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Proactiveplanningpresentation2011
Proactiveplanningpresentation2011
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Proactiveplanningpresentation2011
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Proactiveplanningpresentation2011
Proactiveplanningpresentation2011
Proactiveplanningpresentation2011
Proactiveplanningpresentation2011
Proactiveplanningpresentation2011
Proactiveplanningpresentation2011
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Proactiveplanningpresentation2011
Proactiveplanningpresentation2011
Proactiveplanningpresentation2011
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Proactiveplanningpresentation2011

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This is the Proactive Planning presentation from the Alternatives conference that was held in Orlando, Floirida in October 2011. The title: Considering the Risks of Long Term Use of Psychotropic …

This is the Proactive Planning presentation from the Alternatives conference that was held in Orlando, Floirida in October 2011. The title: Considering the Risks of Long Term Use of Psychotropic Medications; A Proactive and Informed Approach to Determining Reduction or Withdrawal and Alternatives to Support Long Term Wellness

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  • My name is I am CPF, CIC and provide nicotine dependence programming in the DM community I am also a trauma survivor and survivor of long term polypharmacy and iatrogenically induced psychiatric symptoms. Today I have 2 passions that fuel my life purpose To speak up about mental health abuse and polypharmacy as a secondary and iatrogenic trauma 2.Share the path that allowed me to see my life issues as something that could be overcome vs an illness that had no ending I believe that knowledge is empowerment and am excited to be here today to share this new way of viewing and overcoming what we have come to know as a lifelong illness through proactive learning, planning and preparing to create change that was once thought impossible and the skills and tools that allow me to live beyond that place of broken where I repeated the original oppression and dysfunction in my adult life. CAROLYN INTRO OF SELF
  • Learning how to take a proactive stance on my health and well being was a learning process. This workshop will hopefully provide a framework to empower those who seek mh services, those who provide mh services and other interested persons an opportunity to be the change we want to see in the world. This workshop has 3 core components (80/20) 1. Considering the risks of long term use of psychotropic medications 2. Preparing and planning for a SUCCESSFUL reduction or withdrawal from these drugs and an overview of the many paths to empower us to creating our best life around a holistic and helpful definition and model of well being. Preparing includes learning about the issues we are interested. Much like preparing for your trip here but on a larger scale. I had to know where I was at, where I wanted to be and how I was going to get there. This workshop is a sort of compiliation of this process and the life lessons I’ve learned along the way. 3. An overview of what's going on around the nation and throughout the world that is revolutionizing how we view human distress and the most effective ways to create, support and experience a long term state of well being. So this workshop is intended to provide you with the information to empower yourself by providing you the information, ideas and resources that will allow you to effectively advocate for yourself and involve your support teams and providers into the process in the event that you make the choice to reduce or withdraw from psychotropic drugs. We have a companion website to this workshop that you can find at www.proactiveplanning.org
  • Part 1 Introducing some food for thought as we contemplate taking a proactive stance in our health care by considering some of the long term risks of long term use of psychotropic drugs. These are not even necessarily potential risks but are known to be actual problems that users (and providers) of mh services accepted in this model of treatment. Yet the as research is showing – the costs of long term psychotropic use most often far outweighs the benefits of this sole model that we have been offered to date.
  • Over the past now nearly 60 years we have seen not the expected reduction in chronic distress but actually we have experienced epidemic increase in long term disabling mental health diagnosis. Pharmaceuticals promised a revolution. Yet what we have seen is an increase instead of expected reduction chronic long term disability since the introductions of pharmaceuticals in 1954 Source: Whitaker, Robert; Anatomy of an Epidemic; Magic Bullets, Psychiatric Drugs and the Astonishing Rise of Mental Illness in America. Pages 1-5
  • Since 1955 with the introduction of pharmaceuticals that were supposed to be the “magic bullet” or quick fix for emotional and mental distress we have seen the numbers of functionally disabled adults – and now children – increase rather than decrease. We are also seeing Countries that in the past experienced very good outcomes of episodic illness who are or have been adopting the medical/biological model and pharmaceuticals as the first and only option are now beginning to similar outcomes as we have experienced here in the US; the home of poly-pharmacy and long term maintenance via drug therapy. What we are now seeing is that It is not only possible to live in recovery but often to live as fully recovered. Management and maintenance is no longer the only expected outcome we are beginning to question the biomedical model of human distress.
