Strober reports.

#Bipolardisorder is a chronic disorder, but with a combination of medications, psychotherapy, #stress-management, a regular schedule and early identification of symptoms, many people live very well with the diagnosis.

https://standingabovethecrowd.com/2023/07/jamesdonaldson-on-mentalhealth-bipolardisorder-why-its-often-misdiagnosed/

A recent study found that #bisexual #women are over three times more likely, and #gay #men and #women twice as likely, to attempt #suicide compared to #heterosexual individuals. The research, based on survey data linked with health records for 123,000 people, emphasized a pressing need for improved #mentalhealthsupport within the #LGBTQ+ community.

A recent study conducted by researchers at York University and ICES revealed that bisexual women are over three times more likely to attempt suicide than their #heterosexual counterparts.

This groundbreaking research, which connects data from population-based surveys with health records of more than 123,000 individuals, also discovered that suicide-related behavior (SRB) events, both fatal and non-fatal, are twice as likely among gay men and #lesbians compared to heterosexual individuals. These findings underscore the critical need for improved #mentalhealthsupport within the #LGBTQ+ community.

“We wanted to better characterize the disparity in #suicide-related #behaviors across #sexualorientations and #gender,” says lead author Antony Chum, a Faculty of Health assistant professor and Canada Research Chair in Population Health Data Science at York University and adjunct scientist at ICES. “Prior research on #suicideattempts has mostly relied on self-reported data from surveys, which means we don’t have information on people who are too sick to participate or have died by #suicide.”

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

www.celebratingyourgiftoflife.com

Published in the American Journal of Psychiatry, the study looked at Ontario participants from the Canadian Community Health Survey, which was linked to anonymous administrative health data such as emergency room visits or hospitalizations for non-fatal #self-harm and fatal #suicide events between 2002 and 2019.

The researchers, who include York University postdoctoral fellows Gabriel John Dusing and Chungah Kim, found:

- The overall prevalence of one or more SRB events was around two percent in heterosexual individuals, five percent in gay/lesbian individuals, and eight percent in bisexual individuals.

- Sexual minority individuals were at higher risk of SRB events, ranging from 2.10 to 4.23 times more likely when compared to heterosexual people.

- After adjusting for age and #gender, the risk of a SRB event was more than three times greater among bisexual individuals, and this risk was most pronounced for bisexual women.

“The higher risk for bisexual women could be attributed to greater discrimination that bisexual people face within the LGBTQ+ community, as well as higher rates of violence, #trauma, and caregiving burden that bisexual women may experience in opposite-sex relationships,” says Chum.

One limitation of the study is that data were not available for non-binary individuals and sexual orientations such as asexual and #queer. Nevertheless, this was the first study to use a large representative sample linked with medical records, which improves the generalizability of the findings for other regions and populations.

“The study shows a clear need for better funding, policy, and programming to address LGBTQ+ suicide risk,” says Chum. “We also need increased training for healthcare workers to address LGBTQ+ suicide risk. Further, we want to encourage hospitals and clinics to collect #sexualorientation data as part of routine #patient care.”

Chum also notes the increasing creep of healthcare privatization and that publicly funded #mentalhealth supports need to be increased not just for LGBTQ+ people, but across the board.

Reference: “Disparities in Suicide-Related Behaviors Across Sexual Orientations by Gender: A Retrospective Cohort Study Using Linked Health Administrative Data” by Antony Chum, Ph.D., Chungah Kim, Ph.D., Andrew Nielsen, M.Sc., Gabriel John Dusing, Ph.D., Patricia O’Campo, Ph.D., Flora I. Matheson, Ph.D., Lucy Barker, M.D., Simone Vigod, M.D., Vicki Ling, M.Sc., Kinwah Fung, M.Sc. and Sidney Kennedy, M.D., 7 June 2023, American Journal of Psychiatry.DOI: 10.1176/appi.ajp.20220763

Photo by Matteus Bernardes on Pexels.com
https://standingabovethecrowd.com/2023/07/jamesdonaldson-on-mentalhealth-troubling-findings-bisexual-women-are-three-times-more-likely-to-attempt-suicide/

#JamesDonaldson On #MentalHealth – Troubling Findings: #Bisexual #Women Are Three Times More Likely To Attempt #Suicide

A recent study found that #bisexual #women are over three times more likely, and #gay #men and #women twice as likely, to attempt #suicide compared to #heterosexual individuals. The research, based on survey data linked with health records for 123,000 people, emphasized a pressing need for improved #mentalhealthsupport within the #LGBTQ+ community.

A recent study conducted by researchers at York University and ICES revealed that bisexual women are over three times more likely to attempt suicide than their #heterosexual counterparts.

This groundbreaking research, which connects data from population-based surveys with health records of more than 123,000 individuals, also discovered that suicide-related behavior (SRB) events, both fatal and non-fatal, are twice as likely among gay men and #lesbians compared to heterosexual individuals. These findings underscore the critical need for improved #mentalhealthsupport within the #LGBTQ+ community.

“We wanted to better characterize the disparity in #suicide-related #behaviors across #sexualorientations and #gender,” says lead author Antony Chum, a Faculty of Health assistant professor and Canada Research Chair in Population Health Data Science at York University and adjunct scientist at ICES. “Prior research on #suicideattempts has mostly relied on self-reported data from surveys, which means we don’t have information on people who are too sick to participate or have died by #suicide.”

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy



www.celebratingyourgiftoflife.com

Published in the American Journal of Psychiatry, the study looked at Ontario participants from the Canadian Community Health Survey, which was linked to anonymous administrative health data such as emergency room visits or hospitalizations for non-fatal #self-harm and fatal #suicide events between 2002 and 2019.

The researchers, who include York University postdoctoral fellows Gabriel John Dusing and Chungah Kim, found:

- The overall prevalence of one or more SRB events was around two percent in heterosexual individuals, five percent in gay/lesbian individuals, and eight percent in bisexual individuals.

