Mental Health Prevention,

Education, Recovery

The Association for Natural Psychology

For Behavioral Health Services,
Mental Health Professionals and Facilities
Like tuning a violin…

All photos in this

. presentation, with the
exception of selected
books, are courtesy of
FreeDigitalPhotos.net
http://www.freedigitalphotos.net

Violin Head " by nuchylee

The brain is a delicate instrument

"Human Brain" by ddpavumba

 Scope of mental health disorders
in U.S. population 26.2% of U.S.
population -
• According to the National Institute of Mental approximately
Health (NIMH), at any given year, An estimated 1 in 4
26.2 percent of Americans ages 18 and older
— about one in four adults — suffer from a
diagnosable mental disorder.1

• When applied to the 2004 U.S. Census

residential population estimate for ages 18
and older, this figure translates to 57.7 million 57.7 million
people. 2 people in
The Numbers Count: Mental Disorders in America. U.S.
National Institute of Mental Health (NIMH).
http://www.nimh.nih.gov/health/publications/the-numbers-count-mental-disorders-in-america/index.shtml
Silhouette guys walking" by sattva
 Serious Mental Illness
• 6 percent, or 1 in 17 —
suffer from a serious mental illness.1
• The leading cause of disability in the
U.S. and Canada.3
• Many suffer from more than one
mental disorder at a given time.
Nearly half (45 percent) of those with
any mental disorder meet criteria for
2 or more disorders, with severity
strongly related to comorbidity.1
The Numbers Count: Mental Disorders in America.
National Institute of Mental Health (NIMH).
http://www.nimh.nih.gov/health/publications/the-numbers-count-mental-disorders-in-america/index.shtml

"Human Pyramid" by digitalartt

 The first part of this presentation
is to demonstrate that
• Education of the
client/patient
Section I
• Self help
• Lifestyle changes
• Developing Coping
Skills
• Bibliotherapy
• Prevention

are key elements of

success for long-term
recovery.
 Sections I - IV
• Part I Education, self help, lifestyle changes,
developing coping skills, bibliotherapy, prevention
– 54 slides

• Part II Models of Mental Health – 11 slides

• Part III Issues with Psychiatric Drugs – 19 slides

• Part IV Psychiatric Facilities and Professional

Approaches Towards Reduced Emphasis on
Pharmaceuticals – 9 slides
 Lifestyle adjustments
can positively affect mental health
and that these need to be taught to the client/patient
-synopsis

Section I
•Education of the
client/patient
•Self help
•Lifestyle changes
• Developing
Coping Skills
•Bibliotherapy
•Prevention
 Developing coping skills
-synopsis
• is an important element to prevent relapse
and to improve mental health outcomes.

Section I
•Education of the
client/patient
•Self help
•Lifestyle changes
• Developing
coping skills
•Bibliotherapy
•Prevention
e.g. Journaling
 Self Help, Education and
Bibliotherapy - read a book!
In the UK, British mental health professionals
prescribe “Bibliotherapy” for their patients.
Patients are required to read up on their mental
health disorders, learn about causes, practical
measures and self help.
Some mental health professionals in the U.S. also prescribe bibliotherapy.

“A growing number of therapists are recommending something surprising for depressed and anxious patients:

Read a book.
The treatment is called bibliotherapy, and it is gaining force from a spate of research showing that some self-
help books can measurably improve mental health. In May alone, the journal Behaviour Research and Therapy
published two studies demonstrating the effectiveness of bibliotherapy in patients with depression or other mood
disorders. The national health system in Britain this year is prescribing self-help books for tens of thousands of
people seeking medical attention for mood disorders.” Kevin Helliker.
Bibliotherapy: Reading Your Way To Mental Health. (2007). Wall Street Journal.
http://online.wsj.com/article/SB118583572352482728.html
Education is one of the keys to learning how to
recover from mental health disorders,
both serious and less serious disorders.
This can lead to…
• Lifestyle changes • Developing coping skills
Lifestyle
changes
and
developing
coping
skills are
essential
elements of
successful
Good nutrition recovery. Journaling
 Mental Health America, a mainstream
U.S. activist mental health non-profit
recommends
9 strategies for better mental health
6. Keep a journal
1. Connect with others 7. Watch your negative self-talk
2. Relax your mind 8. Get involved with spiritual
3. Exercise activities
4. Get enough rest 9. Write down 3 good things that
happen to you each week.
 Focus on: Nutrition
• To select one area of lifestyle
change – Nutrition
Many who suffer from a broad arena of
mental health difficulties and disorders,
including sleep disorders, depression and
bipolar disorder, as well as serious mental
health disorders such as symptoms
associated with schizophrenia, do well to
give serious consideration to nutrition.
Poor nutrition can precipitate Major
Depression and other mental
disorders, and positive lifestyle
changes can make a big difference
towards improvement in mental
health.
 Exercise
Lifestyle change and coping skill
Clinical studies indicate that exercise
can be more effective than
antidepressants for mild to moderate
depression. (Duke University).
Study: Exercise Has Long-Lasting Effects on
Depression. September 22, 2000. Duke Today, (Duke
University). http://today.duke.edu/2000/09/exercise922.html