  • Some of the risks associated with long term use of these drugs… “ Black label” warnings on anti depressants and stimulants that increase in psychiatric symptoms and severity We are also seeing a correlation to an increase of violence and rate of suicide and other self harming behaviors as documented by Dr Ann Blake Tracey, the leading world expert on seratogenic medications (anti depressants) Serious side. Some permanent Not always differentiated from symptoms Providers not always aware These are issues that users of psychiatric services have often accepted as part of this model of care.
  • Side effects may not always be differentiated from diagnosis and may be dismissed if providers are unfamiliar A few are insomnia, agitation, nervousness, increased depression, lack of concentration We can find ourselves with physical, emotional and psychological dependence using medications to cope with life experiences, thoughts and feelings DEPENDENCE ISSUES: Physical Withdrawals Can lead to increasing dose or adding to the “cocktail” ie poly-pharmacy as another drug is added to offset the effects of previous drugs Iatrogenic increase in psychiatric symptoms Drug sensitivities following withdrawal (a caution) Emotional Instability Flat affect/numbing Psychological Fear Increase in symptoms Loss of Control Sense of helplessness and powerlessness Impairments Cognitive Memory Intelligence
  • We can experience iatrogenic illnesses related to withdrawal symptoms and Increase of emotional and cognitive distress or “discontinuation syndrome” if the dose is missed or suddenly stopped and can lead to misinterpretation, possible increase of dose, addition of other drugs to the mix resulting in a progression of dysfunction, hospitalizations, legal issues, jail, institutionalization, social isolation etc SOCIAL DISCRIMINATION has been something most of us have learned to accept and tolerate A sense of shame seemed to perpetrate my life and increase my sense of isolation WE often begin to lose our sense of self and person as we begin to identify as the labels we have been given
  • Dr. Paula Caplan speaks to this issue of the 25 year disparity At first glance it may appear that this workshop endorses a “all or nothing” approach to the use of psychotropic drugs – and understandably so. The reality though is that I am not against the informed use of these drugs but rather I am for the idea of true informed consent. In order to make informed, self directed decisions about our health care we must have full, transparent and complete information. This first section on considering the risks only begins to touch on some of the information that had I been aware of would have drastically altered the course of the nearly 2 decades where I was incapacitated by psychotropic drugs. In this first section we’ve touched lightly on some of the major risks to consider in empowering ourselves through knowledge to make informed decisions about our health care with our health care providers. Now lets move on to some things to consider before we take action in this area.
  • In making the shift to a more holistic model to create, support and live in a state of well being, it is vital to become informed and create a plan that can be flexible and adapt it to our individual needs and resources. In creating an effective plan that will enable long term wellness in the planning to reduce or withdraw from psychotropic drugs it is vital to have a solution focus vs. a problem or symptoms focus. We begin with identifying what we DO want over what we DON’T want We focus on where we want to be instead of what we want to get away from Why is this vital? 1. Because the providers often don’t know how to help us safely make this transition as in my experience and many others 2. And because knowledge is where we begin to empower ourselves to lead that self directed self decided “best life” Too often I’ve seen people try to just “wing it” and it invariably ends up with them believing that they can’t do this The best way to a successful reduction or withdrawal is to begin with preparing by seeking the knowledge that will empower an effective plan And remember – a plan that fails is not a failure but an opportunity to adjust, learn and grow.