- Sexual minority individuals were at higher risk of SRB events, ranging from 2.10 to 4.23 times more likely when compared to heterosexual people.

- After adjusting for age and #gender, the risk of a SRB event was more than three times greater among bisexual individuals, and this risk was most pronounced for bisexual women.

“The higher risk for bisexual women could be attributed to greater discrimination that bisexual people face within the LGBTQ+ community, as well as higher rates of violence, #trauma, and caregiving burden that bisexual women may experience in opposite-sex relationships,” says Chum.

One limitation of the study is that data were not available for non-binary individuals and sexual orientations such as asexual and #queer. Nevertheless, this was the first study to use a large representative sample linked with medical records, which improves the generalizability of the findings for other regions and populations.

“The study shows a clear need for better funding, policy, and programming to address LGBTQ+ suicide risk,” says Chum. “We also need increased training for healthcare workers to address LGBTQ+ suicide risk. Further, we want to encourage hospitals and clinics to collect #sexualorientation data as part of routine #patient care.”

Chum also notes the increasing creep of healthcare privatization and that publicly funded #mentalhealth supports need to be increased not just for LGBTQ+ people, but across the board.

Reference: “Disparities in Suicide-Related Behaviors Across Sexual Orientations by Gender: A Retrospective Cohort Study Using Linked Health Administrative Data” by Antony Chum, Ph.D., Chungah Kim, Ph.D., Andrew Nielsen, M.Sc., Gabriel John Dusing, Ph.D., Patricia O’Campo, Ph.D., Flora I. Matheson, Ph.D., Lucy Barker, M.D., Simone Vigod, M.D., Vicki Ling, M.Sc., Kinwah Fung, M.Sc. and Sidney Kennedy, M.D., 7 June 2023, American Journal of Psychiatry.
DOI: 10.1176/appi.ajp.20220763

Photo by Matteus Bernardes on Pexels.com
https://standingabovethecrowd.com/2023/07/jamesdonaldson-on-mentalhealth-troubling-findings-bisexual-women-are-three-times-more-likely-to-attempt-suicide/

Egl? Krištopaityt?

Image by Jo Panuwat D via Shutterstock

#Stephen"tWitch"Boss, best known as the dancing DJ on The Ellen Show, dies at 40 by #suicide. It is important to know the warning signs to help your loved ones with #suicidalthoughts.

According to the medical examination by the Los Angeles County Medical Examiner's office, Boss died of a self-inflicted gunshot wound to the head.

His wife, Allison Holker Boss, confirmed her husband's death in a statement to People magazine.

"Stephen lit up every room he stepped into. He valued family, friends and community above all else and leading with love and light was everything to him," she said.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleOrder your copy of James Donaldson's latest book,#CelebratingYourGiftofLife:From The Verge of Suicide to a Life of Purpose and Joy

www.celebratingyourgiftoflife.com

#Suicide is a leading cause of death in the US. It was responsible for nearly 46,000 deaths in 2020, the #CentersforDiseaseControlandPrevention (#CDC) data shows.

According to the #NationalInstituteofMentalHealth, the #suicide warning signs include:

- Talking about wanting to die, great guilt or shame, or being a burden to others.

- Feeling empty, empty, hopeless, trapped, or having no reason to live, as well as extremely sad, more anxious, agitated, or full of rage. Feeling unbearable emotional or physical pain may also be a sign of #suicide.

- Changing #behavior, such as making a plan or researching ways to die, withdrawing from friends or saying goodbye, taking dangerous risks, and using #drugs or #alcohol more often.

If you suspect someone is having #suicidalthoughts, ask them directly about it, keep them safe, and help them connect with professionals.

If you are having #suicidalthoughts, contact the #988 #SuicideandCrisisLifeline.
https://standingabovethecrowd.com/2023/07/jamesdonaldson-on-mentalhealth-stephentwitchboss-dj-on-the-ellen-show-dies-by-suicide/

#JamesDonaldson On #MentalHealth – #Stephen'tWitch'Boss, DJ On The Ellen Show, Dies By #Suicide

Egl? Krištopaityt?

Image by Jo Panuwat D via Shutterstock

#Stephen"tWitch"Boss, best known as the dancing DJ on The Ellen Show, dies at 40 by #suicide. It is important to know the warning signs to help your loved ones with #suicidalthoughts.

According to the medical examination by the Los Angeles County Medical Examiner's office, Boss died of a self-inflicted gunshot wound to the head.

His wife, Allison Holker Boss, confirmed her husband's death in a statement to People magazine.

"Stephen lit up every room he stepped into. He valued family, friends and community above all else and leading with love and light was everything to him," she said.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle

Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife:
From The Verge of Suicide to a Life of Purpose and Joy

www.celebratingyourgiftoflife.com

#Suicide is a leading cause of death in the US. It was responsible for nearly 46,000 deaths in 2020, the #CentersforDiseaseControlandPrevention (#CDC) data shows.

According to the #NationalInstituteofMentalHealth, the #suicide warning signs include:

- Talking about wanting to die, great guilt or shame, or being a burden to others.

- Feeling empty, empty, hopeless, trapped, or having no reason to live, as well as extremely sad, more anxious, agitated, or full of rage. Feeling unbearable emotional or physical pain may also be a sign of #suicide.

- Changing #behavior, such as making a plan or researching ways to die, withdrawing from friends or saying goodbye, taking dangerous risks, and using #drugs or #alcohol more often.

If you suspect someone is having #suicidalthoughts, ask them directly about it, keep them safe, and help them connect with professionals.

If you are having #suicidalthoughts, contact the #988 #SuicideandCrisisLifeline.

https://standingabovethecrowd.com/2023/07/jamesdonaldson-on-mentalhealth-stephentwitchboss-dj-on-the-ellen-show-dies-by-suicide/

Catching #kids early and supporting them before they're in crisis can delay #mentalhealthdisorders and reduce impairment

Photo by Andrea Piacquadio on Pexels.com

Writer: Juliann Garey

Clinical Experts: Tiziano Colibazzi, MD , Christoph Correll, MD

What You'll Learn

- What is psychosis?