Other studies and observational evidence

indicate that exercise can be effective for Major
Depression. See Keith Johnsgard’s book (right),
Conquering Depression & Anxiety Through
Exercise.
 Exercise for Depression
• Harvard Mental Health Newsletter
• and Mayo Clinic
similarly recommend
exercise for depression.

"Feet Of Runner In Evening Light" by Sura Nualpradid

Exercise and Depression. August 3, 2009. Harvard Mental Health Letter.

https://www.health.harvard.edu/newsweek/Exercise-and-Depression-report-excerpt.htm

Depression (Major Depression) - Depression and anxiety: Exercise eases

symptoms. (2011, October 1). Mayo Clinic.
http://www.mayoclinic.com/health/depression-and-exercise/MH00043
 Exercise
can positively affect mental health of
individuals with bipolar disorder
Dr. Gary Sachs, Director of the Bipolar Clinic
and Research Program, Massachusetts General
Hospital in Boston states that both exercise and
lifestyle play a significant role in recover from
bipolar disorder, though these are
underutilized.
How Can Exercise Or Lifestyle Help Bipolar Disorder? Gary Sachs, M.D.
April 29, 2008. I ABC News. Interview with Gary Sachs, M.D., Massachusetts
Director, General Hospital
in Boston
http://abcnews.go.com/Health/BipolarTreatment/story?id=436021
http://www.massgeneral.org/p
9#.UGcID5jMhOI sychiatry/doctors/doctor.aspx?
id=16732
 Bipolar Disorder is proven to
benefit from lifestyle changes.
• Stanford University psychiatrist and professor Wes Burgess,
M.D., Ph.D. notes that persons with bipolar disorder can
experience up to a 30% decrease in symptoms by giving
attention to…
• diet
• nutrition
There is a high
• exercise
correlation between
alcohol, past or • quitting smoking
present, abuse and
bipolar disorder. New • abstaining from alcohol
lifestyles need to be (from The Bipolar Handbook.
implemented for many. Wes Burgess, M.D., Ph.D.)
 Answer to problems
of bipolar disorder
Gary Sachs, M.D., Director, Bipolar Clinic and Research
Program, Massachusetts General Hospital
• “The answer to the problems that bipolar disorder causes
are not all medication-related. A healthy lifestyle, adopting
an exercise program, not only helps regulate your
circadian rhythms but can help you reach your life goals.”

“It's extremely important to set out for

yourself a purpose in life apart from
managing your symptoms - to use lifestyle
interventions to help regulate your sleep and
wake cycles, your diet, and promote
wellness by adopting a healthy lifestyle.”
 Recovery, Remission and Self-Help
for Bipolar Disorder
Dr. Liz Miller is an occupational
health physician in UK, with a
background in neurosurgery.
She developed mood mapping as a
result of her own diagnosis of
bipolar disorder, and her
struggles to overcome it.

Mood Mapping is one method

of self help whereby individuals
can gain insight and make
needed adjustments.
 “Cured of bipolar disorder”
"I consider myself cured of bipolar, [ Bipolar 1 ]
which I had for ten years, including three
mental health sections and industrial quantities
of psychiatric medication. I have been
completely well for the last twelve years and not
taken so much as an aspirin. I am certain that
nothing can happen to bring it back again. I
know I will never be manic or seriously
depressed again. I see these conditions as
nothing more than states of mind, which I have
learnt to manage..." (quoted w/permission from
Dr. Miller).
U.K. Neurosurgeon
Dr. Liz Miller
 Bipolar Disorder I or II
are not necessarily lifetime disorders
and some do fully recover to see their disorder go into
permanent remission.

Dr. Miller’s experience is not unique. This idea is

supported by clinical psychologist and university
professor of psychology, Donald J. Kiesler, PhD, as
well as by mental health service providers in Quebec,
Canada.