  • I’ve heard of one person who was able to access a 90 day inpatient stay at a drug rehab facility. There seems to be a balance to strike in seeking support in the journey of learning to live beyond trauma. On the website there is a section titled TRAUMA INFORMED CARE This is a broader discussion and one deserving of much more time In the context of this workshop and learning to be the creator of our journey it is through gaining an understanding of what our goals are and what trauma model work is and is not that we become empowered to say “this is helpful to me’ or “this is not helpful and what other options do I have”
  • Knowledge is (em)power(ment)
  • Titration – always slowly, sometimes minute fracitons of reductions. Withdrawal symptoms – knowledge is power. I was able to go through it because I knew I would then be free from it. I was sort of guessing that what I was experiencing was withdrawals and this enabled me to stick it out. No one knew or could tell me what I was experiencing and this was in fact used again to justify “diagnosis” (SIC play) This is also part of why I do what I’m doing – to share the kind of information that was not available to me as I went through this alone. Next….Susan Kubler Ross – Stages of emotional healing from loss or major life change denial, anger, bargaining, depression, acceptance Stages of Change Model was originally developed in the late 1970's and early 1980's by James Prochaska and Carlo DiClemente at the University of Rhode Island Resisting these stages is how we get stuck in them. Not linear – truly is a journey/process that can repeat itself many times in a day. Understanding these very normal stages of creating change allows us to understand and move through the related emotions and also enables us to let go of the distress around these feelings as we develop a sense of both competence and confidence of our ability to learn to tolerate emotional discomfort and that it is not “forever”.
  • To help you in preparing to engage in this process and safely enter the reduction or withdrawal process….
  • Additional online resources Gianna kali – a provider and a survivor of psychiatry. Currently in extended withdrawals and shares her expertise and experience survivingAD’s – good information and a community forum for interaction and support. Anyone else have any resources you would like to share here?
  • Considering a paradigm shift from one based on managing and coping with symptoms vs one where we learn to live beyond them Disease model / distress model Developing emotional awareness Understanding triggers associations and knowing that in finally facing and resolving my trauma issues allowed me to live beyond the stress responses like extreme reactions Again – knowledge is where we begin to empower ourselves to live that self defined self decided self directed life. This is where I began to live in freedom and confidence that comes with feeling competent to resolve my own distress.
  • I firmly believe that we all hold our own inner wisdom and can learn to tap into it Cultivating a conscious awareness of our own thoughts, feelings and choices enables us to embrace our unique inner wisdom and create our best life
  • There are many paths to inner calmness but all revolve around the idea of discovering our innate ability to choose this for ourselves through a practice such as mediation, yoga, chi kung etc In 2010 I did an interview with a gentelman from the UK around his book – Mindfulness for dummies Part of the Mindfulness For Dummies Cheat Sheet We all have bad days; some are worse than others. When emotions become overwhelming, you can use this RAIN formula to help manage your feelings in a mindful way:• R – Recognise the emotion you’re feeling. Name the emotion in your mind if you can.• A – Accept the experience you’re having. Yes you probably don’t like the feeling, but the reality is the emotion is here at the moment.• I – Investigate. Become curious about your experience. Where do you feel the emotion in your body? What kind of thoughts are going through your mind?• N – Non-identification. See the emotion as a passing event rather than who you actually are, just as different images are reflected in a mirror but are not the mirror. Different emotions arise and pass in you, but are not you, yourself. The most powerful step is non-identification. Have the attitude ‘anger is arising and will soon pass away’ or ‘sadness is coming up in me, and at some point will dissolve’. Sometimes you just need to do one step, whereas at other times you may want to work through the whole formula. Practice using the formula whenever you can, so when things become challenging for you, you’ll find it easier to use. LOCAL mindfulness or meditation groups, yoga, chi kung etc Developing a practice when things are calm will serve you well when things are not To all subscribers from alt2011 - RAIN formula and using Mindfulness to deal with difficult emotions pdf and audio interview when you subscribe at www.proactiveplanning.org
  • Your TI Therapist would be a great resource to support the development of this skill as a tool to support long term well being Emotional expression as a tool to create conscious change and enjoy long term well being A learned skill Acknowledging vs avoiding feelings of distress Avoiding the negative also limits the positive Experiencing our emotions vs resisting them allows us to engage in the natural emotional healing process Seeing our emotions as our guide vs something to be avoided or as an is empowering. Creative expression tools to practice Journaling (3 levels) what is happening in my day How I feel about what is happening Addressing the trauma – in supported TI therapy Art therapies (collage, drawing, painting, dance etc Many other tools to develop this core life skill
  • Physical foundation based on lifestyle and life skills that support long term well being. Nutrition as a tool for creating, supporting long term wellness Sugar and gluten tied to mental illness Physical activity is simply finding more ways to move throughout the day not necessarily a gym membership. Sleep is another major issue and insomnia can be another side effect of pharmaceuticals that can lead to polypharmacy as sleep drugs are added to the mix. As I entered WD’s I knew that my body and brain had to learn how to sleep. It took many months for my sleep patterns to normalize and now 4 years later – I can sleep though the night and wake feeling rested.