- What are prodromal symptoms?

- What symptoms should I look for in my teen?

- How is early psychosis in teens treated?

- Quick Read

- Full Article

- What are “prodromal” symptoms?

- First step if you feel your child is at risk: An evaluation

- Lifestyle and #mentalhealth options

- Treatment for prodromal psychotic symptoms

Psychosis is a condition in which a person loses touch with reality. If a teen has psychosis, they might hear or see things that aren’t there. Psychosis is often a symptom of an illness called schizophrenia. It shows up in the late teen or early adult years.

But some teens show early warning signs of psychosis. If doctors can catch these early signs, they may be able to delay the full-blown illness and minimize its symptoms. Since psychotic symptoms cause problems in everything from #school to friendships to family, acting fast can help teens a lot.

Early signs of psychosis are called “prodromal” symptoms. They include things like not wanting to see friends, feeling like people want to hurt them, not showering, and seeing or hearing things that aren’t there. To a #parent, the change in their teen would probably be very noticeable.

The good news is that in the early stages, psychosis in teens can be treated by making pretty simple changes in their habits. These include reducing stress, making sure they have good sleep habits and getting treatment for other problems like anxiety.

If you’re worried your teen might be having these symptoms, the first step is to take them to their regular doctor. Their doctor will rule out drug use, which can also cause these symptoms. Then, they will send the teen to be examined by a psychiatrist. It’s hard for #doctors to know which teens will go on to develop serious psychotic illnesses — not all will. But getting your teen to a professional who can watch their symptoms may be the most important step a parent can take.

There are fewer more frightening or challenging psychiatric conditions for a family to face than psychosis, an extreme mental state in which impaired thinking and emotions cause a person to lose contact with reality. This could mean hearing or seeing things that aren’t there (hallucinations), or believing things that aren’t true (delusions).

The illness most often associated with #psychosis, #schizophrenia, usually doesn’t show up until very late #adolescence or early #adulthood. Recently, however, experts in the field have been working to identify high-risk kids who show symptoms that could serve as early warning signs of psychosis, and several academic centers have been set up to focus on this crucial period when it may be possible to change the trajectory of mental illness.

Not all the kids who are identified with what experts call “prodromal” symptoms will progress, or “convert” to full-blown psychotic illness. But early intervention has been shown to improve outcomes for those who do. And since psychotic symptoms cause disruption across a teenager’s life, from school to friendships to family, researchers are hoping quick action can prevent impairment and prolong typical functioning.

What’s more, some of the approaches that show promise in delaying onset of psychosis or mitigating symptoms include fairly simple lifestyle changes like #stress reduction and sleep hygiene, and managing co-occurring disorders like #anxiety. The key: identifying at-risk kids earlier when these low-impact measures are still effective.

What are “prodromal” symptoms?

Prodromal symptoms are “attenuated” or weak symptoms of psychosis. Moreover, “they are a warning sign,” says Christoph Correll, MD, the medical director of the Recognition and Prevention Program (RAP) at Zucker Hillside Hospital in Queens, NY, which specializes in diagnosing and treating early symptoms of #mentalillness in #teenagers and young adults. “These signs can happen in people who don’t go on to develop psychosis—but if we follow these people who are in the risk state based on these watered-down versions, one third will probably go on to develop psychosis. That’s a lot more than in the general population.”

Prodromal symptoms occur on a spectrum from very, very mild to severe and can include:

- Withdrawing from friends and family/feeling suspicious of others

- Changes in sleeping or eating patterns

- Less concern with appearance, clothes or hygiene

- Difficulty organizing thoughts or speech

- Loss of usual interest in activities or of motivation and energy

- Development of unusual ideas or behaviors

- Unusual perceptions, such as visions or hearing voices (or even seeing shadows)

- Feeling like things are unreal

- Change in personality

- Feelings of grandiosity (belief he has a superpower, etc)

In some cases, these symptoms represent the early stages of a disorder, and will eventually convert. In others, the symptoms actually fade or remain mild. Tiziano Colibazzi, MD, is a #psychiatrist at Columbia Presbyterian’s COPE clinic (Center for Prevention and Evaluation), which was established to research and treat prodromal symptoms. “We can identify a group of people that are at clinically high risk,” says Dr. Colibazzi. “What we can’t do is narrow that group down further to identify the 30 percent who will convert.”

First step if you feel your child is at risk: An evaluation

The right treatment for prodromal symptoms depends entirely on how severe they are when they are diagnosed. The first step is a proper and complete diagnosis by a #mentalhealthprofessional with experience in assessing psychotic illness.

If you see marked changes in motivation, thinking, and/or behavior in your child, the first place to start is with her pediatrician to rule out a medical illness. #Substanceuse also needs to be ruled out as the cause of any #behavior changes in #adolescents. After that, you’re going to want to have your child evaluated by a qualified #psychiatrist or #psychologist. This in itself might be a multi-step process.

“You can’t just look at the kid once and get a bit of a history and then know what’s going on, ” says Dr. Correll. “Kids develop; symptoms develop. And the trajectory—how things change, get better or worse, what other symptoms add on to it—will be highly informative in telling us something about the prognosis, what we expect to happen.”

One aid to predicting the evolution and severity of symptoms, notes Dr. Colibazzi, is the patient’s ability to doubt his symptoms. If your child retains the self-awareness to know that it’s his mind that is playing tricks on him, it’s an indication that symptoms are still in the very early stages. As symptoms become more severe, the patient’s beliefs (whether paranoid, grandiose or hallucinatory) become increasingly difficult to challenge.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

www.celebratingyourgiftoflife.com

Lifestyle and #mentalhealth options

Psychotic symptoms and illnesses have been shown to vary quite a bit depending on the environment—the health of our bodies, our interpersonal relationships, our mindsets. As with any illness, but particularly important in at-risk #youth, healthy living is key. Regardless of the severity of prodromal symptoms, Dr. Correll says that your child’s outcome can be improved by making sure your kid sticks to a routine that includes:

- Eating well

- Getting regular exercise

- Adhering to a regular sleep schedule

- Reducing stress as much as possible

- Staying away from drugs—particularly marijuana, which can interact with prodromal symptoms and increase the risk for psychosis significantly

Also, don’t forget to address depression and #anxiety. According to Dr. Correll, “#adults who eventually developed #schizophrenia identified a three to five year period during which they experienced depression or anxiety before developing the prodromal symptoms of psychosis and then developed full-blown psychosis.” “So treating the #depression early,” he says, “might actually interrupt the progression from depression to psychosis in some #patients.”