Similar experiences verify that Bipolar

Disorder I and II are not necessarily
lifetime disorders.
 Television and Depression
• Television may cause or contribute to depression in some
individuals. American psychologist in Britain, Aric
Sigman, links a television lifestyle with higher rates of
depression.

This is a reasonable conclusion, as the passive

nature of television lends itself well to a depressed
state.
 ½ hour of watching television
can contribute to depression for some who may
be pre-disposed towards depression

Life Coach, author and relationship expert Mel

Robbins states that only ½ hour of television
makes her feel depressed.

When television is a lifestyle, then both the

passivity, as well as the depressing nature of the
news and some news magazine programs, can
contribute to depression in individuals. For some
women, soap opera or novella addiction might
contribute towards depression, as they never can
attain to the level of relationships developed in
this fantasy world. Life Coach and media
personality Mel Robbins
 Living Without the Screen
For some, perhaps many, with
mental health disorders, the
lifestyle advocated by
sociologist Marina Kromar is
more conducive to good
mental health.
For those with any mental health
disorder, the Association for Natural
Psychology recommends a completely or
relatively “screen-free” lifestyle,
especially during the first six months to
one year of recovery.
 Pornography
and Mental Health Disorders
• Pornography addiction and/or excessive
masturbation might also be a factor in
depression or bipolar disorder for some.
The absence of emotional bonding with
daily sexual stimulation can create a
vacuum of loneliness which leads to
depression or emotional, behavioral, or
psychological instability. Real relationship
might become more difficult to manage in
view of solitary sexual stimulation.
University of Texas study links female masturbation to depression.
Sexual Functioning and Self-Reported Depressive Symptoms Among
College Women. Penny Frolich, Cindy Meston, University of Texas, Austin
(2003) http://homepage.psy.utexas.edu/homepage/group/MestonLAB/Publications/depress.pdf
 Self-Help
Overcoming Pornography
University of Texas at Dallas
Addiction
Ideas for Changing Pornography
http://www.utdallas.edu/counseling/pornaddiction/ Usage
How would you know if •Change routines and environments that
your lead to pornography usage. Avoid high risk
pornography use is situations.
harmful •Make a list of the positive and negative
to you? consequences of using versus not using
pornography.
• The use feels like it is out •Spend less time alone. Review the status
of your control. You make of your friendships and relationships. Are
unsuccessful efforts to they meaningful and satisfying? If not,
quit or limit your use. what would make them more fulfilling?
• Your use of pornography •Learn new ways of coping with strong
is incompatible with your feelings like anxiety, loneliness, anger,
beliefs and values. You depression, and boredom.
feel guilt, shame, •Identify activities that can help you relax,
depression, and/or enjoy yourself, and feel refreshed.
 Psychotherapy, Talk and
Cognitive Behavioral Therapy
• Various psychological therapies can also be as
effective as psychiatric drugs in the short and
long-term for many.

Therapy" by Ambro courtesy of FreeDigitalPhotos.com

http://www.freedigitalphotos.
 Cognitive Behavioral Therapy as
Self-Help
• Cognitive behavioral therapy
can be employed as a self-
help tool and mental health
strategy.

Learning to recognize and correct

common faulty reasoning or cognitive
errors can help some out of depression,
including depression associated with There are many books
similar to this self-help book.
bipolar disorder.
Coaching
Coaching for mental health, with its emphasis on practicality and
sticking to treatment plans and goals, is an excellent tool which some
have found as effective or even “more effective” than therapy.

• Life Coaching can be helpful for many high-functioning

adults experiencing mental health difficulties or disorders.

• Coaching for ADHD is totally mainstream and

well-developed, supported by professional
organizations.

• Coaching for Bipolar Disorder, is not as well-

developed, however, there are experienced
coaches who specialize in bipolar disorder, who
have helped many towards the goal of managing
bipolar disorder, and some to full recovery.
http://giantstepscoaching.com/category/home/
 Coaching for Bipolar Disorder

“I see it as my job to help balance the

individual and encourage him to change
some of his habits. For instance if he isn’t
exercising or sleeping properly, I focus on
those core habits then work on fine tuning
other habits. I find people with bipolar
disorder inherently unbalanced. I have to
teach it to them.” Bipolar disorder coach,
specialist, Bradley Foster.
 Art as a Professional Therapy
and as Self Help
• Professional Art Therapy can be a form
of therapy that is very effective for
many individuals for a wide variety of
mental health disorders. It can help
people to open up when they might be
reticent.
• Art as self help can be very effective
for most psychiatric disorders. It
soothes the mind, helps individuals
recover from stress trauma and is a
natural aid for anxiety.
Creating art can contribute to feelings of self
worth and self esteem, as well as to inner peace.
Art Therapy is not an alternative treatment

Art therapists are

board licensed,
and therefore art
therapy is not an
alternative, but
mainstream
psychological
treatment.

