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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 Medications; A Proactive and Informed Approach to Determining Reduction or Withdrawal and Alternatives to Support Long Term Wellness

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  1. 1. 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. 2. 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. 3. considering the risks of long term Use of psychotropic medications
  4. 4. what does the research say about disability rates? • 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. 5. Outcomes • 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. 6. what are some of the potential risks with long term use of psychotropic medications?
  7. 7. • “black label” warnings on anti depressants and stimulants Dr. Ann Blake Tracy; International Coalition for drug awareness
  8. 8. • 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
  9. 9. • 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. 10. • shortened life span average 25 years of those not taking psychotropic drugs – diabetes – heart disease – metabolic diseases
  11. 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.
  12. 12. 12 Those two 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).
  13. 13. things to consider before taking action
  14. 14. building support • core relationships – social – peer – Physician • supporting titration – one word: SLOWLY – – therapist • trauma Informed • educated on or willing to learn about the withdrawal process as it relates to psychotropic drugs
  15. 15. 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
  16. 16. 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
  17. 17. • 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 – Coming Off Psychiatric Drugs • Peter Lehmann –
  18. 18.
  19. 19. creating, living in and supporting long term wellness for those who access MH services those who provide MH services and other interested persons
  20. 20. healthy coping and life skills to cultivate well being Cultivating a conscious awareness of our own thoughts, feelings and choices enables us to embrace our unique inner wisdom and create our best life
  21. 21. Inner Wisdom • Meditation and Mindful Awareness • Mindfulness for Dummies by Shamash Alidina • RAIN formula for dealing with difficult emotions – Recognize – Accept – Investigate – Non-Identification – • Local mindfulness or meditation group – google is your best friend
  22. 22. • Emotional expression – Acknowledging vs avoiding – Experiencing vs resisting – 3 creative expression tools • Journaling • Art therapies • Physical expression
  23. 23. Physical Foundation • Nutrition • Sleep Hygiene • Physical Activity
  24. 24. Alternative and Holistic Therapies • Reiki • Bodywork • Acupuncture • Yoga • Laughter Yoga
  25. 25.
  26. 26. I've never been forced on psychiatric medications. I've never taken them; yet, the whole strangle hold that the drug companies have on the information most people are given is devastating, when you need an answer. Even when you're not on medications but just looking for an answer. I've actually had what psychiatry would label as psychosis for 20 years. I finally found exercises I can do in a book called A Course in Miracles where it gets me to not invest in fear based thoughts. Thus, I don't get into that state where the adrenaline starts making up paranoia (or mania) or whatever it is I'm just using a word -- adrenaline-- that's associated with something producing fear. It's really just me checking my thoughts that I'm really thinking and not just going along with how one is supposed to respond investing in fear based thoughts…Now that I've learned to stop responding and am gaining perspective (I'm not escaping in a "psychotic" episode) ~R.A.
  27. 27. Overview of What’s Happening Around the Country and Throughout the World
  28. 28. 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
  29. 29. “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
  30. 30. 30 The Take Away •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 oneself as complete and capable that one can begin to unearth their own innate ability to see through the lens of hope the potential to perpetuate ones own “best life”
  31. 31.