Treatment for prodromal #psychotic symptoms

Dr. Correll recommends trying several approaches. Mild symptoms call for more low-key treatments including:

- Psycho-education: teaching both the kid and the family more about the symptoms and the illness.

- Therapy, particularly #cognitivebehavioraltherapy: “#CBT can be good to change one’s thinking patterns,” says Correll, “and also to address developing #self-esteem. We have to be careful that kids with a psychiatric diagnosis don’t self-stigmatize and get into a hopeless or negative mode where they feel they can’t achieve.”

- Lifestyle adjustments: Assessing whether the current school environment is best for the child. Perhaps a therapeutic social group to help the #child cope.

- Reducing #Stress: #Stress is often a trigger for symptoms, so reducing stress in these kids’ lives is crucial and may prevent or delay conversion to psychotic illness.

Understanding prodromal symptoms and monitoring kids who are at high risk for psychotic illness means that #parents can do more for their kids than wait for symptoms to get worse or merely hope for the best. Early monitoring and intervention can give high-risk #kids an advantage, which researchers hope will eventually change the odds when it comes to #psychotic illness.

“The duration of untreated #psychosis does actually seem to affect the course of the illness,” Dr. Colibazzi says. The longer the illness goes untreated, the greater the chance that it will cause serious disruption in all areas of the #patient’s life. “So it is reasonable to think that just following someone very closely and treating them very early, as soon as they develop symptoms, would be helpful.”

Photo by Andrea Piacquadio on Pexels.com
https://standingabovethecrowd.com/2023/07/jamesdonaldson-on-mentalhealth-watching-for-signs-of-psychosis-in-teens/

#JamesDonaldson On #MentalHealth – Watching For Signs Of #Psychosis In #Teens

Catching #kids early and supporting them before they're in crisis can delay #mentalhealthdisorders and reduce impairment

Photo by Andrea Piacquadio on Pexels.com

Writer: Juliann Garey

Clinical Experts: Tiziano Colibazzi, MD , Christoph Correll, MD

What You'll Learn

- What is psychosis?

- What are prodromal symptoms?

- What symptoms should I look for in my teen?

- How is early psychosis in teens treated?

- Quick Read

- Full Article

- What are “prodromal” symptoms?

- First step if you feel your child is at risk: An evaluation

- Lifestyle and #mentalhealth options

- Treatment for prodromal psychotic symptoms

Psychosis is a condition in which a person loses touch with reality. If a teen has psychosis, they might hear or see things that aren’t there. Psychosis is often a symptom of an illness called schizophrenia. It shows up in the late teen or early adult years.

But some teens show early warning signs of psychosis. If doctors can catch these early signs, they may be able to delay the full-blown illness and minimize its symptoms. Since psychotic symptoms cause problems in everything from #school to friendships to family, acting fast can help teens a lot.

Early signs of psychosis are called “prodromal” symptoms. They include things like not wanting to see friends, feeling like people want to hurt them, not showering, and seeing or hearing things that aren’t there. To a #parent, the change in their teen would probably be very noticeable.

The good news is that in the early stages, psychosis in teens can be treated by making pretty simple changes in their habits. These include reducing stress, making sure they have good sleep habits and getting treatment for other problems like anxiety.

If you’re worried your teen might be having these symptoms, the first step is to take them to their regular doctor. Their doctor will rule out drug use, which can also cause these symptoms. Then, they will send the teen to be examined by a psychiatrist. It’s hard for #doctors to know which teens will go on to develop serious psychotic illnesses — not all will. But getting your teen to a professional who can watch their symptoms may be the most important step a parent can take.

There are fewer more frightening or challenging psychiatric conditions for a family to face than psychosis, an extreme mental state in which impaired thinking and emotions cause a person to lose contact with reality. This could mean hearing or seeing things that aren’t there (hallucinations), or believing things that aren’t true (delusions).

The illness most often associated with #psychosis, #schizophrenia, usually doesn’t show up until very late #adolescence or early #adulthood. Recently, however, experts in the field have been working to identify high-risk kids who show symptoms that could serve as early warning signs of psychosis, and several academic centers have been set up to focus on this crucial period when it may be possible to change the trajectory of mental illness.

Not all the kids who are identified with what experts call “prodromal” symptoms will progress, or “convert” to full-blown psychotic illness. But early intervention has been shown to improve outcomes for those who do. And since psychotic symptoms cause disruption across a teenager’s life, from school to friendships to family, researchers are hoping quick action can prevent impairment and prolong typical functioning.

What’s more, some of the approaches that show promise in delaying onset of psychosis or mitigating symptoms include fairly simple lifestyle changes like #stress reduction and sleep hygiene, and managing co-occurring disorders like #anxiety. The key: identifying at-risk kids earlier when these low-impact measures are still effective.

What are “prodromal” symptoms?

Prodromal symptoms are “attenuated” or weak symptoms of psychosis. Moreover, “they are a warning sign,” says Christoph Correll, MD, the medical director of the Recognition and Prevention Program (RAP) at Zucker Hillside Hospital in Queens, NY, which specializes in diagnosing and treating early symptoms of #mentalillness in #teenagers and young adults. “These signs can happen in people who don’t go on to develop psychosis—but if we follow these people who are in the risk state based on these watered-down versions, one third will probably go on to develop psychosis. That’s a lot more than in the general population.”