Art Therapy Photo: Creative Commons license

 Art as self help for mental health
disorders or difficulties
• In Brazil, a Rio De Janeiran middle aged woman went to her
doctor for help with anxiety. Rather than prescribe drugs, he
encouraged her to take up art. She began taking lessons, and
discovered she had a hidden talent. The art helped to relieve the
stress and anxiety she was experiencing, and to get through a
particularly difficult period of time in her life. She was 50 years
old when she took up art. These are some of her works.
 Music, Music Therapy
and Mental Health
• Music can have a positive influence on mental
health when the music is positive, individuals
listen to music moderately.
• A wide variety of music can have positive
affect on mood.

Stevie Wonder, as an example, is

known for quite a bit of positive,
catchy music. More recently,
Alicia Keys has some popular
positive music.
 Music Therapy can be effective when
administered in clinical settings or in
From:
outpatient settings.
American Music Therapy
Association, Inc.
How Does Music Therapy Make a Difference for Persons with Mental
Health Needs?
Music therapy is an efficacious and valid treatment for persons who have psychosocial, affective,
cognitive and communicative needs. Research results and clinical experiences attest to the viability of
music therapy even in those who are resistive to other treatment approaches. Music is a form of
sensory stimulation that provokes responses due to the familiarity, predictability and feelings of
security associated with it. Music therapy for clients with mental health concerns uses musical
interaction as a means of communication and expression. The aim of therapy is to help individuals
develop relationships and address issues they may not be able to address using words alone. Music
therapy sessions include the use of active music making, music listening, and discussion.
http://www.musictherapy.org/assets/1/7/MT_Mental_Health_2006.pdf
 Type of music is a factor
A Netherlands study indicates that the type of music
adolescents choose can affect behavior. Some behaviors
are symptoms of mental health disorders. Indirectly,
then, type of music can be a factor contributing to a
mental health diagnosis or label. Early Adolescent Music Preferences
and
Minor Delinquency. (2012, October 1).
Tom F.M. ter Bogt, PhD, Loes Keijsers,
PhDb, Wim H.J. Meeus, PhD.
Pediatrics.
http://pediatrics.aappublications.org/co
ntent/early/2013/01/02/peds.2012-
0708
Choices
in
Music
 When music is
• Too intense
• Negative
• Or the listener listens to immoderate amounts of
music
It can contribute to depression, destabilization, anger problems,
symptoms associated with bipolar disorder and other mental health
difficulties.

Bizkit - Break Stuff

 Influence of Type of Music
on Mood and Behaviors
The study states: “early fans of different
types of rock (eg, rock, heavy metal, Rock
gothic, punk), African American music
Heavy Metal
(rhythm and blues, hip-hop), and
electronic dance music (trance, Gothic
techno/hardhouse) showed elevated
minor delinquency concurrently and Punk
longitudinally. Preferring conventional
pop (chart pop) or highbrow music R&B
(classic music, jazz), in contrast, was not
related to or was negatively related to Hip-Hop
minor delinquency.”
Electronic dance
Because musical taste often follows into one’s adult years, the emotions and
behaviors acquired or influenced by certain types of music, for some, can be
a factor in mental health disorders as adults or young adults (18 and older).
 Natural Prozac
• Clinical psychologist
Joel Robertson
establishes such a
connection with music
and depression, where
the positive and negative
effects of music on the
listener are highlighted.
 Amount of Time Listening to Popular Music
Correlated with Major Depressive Disorder

Time Listening to Popular Music Correlated with Major

Depression - Major Depressive Disorder (MDD) - in
Adolescents - Researchers at the University of Pittsburgh
concluded that there is a correlation between Major
Depression and the amount of time an adolescent spends
with popular music. Conversely, Major Depression is
negatively, or reversely correlated with reading print media
such as books.
Though the study focused on adolescents, there are many adults,
especially those 18 through 25, for whom this might also be true.