  • There are times when we all need a little help from others and here are some examples. The main idea is that we take charge rather than waiting for someone else to make it happen for me I had to learn how to make it happen for myself. Seek out local resources for alternative therapies. Youtube videos Books Local Y Chi Kung Learn then help others Again – today is an overview. The website will be your best resource for this and other components of creating and sustaining a long term state of well being.
  • Links to each of these and other sources I find will be posted on the website for easy access.
  • IN CLOSING…. In this journey the foundation to creating our best life is in beginning we are complete and whole as we are, fully capable to become the directors of our destiny.
  • THANK YOU FOR COMING In closing The take away message today is Distress is a temporary life issue Hope for a chronic state of well being is not only possible but probable It is through taking a proactive stance and choosing to see ourselves as complete and capable that we begin to unearth our own innate ability to see through the lens of hope the potential to perpetuate our own “best life”. Please turn in your cards with your contact information – receive a pdf of todays ppt Go to the website and subscribe with your email to receive your own basic Proactive Plan template.
  • Transcript

    • 1. proactiveplanning.us considering the risks of long term use of psychotropic medications; a proactive and informed approach to determining reduction or withdrawal and alternatives to support long term wellness your facilitators susan smith carolyn petit-lange
    • 2. proactiveplanning.us the goal of this workshop share a responsible and informed approach to evaluating the use of psychotropic medications offer a framework based on a proactive, solution focused approach an overview of nation and world trends
    • 3. proactiveplanning.us considering the risks of long term use of psychotropic medications
    • 4. proactiveplanning.us what does the research say? • every day – 850 adults – 250 children – increased even more with second generation drugs in 1988 Source: Whitaker, Robert; Anatomy of an Epidemic; Magic Bullets, Psychiatric Drugs and the Astonishing Rise of Mental Illness in America. Pages 1-5
    • 5. proactiveplanning.us • functionally disabled – 1 in 468 1955 – 1 in 76 today • “for life” vs. episodic – third world vs. developed nations outcomes are drastically different Whitaker; Summary of Findings
    • 6. proactiveplanning.us what are some of the potential risks with long term use of psychotropic medications?
    • 7. proactiveplanning.us • “black label” warnings on anti depressants and stimulants Dr. Ann Blake Tracy; International Coalition for drug awareness
    • 8. proactiveplanning.us • serious side effects • physical, emotional, psychological dependence WWhitaker, Robert; Anatomy of an Epidemic; Suffer the Children, An Episodic Illness turns chronic P150, An Epidemic explained P 211 Whitfield, Charles L.; Psychiatric Drugs as Agents of Trauma; Drug Stress Trauma Syndrome www.fda.gov/NewEvents/Newsroom/PressAnnouncements/2007/ucm108905.htm
    • 9. proactiveplanning.us • iatrogenic Illnesses – “legal drug toxicity” – chemically induced neurologic illnesses • discrimination • loss of a sense of self Whitfield, Charles M.D.; Psychiatric Drugs as Agents of Trauma [Peter Breggin M.D.]