Prodromal symptoms occur on a spectrum from very, very mild to severe and can include:

- Withdrawing from friends and family/feeling suspicious of others

- Changes in sleeping or eating patterns

- Less concern with appearance, clothes or hygiene

- Difficulty organizing thoughts or speech

- Loss of usual interest in activities or of motivation and energy

- Development of unusual ideas or behaviors

- Unusual perceptions, such as visions or hearing voices (or even seeing shadows)

- Feeling like things are unreal

- Change in personality

- Feelings of grandiosity (belief he has a superpower, etc)

In some cases, these symptoms represent the early stages of a disorder, and will eventually convert. In others, the symptoms actually fade or remain mild. Tiziano Colibazzi, MD, is a #psychiatrist at Columbia Presbyterian’s COPE clinic (Center for Prevention and Evaluation), which was established to research and treat prodromal symptoms. “We can identify a group of people that are at clinically high risk,” says Dr. Colibazzi. “What we can’t do is narrow that group down further to identify the 30 percent who will convert.”

First step if you feel your child is at risk: An evaluation

The right treatment for prodromal symptoms depends entirely on how severe they are when they are diagnosed. The first step is a proper and complete diagnosis by a #mentalhealthprofessional with experience in assessing psychotic illness.

If you see marked changes in motivation, thinking, and/or behavior in your child, the first place to start is with her pediatrician to rule out a medical illness. #Substanceuse also needs to be ruled out as the cause of any #behavior changes in #adolescents. After that, you’re going to want to have your child evaluated by a qualified #psychiatrist or #psychologist. This in itself might be a multi-step process.

“You can’t just look at the kid once and get a bit of a history and then know what’s going on, ” says Dr. Correll. “Kids develop; symptoms develop. And the trajectory—how things change, get better or worse, what other symptoms add on to it—will be highly informative in telling us something about the prognosis, what we expect to happen.”

One aid to predicting the evolution and severity of symptoms, notes Dr. Colibazzi, is the patient’s ability to doubt his symptoms. If your child retains the self-awareness to know that it’s his mind that is playing tricks on him, it’s an indication that symptoms are still in the very early stages. As symptoms become more severe, the patient’s beliefs (whether paranoid, grandiose or hallucinatory) become increasingly difficult to challenge.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy



www.celebratingyourgiftoflife.com

Lifestyle and #mentalhealth options

Psychotic symptoms and illnesses have been shown to vary quite a bit depending on the environment—the health of our bodies, our interpersonal relationships, our mindsets. As with any illness, but particularly important in at-risk #youth, healthy living is key. Regardless of the severity of prodromal symptoms, Dr. Correll says that your child’s outcome can be improved by making sure your kid sticks to a routine that includes:

- Eating well

- Getting regular exercise

- Adhering to a regular sleep schedule

- Reducing stress as much as possible

- Staying away from drugs—particularly marijuana, which can interact with prodromal symptoms and increase the risk for psychosis significantly

Also, don’t forget to address depression and #anxiety. According to Dr. Correll, “#adults who eventually developed #schizophrenia identified a three to five year period during which they experienced depression or anxiety before developing the prodromal symptoms of psychosis and then developed full-blown psychosis.” “So treating the #depression early,” he says, “might actually interrupt the progression from depression to psychosis in some #patients.”

Treatment for prodromal #psychotic symptoms

Dr. Correll recommends trying several approaches. Mild symptoms call for more low-key treatments including:

- Psycho-education: teaching both the kid and the family more about the symptoms and the illness.

- Therapy, particularly #cognitivebehavioraltherapy: “#CBT can be good to change one’s thinking patterns,” says Correll, “and also to address developing #self-esteem. We have to be careful that kids with a psychiatric diagnosis don’t self-stigmatize and get into a hopeless or negative mode where they feel they can’t achieve.”

- Lifestyle adjustments: Assessing whether the current school environment is best for the child. Perhaps a therapeutic social group to help the #child cope.

- Reducing #Stress: #Stress is often a trigger for symptoms, so reducing stress in these kids’ lives is crucial and may prevent or delay conversion to psychotic illness.

Understanding prodromal symptoms and monitoring kids who are at high risk for psychotic illness means that #parents can do more for their kids than wait for symptoms to get worse or merely hope for the best. Early monitoring and intervention can give high-risk #kids an advantage, which researchers hope will eventually change the odds when it comes to #psychotic illness.

“The duration of untreated #psychosis does actually seem to affect the course of the illness,” Dr. Colibazzi says. The longer the illness goes untreated, the greater the chance that it will cause serious disruption in all areas of the #patient’s life. “So it is reasonable to think that just following someone very closely and treating them very early, as soon as they develop symptoms, would be helpful.”

Photo by Andrea Piacquadio on Pexels.com
https://standingabovethecrowd.com/2023/07/jamesdonaldson-on-mentalhealth-watching-for-signs-of-psychosis-in-teens/

The right care for #teenagers and young #adults after a first #psychotic episode decreases later relapses by more than 50%

Writer: Caroline Miller

Clinical Expert: Michael Birnbaum, MD

What You'll Learn

- What is a psychotic break, and what are its symptoms?

- What kind of treatment helps young people get back on track after a psychotic episode?

- Why is it important for people to get treatment quickly?

- Quick Read

- Full Article

- Breakthrough psychosis treatment

- What is early treatment?

- A team approach

- Empowering the patient

- A message of hope

A #teen stops paying attention to family, school and fun. They worry more and more that someone is out to get them. They start seeing or hearing things that aren’t there. They believe in strange things, like aliens tracking them. They stop trusting people close to them. Their speech might stop making sense.

These are signs of a psychotic break. That’s when someone loses touch with reality. It’s often a symptom of #schizophrenia. Sometimes it’s part of #bipolardisorder or #depression. It usually happens to someone for the first time when they’re 15–25 years old. It’s truly scary, both for the young person and their loved ones.