Using Ecological Momentary Assessment to Determine Media Use by

Individuals With and Without Major Depressive Disorder.
April 04, 2011.
Brian A. Primack, MD, EdM, MS; Jennifer S. Silk, PhD; Christian R. DeLozier,
BS; William G. Shadel, PhD; Francesca R. Dillman Carpentier, PhD; Ronald E.
Dahl, MD; Galen E. Switzer, PhD. JAMA Pediatrics.
http://archpedi.jamanetwork.com/article.aspx?articleid=384518
 Positive adjustments in music
• Making adjustments in music habits from intense to less
intense.
• and listening to music in moderate amounts rather than
constantly – allowing for quiet time w/o external
stimulation.
• And by choosing positive rather than negative, anti-social,
dark or angry music.

"Shouting Woman Listening Music" by imagerymajestic "Piano" by healingdream

 As noted, the brain is a delicate
instrument

In the same way a little bit of sand can ruin a car’s engine, there
are many external factors which can cause the brain to
malfunction or not perform optimally.
"Human Brain" by ddpavumba
"Close Up Of Car Engine" by Stoonn“
Psychedelic Guitar" by dan
 Sensory Overload
The Manual of Nursing Diagnosis lists “sensory overload”
as a real condition, where “environmental stimuli” is above
normal levels. This can resulting in…
• Decreased cognitive • Decreased stress tolerance
capability • Restlessness
• Reduction in reasoning • Fatigue
ability • Increased anxiety
• Sleep disturbances, • Irritability
nightmares
• Loss of control
• Disorientation
• Short attention span
 Mental overstimulation through
excessive media channels such as
• Movies
• Television
• Music
can be adjusted to more moderate levels, or
even therapeutic levels, and this can have a
positive mental health affect.
However, the client/patient needs to be taught
new life habits or adjust their lifestyle
outside the clinical setting in order to
benefit from a lifestyle that is more
conducive to better mental health.
“Front View Of Screaming Young Woman Listening Music" by imagerymajestic
"Satellite Dish" by renjith krishnan
 Thoughts do not originate with
chemistry but with electrical charges.
• Thoughts are sparked through electrical, rather than chemical
charges.
The source of the
errant thinking
Mental disorders then,
must be
might more
considered, the
appropriately be
brain chemistry is
referred to in terms of
often an after-fact,
electro-chemical
or may have a
rather than as
source that is
chemical imbalances.
controllable or
modifiable.

• It is only after the fact, between the synapses of the neurons, from
thoughts already originating electrically, that the gap between
synapses is crossed by chemical impulses in the form of Neuron" by renjith
neurotransmitters. krishnan
 Addressing faulty thinking and external
stimuli, we come closer to the source.
By addressing thought and mood at its source, the
electrical charge, rather than concentrating on the
chemical neurotransmitter, we come closer to the source
of faulty thinking, mental health or mood disorder.

Image, Synapse,
courtesy of
Synapse Sheelam
Ohan

Some professionals consider referring to mental health disorders as a

“chemical imbalance,” as inaccurate.
 Differentiating between cause and effect

There are some 23 The thought is then

different types of converted back
neurotransmitters into an electrical
in the brain. signal as it runs
Thoughts start with through the next
electrical impulses neuron.
that run through The process is
the individual repeated through
neuron, nerve or, in millions of neurons,
this case, brain to complete the
cell. thought, and
The gap between possibly action of
neurons is referred the body.
to as the synapse. Effect The most well-
The electrical known
signal is converted Depression, neurotransmitters
to a chemical are serotonin and
signal, as it bridges
chemical imbalance dopamine..
the synapse.
of neurotransmitters
 SSRI antidepressants

SSRI antidepressants block the reuptake of serotonin into the

nerve cell, by “plugging up” reabsorption points or “holes,”
thus leaving more serotonin in the gap between the neurons.
 Cognitive Behavioral Therapy
Is more successful in treating depression and other mental health
disorders for some people, because it addresses depression at the
cause, and targets faulty thinking. It is assumed that the faulty
thinking causes the depression, or causes the ultimate chemical
imbalance of neurotransmitters, and that the chemical imbalance is
not the ultimate cause of the depression. The positive affect, then,
can be more long-term, as thinking and associated behaviors are
corrected or adjusted.

Cause Effect
Faulty thinking Depression,
chemical imbalance
of neurotransmitters
Pharmaceutical drugs address
symptoms rather than causes of
mental health disorders
• To illustrate: You can provide medicine to individuals with
malaria, and they will experience relief.
• However, the cause of the malaria is not a blood or organ
imbalance, but a parasite.
• The parasite is transmitted by a mosquito.

By killing the mosquitoes, you are

closer to the source of the problem.

