Some Medications Produce Weight GainSo Mentally Ill Must Watch Their Diets
Our nation is still reeling from the tragedy at Virginia Tech. As the shock wears off, the natural inclination is to find fault. We search for the “black box” – the evidence of what went wrong. While there are undoubtedly many factors that might have changed the outcome of April 16, there is an underlying issue that can’t be ignored.
Mental illness affects almost 60 million Americans. That’s an estimated one in every four adults and one in every five children. Mental illness is more common than cancer, diabetes or heart disease, making it the leading cause of disability in the United States.
As Americans, we are so frightened by mental illness, or the stigma associated with it, that we do a fairly good job of ignoring it. So does our government.
Despite advances in medicine and therapy that make it possible to treat and prevent lifelong disability from mental illnesses with increasingly greater success, the systems that do so are woefully under-funded at all levels. Even Medicare discriminates against mental health treatment, as do private health insurance companies. Almost 90 percent of private health plans place limits on mental health care that they don’t place on medical/surgical care.
The cost to all of us is horrific. Senseless tragedies. Wasted lives. Broken families. Increased crime. Lost productivity.
How many more tragedies must occur before our national and state leaders get serious about making mental health care a priority?
There are more than 2,000 community mental health organizations across the country, which have brought quality treatment to millions in need of mental healthcare—including those with serious mental illnesses, the uninsured, the homeless and children in foster care.
Chronically under-funded, most of these organizations have, in recent years, wrestled with managed care, diminishing resources, and growing needs. Some have been forced to merge or go away entirely, leaving large geographic areas without accessible care. For the most seriously mentally ill, case management services and community supports are being cut back. And services to adults and children with depression, anxiety or disruptive behaviors, who with treatment could lead highly productive lives, have been all but eliminated. There are too few dollars to support experienced professional staff capable of doing so much more.
We know now that Seung Hui Cho, the gunman at Virginia Tech, was diagnosed with a mental illness and ordered to get treatment. He spent some time at a psychiatric hospital. But it wasn’t enough. He fell through the cracks. Our nation’s funding priorities did not allow for a comprehensive system of early intervention, assessment, monitoring, treatment and authority to keep him from being a danger to himself or others.
There are solutions, but the problem is of such magnitude that it will take a dramatic shift in our thinking and it will take government action, recognizing the prevalence of mental illness and recognizing that treatment is indeed worth our time and money.
Perhaps the tragedy at Virginia Tech will help focus our national, state and local leaders on the need for seamless, ongoing care for those with mental illness. We can continue our patchwork approach to public mental health services and suffer the consequences. Or we can move toward a more cohesive national mental health system that better meets the needs of those with mental illness and their families and communities.
(Mr. Shulman is President/CEO of South Shore Mental Health, 1- 617- 847-1903.)
We live in such a privileged society that it almost seems shameful to not be grateful for every moment. And yet, life brings everyone challenges that affect our ability to enjoy life. When one is not able to find joy in life, then one’s mental health has been compromised.
Enjoyment comes from inside, it is not dependent on external factors. How we handle stressors ultimately determines whether we are mentally and emotionally healthy. Following is a brief introduction to the concept of restorative healing vs. reorganizational healing as proposed by Donald Epstein, DC, the founder of Network Spinal Analysis and Somatorespiratory Integration.
How we perceive who we are in relationship to ourselves and our community has a great effect on our mental health. Have you ever heard people say they wanted to get back to their old self again? This is restorative healing because you are attempting to restore yourself back to the way you were before your routine was disturbed.
Dr. Epstein has proposed what is called reorganizational healing. What if our illnesses or disturbances were signs that a change is necessary in some area of your life? The symptom, the crisis or the disturbance is instructive, it is not an enemy. It is a directional signal leading you down a different path than the one you were going down before. It is getting you to break with your usual routine so you can grow in some area of your life and participate in it again.
Reorganizational healing is a call to wake up and participate in your life. We don’t ever stop growing or changing, but sometimes we shut down and go on autopilot. Success in this model of reorganizational healing is creating new energy-efficient sustainable states that are at a higher level of organization in the body. In reorganizational healing we say, “Let’s see what we can do to get a life that we never had before, regardless of what went on in the past, regardless of the diagnosis, regardless of anything else. How can we start today to create a different life in a different direction? How can we move more toward the life of our dreams?”
(Dr. Nash is a Certified Network Chiropractor in South Dennis, 508-394-9355.)Some Medications Produce Weight GainWe are a growing nation but not always in a good way. The incidence of overweight or obesity has been spiraling up and, unfortunately, the prevalence is even higher in people with mental illness.
This is alarming because a high weight status is a major risk factor for various medical conditions such as diabetes, hypertension, coronary/artery disease, and is often accompanied by a reduced quality of life.Many factors affect a person's weight status, one being medication. Weight gain is a frequent side effect of some of the antipsychotic medication and can affect compliance. One should keep in mind that although there may be some initial weight gain, that in the long term if the medication is effective the patients should start to feel more positive and be motivated to improve their eating habits and start exercising. The medication compliance is essential to help people take better care of themselves. People should be made aware of the possibility of weight gain at the beginning of treatment and their weight should be monitored.
Some studies have shown that with schizophrenics there is an increased consumption of high-caffeine, high-calorie beverages, which, when accompanied by a lack of motivation to exercise, contribute to a rising weight.
Or perhaps their medication makes them feel tired or thirsty and, to relieve this condition, they increase their intake of caffeine with beverages that also contain sugar.
Low calorie options are available such as water, whether plain, flavored or carbonated, or diet caffeine-free soda.
Start cutting back by alternating regular beverages with sugar-free-caffeine free soda and continue to replace beverages with sugar-free choices that are better for hydration.
A person can be overweight and follow a poor diet because they may not be motivated to cook or plan meals and consequently rely on the high-fat, high-calorie food choices in fast food restaurants or convenience foods from the supermarket. Making changes to decrease high-calorie foods should be accompanied by an increase in fruits, and vegetables and fiber.
Weight loss is difficult but not impossible and ongoing support and education from the beginning of treatment has been effective in improving eating habits and physical activity.
Start learning what a healthy serving size is, how to plan a meal that includes most food groups, that snacks do not mean chips, candy, and cookies but rather fruit, cereal and milk or a yogurt…all quick, and easy.
Ongoing support from family, friends and healthcare providers is necessary to promote changes and maintain these healthy habits.
Eating well and exercising will help improve compliance of medications, reduce medical complications and improve one’s physical and mental health.
(Ms. Gibbons, a Registered Dietician and Certified Diabetes Educator, provides outpatient nutrition medical therapy at Cape Cod Hospital.)