The good news is that getting a treatment called #CoordinatedSpecialtyCare, or #CSC, right after a first episode cuts the chances of later ones in half. It’s called “coordinated” because a team of different people helps the person get back on track.

Often when someone has a psychotic break for the first time, they wind up in the hospital. There, they get medicine that helps but might not make all their symptoms go away. The best time to start CSC is right after they get out of the hospital.

The goal of CSC is to help a person learn to manage their symptoms and build a support network. A doctor fine-tunes their medication, usually a low dose of an anti-psychotic. A #therapist teaches them skills to deal with symptoms and “reality test” whether a sound is really there, or whether a thought makes sense. Another specialist works with patients to get them back on track with school and work.

CSC also teaches families how to deal with a crisis. And it gives them skills to support the person in treatment. Families help make sure kids take their meds, keep appointments, eat and get sleep. These are important because #stress can bring on a psychotic episode.

Patients have a say in treatment. They can try a different dose of their meds or wean off them to see if symptoms come back. The goal is for them to be able to go about their lives without many side effects and with their symptoms under control.

The first sign of #psychosis is usually withdrawal. A #teenager or young #adult, often someone who’s had no prior emotional or #behavioralissues, begins to be less engaged with what’s going on around them. Instead of school, work, friends, family and fun, they are preoccupied with what’s going on internally, increasingly fixated on disturbing ideas that are bubbling up.

They’re being monitored by the FBI. There’s a chip implanted in their brain. Their parents are trying to poison them. They begin seeing and hearing things that others don’t see and hear, and becomes suspicious even of people they are closest to. In turn, their speech and #behavior no longer make sense to them.

This is a psychotic break — when someone loses touch with reality, experiencing delusions (false beliefs) or hallucinations (seeing or hearing things that are not there) and what’s called “disorganized” speech. In the #UnitedStates, about 100,000 #teenagers and young adults each year experience a first episode of psychosis, with the peak onset between the ages of 15 and 25.

A first psychotic break is terrifying both for the person experiencing it and those who are close to them, says #child and #adolescent #psychiatrist Michael Birnbaum, MD, who is an expert in first episode psychosis. Neither understands what’s happening. “#Behavior can drastically change in a very scary way. People stop communicating in the same way. The way they use words and sentences to express what they’re thinking becomes totally disorganized.”

A person experiencing a psychotic episode usually ends up in the hospital when their #behavior escalates to a point of crisis. “Sometimes people are picked up by the #police,” says Dr. Birnbaum. “Sometimes parents or #teachers are so frightened that they call 911.”

Breakthrough psychosis treatment

The most common cause of psychosis is a psychiatric disorder: #schizophrenia or, less often, #bipolardisorder or severe #depression. Psychosis can recur episodically with these illnesses, severely undermining a young person’s developing sense of self, along with school, work and relationships. But there’s substantial good news in the treatment of psychosis: evidence shows that treatment after the initial episode can dramatically reduce the number and intensity of future recurrences.

The right treatment within the first two to three years after the first episode has been shown to decrease relapses of psychosis by more than 50 percent and prevent much of the disability associated with a psychotic illness.

“The earlier we intervene, the better the outcome,” says Dr. Birnbaum. “This is the take-home message. Get help as soon as possible.”

What is early treatment?

Dr. Birnbaum is director of an early treatment program for #teenagers and young #adults who’ve experienced psychotic symptoms for the first time. The program has two locations, at Zucker Hillside Hospital in Queens, New York, and at Lenox Hill Hospital in Manhattan. The specialized treatment that’s offered in centers like Dr. Birnbaum’s  has proven so successful that the federal government earmarked $25 million to aid development of these programs across the country — and then doubled it to $50 million.

Patients generally enter these early treatment programs following their release from the hospital. In the hospital they’ve been given medication that reduces their symptoms, but they may not be symptom-free, since anti-psychotic medication takes 6 to 8 weeks to take full effect. So even if they’re considered safe to go home, Dr. Birnbaum explains, patients and their families both have a lot to deal with. Getting into an outpatient program as soon as possible helps them do just that.

The treatment that has been shown to be successful, called Coordinated Specialty Care, involves a combination of services coordinated by a group of professionals working with the patient and the family. They include:

- Low doses of antipsychotic medication

- #Cognitivebehavioraltherapy for psychosis (#CBTp)

- Family education and support

- Educational and vocational rehabilitation

Unlike the old standard treatment for #schizophrenia, which involved higher doses of medication and no follow-up after hospitalization, the goal of early treatment is not only to reduce psychotic symptoms, but also to help young people learn to manage them and to construct a support network to prevent relapse.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

www.celebratingyourgiftoflife.com

A team approach

At Zucker Hillside, after an extensive initial assessment, patients meet once a week with a #therapist for a session of #CBTp, which is aimed at helping them handle ongoing symptoms and develop healthy coping strategies. For example, a patient might work on identifying delusional beliefs, figuring out strategies for “reality testing” them, and coming up with alternative, more helpful ways of thinking.

Patients are each assigned to a psychiatrist on staff, who monitors their medication to make sure they’re getting the most benefit, at the lowest dose, with the fewest problematic side effects.

The team also works with families, who are essential to recovery. Young people  who’ve experienced #psychosis do better when families support their keeping appointments, taking their medications and eating, sleeping and taking care of themselves. These are important skills, since stress can trigger a relapse. #Parents also learn how to respond when a son or daughter talks about aliens and the FBI — “how to express love without supporting delusions,” as Dr. Birnbaum puts it — and skills for dealing with a crisis and with suicidality.

Finally, staff members work with patients to get them back on track with school and work. “We don’t want people to assume the role of a sick person,” Dr. Birnbaum notes. “We want them to go back to #school despite having these obstacles. Go back to work despite having a temporary handicap. The idea is that this is a bump in the road that we can get over. The best way to start feeling better is to start doing things again.”