Mosquito In Nature" by SweetCrisis

Cause Effect Model of Malaria
Cause Effect
• Stagnant waters • Proliferation of
mosquitoes infected
w/parasites

Effect/Cause Effect
• Proliferation of • Spread of malaria
infected mosquitoes
 Prevention in Mental Health
• By removing sources of
stagnant water, you address
the cause, and have come
closer to a permanent
solution for the mosquito
problem which is leading to
proliferation of mosquitoes,
which contribute to
widespread malaria.
• It is similar with mental
health.
• Prevention is an important
element of both health, and
Stagnant Water Photo by Evelyn Simak
mental health. geograph.org.uk
 Cause and Effect, continued
• Controllable biological causes of depression

Cause Effect Effect

• Poor nutrition • Poorly nourished • Depression
• Skipping meals such as brain
breakfast and lunch

Cause Effect Effect

• Need for exercise • Shortage of certain • Depression
neurotransmitters
 Naturally and gently adjusting
brain chemistry
In Natural Prozac, clinical
psychologist Joel Robertson
suggests numerous natural ways
to adjust the brain chemistry at
the source level, the causal level.
This includes nutrition, exercise,
as well as by adjusting the level
of stimulus through controllable
environmental stimuli, such as
music input type, intensity and
amount.
 Green Therapy
Regular periods of time spent with nature has
positive affect on:
• Depression
• ADHD
• Bipolar Disorder
• OCD
• Other mental health disorders

A Potential Natural Treatment for Attention-Deficit/Hyperactivity Disorder: Evidence From a National Study. Frances E. Kuo, PhD,
and Andrea Faber Taylor, PhD
http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.94.9.1580?hits=10&andorexactfulltext=and&FIRSTINDEX=0&searchid=1&resourcet
ype=HWCIT&RESULTFORMAT=&sortspec=relevance&maxtoshow=&fulltext=%22green+time%22%2C+television&
Exercise and Depression. (Retrieved August 3, 2009). Harvard Mental Health Letter. https://www.health.harvard.edu/newsweek/Exercise-
and-Depression-report-excerpt.htm
Mind Launches Green Agenda for Mental Health. Ecotherapy vs. retail therapy. (2007). Heliq.com. From Heliq database:
http://www.huliq.com/21526/mind-launches-new-green-agenda-for-mental-health
 Sleep
• Rather than classifying problems with sleep or a sleep
disorder as a symptom of a larger disorder, such as bipolar
disorder,
• Addressing the issue itself provides a more practical way
of dealing with issues having to do with sleep.
Mayo Clinic states:
“If you have chronic insomnia, a
better
approach may be to remove the
cause by
changing your lifestyle.”
 Sleep
Sleep can be like the head pin, when
addressed, negate other symptoms that are
caused by the issues dealing with sleep.
For example, better sleep
results in:
-better focus
-less anger
-less irritability
-mood stability
-better judgment

Woman Asleep" by Danilo Rizzuti - Bowling" by Salvatore Vuono

 Addressing sleep issues
Is an example of how focusing on solving the problem
rather than assigning a label results in a better solution
towards improvement in mental health.

"Sleepless And Thoughtful" by David Castillo Dominici

 Positive Lifestyle Changes
can result in lasting improvement in mental health
and can remedy symptoms of even very serious
mental health disorders.

• Awareness
• Incentive
• Education
• Self-Monitoring

can provide impetus for positive lifestyle changes

and a long-term solution.
 Counseling and help with
practical areas of life such as

• Handling finances
• Debt
• Self-sufficiency and
• Employment

are also of importance for stability and good

mental health.
 Studies indicate that Spirituality
can positively affect mental health
and even physical health.
“Across all five [major] faiths, a greater
degree of spirituality was related to better
mental health, specifically lower levels of
neuroticism and greater extraversion.”
In this study, “forgiveness” was the
spiritual trait most predictive of good
mental health, after personality variables
were considered.

Science Daily. Aug 20, 2012. Referring to University of

Missouri researchers’ clinical study.
http://www.sciencedaily.com/releases/2012/08/120820132332.htm
Man Keep His Hands On Head" by
photostock
Rest and Relaxation,
Balance
For some, taking a break from a hectic
schedule, daily, restful vacation periods, and
developing more balance can be preventive and
therapeutic in terms of mental health disorders
and good mental health.
 Character Development
Developing qualities such as

• Integrity
• Honesty
• High ethics

Contributes to good mental health. Someone in the habit of lying to

escape consequences or criticism, for example, can create mental
battles with in his or her own, adding to anxiety, stress and depression.

A minister noted, “There is no pillow so soft as a clean conscience.”