    • 10. proactiveplanning.us • shortened life span average 25 years of those not taking psychotropic drugs – diabetes – heart disease – metabolic diseases
    • 11. dr. paula caplan on informed consent Those in emotional pain long for that pain to stop, but that longing makes them more susceptible to pitches for products that allegedly will help but can do great harm. People who have been labeled seriously mentally ill are dying 15 to 25 years earlier than normal [1], and it is clear that this is largely because of the effects of the drugs they are given. [2] It’s alarming enough when makers of deodorant, for instance, conceal the risks attendant on using their product; how much more reprehensible it is when marketers play not on the fear of having body odor but on the intense suffering of those who are likely to be advised to take powerful psychiatric drugs .Before proceeding, it is essential to state that I believe that suffering people have the right to try anything to ease their pain, as long as two criteria are met – and they almost never are. Source: http://www.psychologytoday.com/blog/science- isnt-golden/201109/full-disclosure-needed-about- psychiatric-drugs-shorten-life Those criteria are: (1)The person recommending a treatment must learn about and disclose to the patient everything that is known about the potential benefits and potential kinds of harm that that treatment carries. (2)The person recommending a treatment must learn about and inform the patient about the whole array of things that have been helpful to those who have suffered in similar ways (not just the traditional, medicalized approaches but all approaches).
    • 12. proactiveplanning.us things to consider before taking action
    • 13. proactiveplanning.us building support • core relationships – social – peer – Physician • supporting titration – one word: SLOWLY – www.psychrights.org/articles/SSRIDiscontinuationSyndrome.htm – therapist • trauma Informed • educated on or willing to learn about the withdrawal process as it relates to psychotropic drugs
    • 14. proactiveplanning.us action planning for safe reduction or withdrawal • being proactive is being empowered • I am responsible to know: – my rights AND my responsibilities – my available resources – the process before I engage in it – and understand the consequences of my decisions
    • 15. proactiveplanning.us understanding the process of reduction or withdrawal • titration and withdrawal symptoms • physical indicators of and the changes to expect in the process • emotional and cognitive changes and stages – Denial – Bargaining – Anger – Sadness – Acceptance Elizabeth Kubler Ross; Stages of Grief James Prochaska and Carlo DiClemente; Stages of Change
    • 16. proactiveplanning.us • some resources – Your Drug May be You’re Problem • Dr. Peter Breggin – The Ashton Manual • Dr. Heather Ashton • Protocol for the treatment of benzodiazepine withdrawal – The Harm Reduction Guide • Will Hall – Dr. Ann Blake Tracy • www.drugawareness.org
    • 17. proactiveplanning.us www.beyondmeds.com www.survivingantidepressants.org
    • 18. proactiveplanning.us creating, living in and supporting long term wellness for those who access MH services, those who provide MH services and other interested persons
    • 19. proactiveplanning.us healthy coping and life skills to cultivate well being
    • 20. proactiveplanning.us Inner Wisdom • Meditation and Mindful Awareness • Mindfulness for Dummies by Shamash Alidina • RAIN formula for dealing with difficult emotions – Recognize – Accept – Investigate – Non-Identification – www.shamashalidina.com • Local mindfulness or meditation group – google is your best friend
    • 21. proactiveplanning.us • Emotional expression – Acknowledging vs avoiding – Experiencing vs resisting – 3 creative expression tools • Journaling • Art therapies • Physical expression
    • 22. proactiveplanning.us Physical Foundation • Nutrition • Sleep Hygiene • Physical Activity
    • 23. proactiveplanning.us Alternative and Holistic Therapies • Reiki • Bodywork • Acupuncture • Yoga • Laughter Yoga
    • 24. proactiveplanning.org Overview of What’s Happening Around the Country and Throughout the World
    • 25. proactiveplanning.us Models of Peer and Provider Resources to Support a Harm Reduction Model of Care • Thrive Program – England based • Vermont – Steve Morgan • Oregon – Medication Optimization • California – Sunrise Center • Whitaker Foundation • Healing Homes – Finland • Open Dialog - Finland
    • 26. proactiveplanning.us “Restoring mental health does not mean simply adjusting individuals to the modern world of rapid economic growth. The world is ill, and adapting to an ill environment cannot bring real mental health. Psychiatric Treatment requires environmental change and psychiatrists must participate in efforts to change the environment, but that is only half the task. The other half is help individuals be themselves, not by helping them adapt to an ill environment, but by providing them the strength to change it. To tranquilize them is not the Way.” ~ Thich Naht Hanh
    • 27. proactiveplanning.us www.proactiveplanning.us

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