At Zucker Hillside there is also an assortment of groups to build recovery skills and encourage exercise and social interaction. And there are competitive game nights to help strengthen cognitive functions such as memory and processing speed, which can be weakened in the wake of a psychotic episode. “Some people feel that their brain just isn’t working the way it used to,” Dr. Birnbaum says.

Some activities are designed to make staying in treatment attractive for young patients, so they remain long enough to get the benefit of early intervention.

Empowering the patient

After an episode, some patients are quickly back to normal, with medicine, while others continue to have psychotic symptoms, but at a less acute level. Delusions and hallucinations might not go away completely, but they are less intense, and the patient can give them less weight and learn to manage them, Dr. Birnbaum says. “They’re in the back of their minds, rather than at the front.”

Patients also vary in their receptiveness to therapy and taking medication. An important part of the program is empowering the individuals who are being treated to participate with the professionals in joint decision-making about their treatment.

“Young people who don’t want to take medication don’t have to,” says Dr. Birnbaum. “We strongly encourage it. I know the medication is incredibly helpful. But it’s an individual decision how much medication they want to take for how long.”

Patients who’ve been taking medication may decide they want to try a lower dose, or go off meds, to see if their symptoms will return. The team approaches it as an experiment, a learning opportunity. Sometimes symptoms don’t return, and the #patient stays at the lower dose; other times they do, and the patient will ask to go back to the higher dose.

“I would rather have these open and honest discussions than have them say, ‘Yes #doctor, I’m taking the medication,’ and then go home and not take anything — lie to me about it. Or just disappear and don’t come back.”

A message of hope

Part of the goal of early treatment is to eliminate the #stigma attached to #schizophrenia, and to show patients, and their families, that it is a more manageable illness than they may think. #Patients “graduate” from the Early Treatment Program at Zucker Hillside when they have a good grasp of their illness and they know what they need to do to stay better.

The national initiative to expand these programs aims to change not only the model of treatment but to send a message of hope and optimism.

What Dr. Birnbaum calls “the old story” of #schizophrenia was a grim one. But thanks to early intervention programs there is a new story that recovery is possible. These programs are designed, as he puts it, “to stop #mentalillness in its tracks before it has a chance to take over somebody’s life.”

To find a treatment center near you, check out the list of programs around the country compiled by Strong 365, a group that aims to fight #stigma surrounding #psychosis and encourage more young people to get early treatment.
https://standingabovethecrowd.com/2023/07/jamesdonaldson-on-mentalhealth-early-treatment-for-schizophrenia-improves-outcomes/

#JamesDonaldson On #MentalHealth – Early Treatment For #Schizophrenia Improves Outcomes

The right care for #teenagers and young #adults after a first #psychotic episode decreases later relapses by more than 50%

Writer: Caroline Miller

Clinical Expert: Michael Birnbaum, MD

What You'll Learn

- What is a psychotic break, and what are its symptoms?

- What kind of treatment helps young people get back on track after a psychotic episode?

- Why is it important for people to get treatment quickly?

- Quick Read

- Full Article

- Breakthrough psychosis treatment

- What is early treatment?

- A team approach

- Empowering the patient

- A message of hope

A #teen stops paying attention to family, school and fun. They worry more and more that someone is out to get them. They start seeing or hearing things that aren’t there. They believe in strange things, like aliens tracking them. They stop trusting people close to them. Their speech might stop making sense.

These are signs of a psychotic break. That’s when someone loses touch with reality. It’s often a symptom of #schizophrenia. Sometimes it’s part of #bipolardisorder or #depression. It usually happens to someone for the first time when they’re 15–25 years old. It’s truly scary, both for the young person and their loved ones.

The good news is that getting a treatment called #CoordinatedSpecialtyCare, or #CSC, right after a first episode cuts the chances of later ones in half. It’s called “coordinated” because a team of different people helps the person get back on track.

Often when someone has a psychotic break for the first time, they wind up in the hospital. There, they get medicine that helps but might not make all their symptoms go away. The best time to start CSC is right after they get out of the hospital.

The goal of CSC is to help a person learn to manage their symptoms and build a support network. A doctor fine-tunes their medication, usually a low dose of an anti-psychotic. A #therapist teaches them skills to deal with symptoms and “reality test” whether a sound is really there, or whether a thought makes sense. Another specialist works with patients to get them back on track with school and work.

CSC also teaches families how to deal with a crisis. And it gives them skills to support the person in treatment. Families help make sure kids take their meds, keep appointments, eat and get sleep. These are important because #stress can bring on a psychotic episode.

Patients have a say in treatment. They can try a different dose of their meds or wean off them to see if symptoms come back. The goal is for them to be able to go about their lives without many side effects and with their symptoms under control.

The first sign of #psychosis is usually withdrawal. A #teenager or young #adult, often someone who’s had no prior emotional or #behavioralissues, begins to be less engaged with what’s going on around them. Instead of school, work, friends, family and fun, they are preoccupied with what’s going on internally, increasingly fixated on disturbing ideas that are bubbling up.

They’re being monitored by the FBI. There’s a chip implanted in their brain. Their parents are trying to poison them. They begin seeing and hearing things that others don’t see and hear, and becomes suspicious even of people they are closest to. In turn, their speech and #behavior no longer make sense to them.

This is a psychotic break — when someone loses touch with reality, experiencing delusions (false beliefs) or hallucinations (seeing or hearing things that are not there) and what’s called “disorganized” speech. In the #UnitedStates, about 100,000 #teenagers and young adults each year experience a first episode of psychosis, with the peak onset between the ages of 15 and 25.

A first psychotic break is terrifying both for the person experiencing it and those who are close to them, says #child and #adolescent #psychiatrist Michael Birnbaum, MD, who is an expert in first episode psychosis. Neither understands what’s happening. “#Behavior can drastically change in a very scary way. People stop communicating in the same way. The way they use words and sentences to express what they’re thinking becomes totally disorganized.”

A person experiencing a psychotic episode usually ends up in the hospital when their #behavior escalates to a point of crisis. “Sometimes people are picked up by the #police,” says Dr. Birnbaum. “Sometimes parents or #teachers are so frightened that they call 911.”