"Pointing Truth On Blackboard" by Stuart Miles - www.freedigitalphotos.net

 Giving and receiving of love is an
important element of good mental health
• Love has been described as “the best
prescription.

Social factors Love is a

can play a universal
major role in psychological
mental health. need.

"Smiling Teenage Girls" by Ambro

 Part II
Models of Mental Health
 Medical Model

The modern “medical model” of psychiatry with emphasis

on genetics and biology stresses…

1. Identifying mental health disorders with a label

which matches a list of symptoms.

2. Prescribing pharmaceutical drugs deemed

appropriate for that specific mental health disorder.
 Psychiatric Labeling
Child psychiatrist Scott Shannon, who
sometimes uses psychiatric medication
in his treatment of children, states that
he often finds he gets better results by
addressing the specific issues and
problems of the individual child, rather
than assigning a label.
The result is that fewer children need to
be prescribed a psychiatric drug, and
more are helped to recovery and
stability.
The same approach can be beneficial in
addressing mental health disorders with
adults.
 Other viable models
of mental health include
• Urie Bronfenbrenner's Bioecological Model
• Engel’s Biopsychosocial Model
• Zubin’s Vulnerability-Stress Model
• Positive Psychology (Penn State)
• Strengths Model
Aspects of these models provide a more complete foundation
on which to build, as opposed to the medical model, with its
emphasis on genetics and non-controllable biological
functions with corresponding pharmaceutical treatment.
 Engel’s Biopsychosocial Model
Engel’s biopsychosocial model of mental
health, as an example, places equal
emphasis on

1. Biological
2. Psychological
3. Social factors
"Open Mind" by Idea got
 Biological Factors
Some biological factors may be
genetic, what can be referred to as a
“genetic predisposition,” but some are
not, and are controllable.

e.g. Diet, including three balanced,

healthful meals a day, is both
behavioral, biological and modifiable.
It can also have psychological roots,
when individuals do not eat regular
meals out of fear of weight gain, or
from anxiety rooted in social isolation.
"Fresh Vegetable Salad" by dusky
 Psychological Factors
of mental health disorders
One individual, male, who suffered from seasonal
debilitating depression experienced permanent relief after
talking to a minister, openly, for the first time, about child
abuse he experienced in his formative years.

"Dad Scolding His Son" by David

Castillo Dominici
 Social Factors
Marital discord, for example, a
social factor, may result in anxiety
or depression. Family therapy of
marital counseling, then, can
provide a more permanent and
practical solution to what, in this
case, is really a symptom,
depression.

• Verbal or emotional abuse

• Isolation
• Need for emotionally-bonding relationships
• Need for fulfilling secular work or
• More fulfilling life purpose
"Young Couple" by imagerymajestic
 Loneliness
Can precipitate depression as another example. There can
be practical solutions for the problem of loneliness.

"Sad Woman
Sitting Alone In
Room" by
FrameAngel
 A “Multi-Causal” Approach to
Mental Health Disorders

Clinical psychologist and university professor

of psychology, Donald J. Kiesler, PhD,
develops the theme that the “biological” or
“medical model” of mental health needs to be
abandoned, in favor of a “multi-causal”
approach, which includes both biological,
social and psychological factors, logically
developing this idea in the book, Beyond the
Disease Model of Mental Disorders.
 Psychiatric facilities
should consider
• Placing less emphasis on the medical model of mental
health and pharmaceutical treatments
• And more emphasis on helping the client/patient to
develop skills, work through problems and develop better
lifestyles which are more conducive to mental health.

While genetics Lifestyle can be

cannot be controlled controlled
 Part III
Issues with Psychiatric Drugs
 Issues with Psychiatric Drugs
While there are potential many “issues” with psychiatric
drugs, this section touches on only three:

• Side Effects
• Risks
• Drug Cocktails
 Side Effects
One of the most common complaints about
pharmaceutical drugs prescribed for mental health
disorders is side effects, some of which can be serious.
 Serious
Side Effects

All prescription drugs prescribed for psychiatric disorders have

side effects. Some of these range from “not feeling myself” to
lethargy and fatigue, sleepiness and sleeping long hours, being
unable to work, to a host of other side effects, including some
which can be life threatening in the long-term, such as diabetes
from pharmaceuticals prescribed for bipolar disorder.
There are benefits vs. risks
in the decision to take psychiatric drugs
 “Many of the two-
thirds of those with
Antidepressants depression who do
not respond fully to
antidepressants are
example of risks vs benefits three times more
likely to improve with
cognitive behavioral
Carry benefits and risks therapy, the
Benefits: Can help relieve depression in 33% to 50% of researchers report.”
individuals who take antidepressants. MedLine Plus. 2012
Risks: 1). Do not provide relief for up to 50% to 67% of those who take
antidepressants. (Medline Plus. Dec 7, 2012).
http://www.nlm.nih.gov/medlineplus/news/fullstory_132017.html

