Walking with someone through a mental illness

1. 70X7 MENTOR TRAINING TOOLS:
WalkingwithSomeone through
Mental Illness

2. PRESENTED BY: MAYA KOOPMAN, MD. BOARD
CERTIFIED PSYCHIATRIST
PRESENTED AT MENTOR TRAINING,
JANUARY 14, 2016
THE INFORMATION PRESENTED HERE IS FOR GENERAL EDUCATIONAL USE ONLY AND MAY NOT BE
USED FOR THE DIAGNOSIS OR TREATMENT OF MENTAL ILLNESS.

3. THE FACTS

6. ANXIETY DISORDERS ARE THE MOST COMMON
FORM OF MENTAL ILLNESS

7. MENTAL HEALTH PROBLEMS IN INMATES:

8. ARE SLEEP MEDICATIONS ADDICTIVE?
Yes:
• most new generation like Ambien (zolpidem)
• all old generation benzodiazepines like Valium, Xanax
• These are all “controlled substances”
No:
• sedating antidepressants
• Rozerem (ramelteon)

9. • With consistent use ALL build
dependence over time like alcohol
and addictive prescription
medications
• Once dependent, MUST taper or
will go into withdrawal.
• In this case dependence results in
drug seeking behavior even at
personal cost
• Abuse and Addiction
• 1:5 people can develop this on stopping
antidepressants suddenly or even more
with beta-blockers
• Unclear why some develop this and
some do not
• Looks like the flu and scattered thinking
• Best to taper when you stop them to
avoid the syndrome
• No High
• No drug seeking behavior
• No Abuse or Addiction
CONFUSION: DEPENDENCE AND ADDICTION?
Drug Discontinuation Syndrome Drug Addiction

10. ALCOHOL CAUSES INSOMNIA?
• “night cap”
• It is a diuretic so wakes you to urinate earlier.
• With on-going frequent use people fall asleep initially and wake up a few hours later.
• In that person, if alcohol is not given they have symptomatic insomnia.
• Sleep quality is completely disrupted.

11. CONCEPT OF “SELF-MEDICATING”
• Someone who has psychiatric symptoms and uses their
substance of choice to find relief.
• PROBLEM: Alcohol is a depressant so if someone is
depressed and drinks they will become more depressed and
may even become more of a suicide risk because they are less
in control of their behavior.
• Depressed people can’t sleep. If you drink to sleep---we know
that alcohol leads to insomnia and more drinking.

12. WALKING WITH SOMEONE THROUGH MENTAL ILLNESS:
Recognition

13. WHAT ARE WE LOOKING FOR?
• Anything new? A psychiatric symptom? A change.
• Change in a physical problem?
• Problems at work?
• Problems in the Mentor Relationship?
• More conflict in relationships that had been going well…family,
significant other…
• New stressors?
• Suicidal thinking: passive or active?

14. WHAT DO WE DO?
• It is not up to you to diagnose. Just to be alert that there may
be a problem that needs to be looked into.
• Help the person get a referral to a doctor that is covered by
their insurance.
• If you think there is any chance of danger to themselves or
others get them to the ER or call 911

15. MAJOR DIAGNOSIS CATEGORIES:
• Anxiety
• Major Depression
• Bipolar
• Schizophrenia
• Personality Disorders

17. WALKING WITH SOMEONE THROUGH MENTAL ILLNESS:
Advocacy

18. GATHERING INFORMATION:
• Are they in Mental Health Court?
• Do they have: a diagnosis? treatment? medication? history of
substance abuse?
• Do they know how to access care?
• Are they stable on their current treatment?
• Are they keeping appointments?
• Do they take their medications? Do they let them run out? Do they
stop them on their own? Do they understand what each one is for?
• Have they had a physical exam?

19. • Did they stop the medication on their own?
• Did they run out?
• Are they missing many doses?
• Medications need to be tapered
DID THEY STOP THEIR MEDICATION?
Discontinuation Syndrome:

20. Help Compliance:
Use a weekly medication strip.
Helps to see if you have taken
that day’s medication
Time saver.
Helps to see when you are
running low on medication.

21. SELF-ADVOCACY
• Keep a regular schedule
• Exercise*and eat a healthy diet
• Set alarms for medications AND to go to bed!
• Get a notebook for keeping information for doctor visits
• Write down questions for the mental health provider
• Note a list of side effects before appointment
• Make a list of prescriptions that you need refilled
• MAKE SURE to tell the provider if you have an addiction
problem and ask that you not receive any habit forming
medications. No controlled substances.

22. GOOD MENTAL HEALTH BEGINS WITH GOOD SLEEP
• Keep a regular daily and sleep schedule
• Leave at least 7-9 hours of time to sleep
• No late eating/caffeine
• No “night caps”
• Avoid artificial light from computers, TV, phones etc. the last
few hours before sleep because they keep your brain “alert”
• Don’t sleep in