Breakthrough psychosis treatment

The most common cause of psychosis is a psychiatric disorder: #schizophrenia or, less often, #bipolardisorder or severe #depression. Psychosis can recur episodically with these illnesses, severely undermining a young person’s developing sense of self, along with school, work and relationships. But there’s substantial good news in the treatment of psychosis: evidence shows that treatment after the initial episode can dramatically reduce the number and intensity of future recurrences.

The right treatment within the first two to three years after the first episode has been shown to decrease relapses of psychosis by more than 50 percent and prevent much of the disability associated with a psychotic illness.

“The earlier we intervene, the better the outcome,” says Dr. Birnbaum. “This is the take-home message. Get help as soon as possible.”

What is early treatment?

Dr. Birnbaum is director of an early treatment program for #teenagers and young #adults who’ve experienced psychotic symptoms for the first time. The program has two locations, at Zucker Hillside Hospital in Queens, New York, and at Lenox Hill Hospital in Manhattan. The specialized treatment that’s offered in centers like Dr. Birnbaum’s  has proven so successful that the federal government earmarked $25 million to aid development of these programs across the country — and then doubled it to $50 million.

Patients generally enter these early treatment programs following their release from the hospital. In the hospital they’ve been given medication that reduces their symptoms, but they may not be symptom-free, since anti-psychotic medication takes 6 to 8 weeks to take full effect. So even if they’re considered safe to go home, Dr. Birnbaum explains, patients and their families both have a lot to deal with. Getting into an outpatient program as soon as possible helps them do just that.

The treatment that has been shown to be successful, called Coordinated Specialty Care, involves a combination of services coordinated by a group of professionals working with the patient and the family. They include:

- Low doses of antipsychotic medication

- #Cognitivebehavioraltherapy for psychosis (#CBTp)

- Family education and support

- Educational and vocational rehabilitation

Unlike the old standard treatment for #schizophrenia, which involved higher doses of medication and no follow-up after hospitalization, the goal of early treatment is not only to reduce psychotic symptoms, but also to help young people learn to manage them and to construct a support network to prevent relapse.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy



www.celebratingyourgiftoflife.com

A team approach

At Zucker Hillside, after an extensive initial assessment, patients meet once a week with a #therapist for a session of #CBTp, which is aimed at helping them handle ongoing symptoms and develop healthy coping strategies. For example, a patient might work on identifying delusional beliefs, figuring out strategies for “reality testing” them, and coming up with alternative, more helpful ways of thinking.

Patients are each assigned to a psychiatrist on staff, who monitors their medication to make sure they’re getting the most benefit, at the lowest dose, with the fewest problematic side effects.

The team also works with families, who are essential to recovery. Young people  who’ve experienced #psychosis do better when families support their keeping appointments, taking their medications and eating, sleeping and taking care of themselves. These are important skills, since stress can trigger a relapse. #Parents also learn how to respond when a son or daughter talks about aliens and the FBI — “how to express love without supporting delusions,” as Dr. Birnbaum puts it — and skills for dealing with a crisis and with suicidality.

Finally, staff members work with patients to get them back on track with school and work. “We don’t want people to assume the role of a sick person,” Dr. Birnbaum notes. “We want them to go back to #school despite having these obstacles. Go back to work despite having a temporary handicap. The idea is that this is a bump in the road that we can get over. The best way to start feeling better is to start doing things again.”

At Zucker Hillside there is also an assortment of groups to build recovery skills and encourage exercise and social interaction. And there are competitive game nights to help strengthen cognitive functions such as memory and processing speed, which can be weakened in the wake of a psychotic episode. “Some people feel that their brain just isn’t working the way it used to,” Dr. Birnbaum says.

Some activities are designed to make staying in treatment attractive for young patients, so they remain long enough to get the benefit of early intervention.

Empowering the patient

After an episode, some patients are quickly back to normal, with medicine, while others continue to have psychotic symptoms, but at a less acute level. Delusions and hallucinations might not go away completely, but they are less intense, and the patient can give them less weight and learn to manage them, Dr. Birnbaum says. “They’re in the back of their minds, rather than at the front.”

Patients also vary in their receptiveness to therapy and taking medication. An important part of the program is empowering the individuals who are being treated to participate with the professionals in joint decision-making about their treatment.

“Young people who don’t want to take medication don’t have to,” says Dr. Birnbaum. “We strongly encourage it. I know the medication is incredibly helpful. But it’s an individual decision how much medication they want to take for how long.”

Patients who’ve been taking medication may decide they want to try a lower dose, or go off meds, to see if their symptoms will return. The team approaches it as an experiment, a learning opportunity. Sometimes symptoms don’t return, and the #patient stays at the lower dose; other times they do, and the patient will ask to go back to the higher dose.

“I would rather have these open and honest discussions than have them say, ‘Yes #doctor, I’m taking the medication,’ and then go home and not take anything — lie to me about it. Or just disappear and don’t come back.”

A message of hope

Part of the goal of early treatment is to eliminate the #stigma attached to #schizophrenia, and to show patients, and their families, that it is a more manageable illness than they may think. #Patients “graduate” from the Early Treatment Program at Zucker Hillside when they have a good grasp of their illness and they know what they need to do to stay better.

The national initiative to expand these programs aims to change not only the model of treatment but to send a message of hope and optimism.

What Dr. Birnbaum calls “the old story” of #schizophrenia was a grim one. But thanks to early intervention programs there is a new story that recovery is possible. These programs are designed, as he puts it, “to stop #mentalillness in its tracks before it has a chance to take over somebody’s life.”

To find a treatment center near you, check out the list of programs around the country compiled by Strong 365, a group that aims to fight #stigma surrounding #psychosis and encourage more young people to get early treatment.

https://standingabovethecrowd.com/2023/07/jamesdonaldson-on-mentalhealth-early-treatment-for-schizophrenia-improves-outcomes/