2). Can cause sexual dysfunction in up to 70% who take antidepressants

(most common reason for discontinuation). (Primary Psychiatry).
http://www.primarypsychiatry.com/aspx/articledetail.aspx?articleid=1362
3). Antidepressants can stop working
in a short or long period of time. (Mayo Clinic).
http://www.mayoclinic.com/health/antidepressants/AN01312
4). Can double risk of suicidal ideation from 2% to 4%,
among certain age groups (under 25 years old).
http://www.bmj.com/content/339/bmj.b2880

5). Can contribute to development of bipolar disorder in

some individuals. (University of Maryland. 2011)
 SSRI Antidepressants
examples of risks
1. SSRI antidepressants, for example, can result in a greater propensity
(double, from 2% to 4%) towards suicidal ideation for certain age groups
(under 25 years of age). For this reason, the FDA requires black box warnings
on most SSRIs clearly stating this risk. (BMJ Group. 2009).
2. Antidepressants also can result in sexual dysfunction,
with up to 70% of those who take them. Many quit taking
antidepressants as a result. (Primary Psychiatry. 2003)
3. Antidepressant use can contribute to the development of
bipolar disorder. (University of Maryland. 2011)
“Many studies indicate that antidepressants may cause patients to “switch” to a
manic state. Any patient with bipolar disorder who takes antidepressants and
who develops symptoms of hypomania should stop taking these drugs, because
hypomania is often a sign of impending mania.” University of Maryland
Medical Center. 2011.
http://www.umm.edu/patiented/articles/what_electroconvulsive_therapy_other_procedures_bipolar_disorder_000066
_8.htm#ixzz2MiXfiMXy
 SSRI Antidepressants and Sexual
Dysfunction – 59%
(Mean age 40 – 1,022 surveyed. Primary Psychiatry. 2003. – Peer reviewed).

“Because antidepressant-associated sexual

dysfunction is considerably underestimated by
physicians, greater recognition and education are
imperative when prescribing antidepressant treatment.”
Prevalence of sexual dysfunction among newer antidepressants. Clayton AH, Pradko JF, Croft HA, Montano CB,
Leadbetter RA, Bolden-Watson C, Bass KI, Donahue RM, Jamerson BD, Metz A. Department of Psychiatric Medicine,
University of Virginia. Journal of Clinical Psychiatry. 2002 Apr;63(4):357-66. http://www.ncbi.nlm.nih.gov/pubmed/12000211

“Sexual dysfunction can adversely affect quality of life, self-esteem, and interpersonal relationships. These
effects are of particular concern among patients with depression, in whom these issues may already be
compromised. Moreover, antidepressant-associated sexual dysfunction may lead to medication noncompliance
and premature discontinuation and thereby may increase the risk of relapse or recurrence of depression.10,11
In an open-label study of 1,022 patients with a mean 40 years of age, 59.1% reported antidepressant-
associated sexual dysfunction.10 10. Montejo AL, Llorca G, Izquierdo JA, et al. Incidence of sexual dysfunction associated with antidepressant agents: a
prospective multicenter study of 1022 outpatients. J Clin Psychiatry.2001;62(suppl 3):10-21.

Sexual dysfunction can contribute to marital problems, further

exacerbating causes of depression or other mental health disorders.
 Suicide risk is lessened
with intervention
Standard treatment involves use of antidepressants.
However, intervention and support in itself, may be the
greatest reason for lessened risk of suicide, rather than use
of psychiatric drugs, for many.

In other words, not all positive

affect of mental health treatment
is attributable to medication. There
are usually many other interventions
taking place at the same time.
 Patients should be Fully Informed
• Psychiatric patients should be fully informed of the benefits vs.
risks, both long and short-term, of specific psychiatric drugs as
well as those of non-drug complementary or optional treatments.
• A realistic view of psychiatric drugs needs to be communicated
between mental health professionals and patients, rather than an
idealistic view.
• Self-determination is not a challenge to the psychiatric
establishment, but is a right of each individual, a core human right.

vs
Illustrations by
Stuart Miles
www.freedigitalp
hotos.com
 Vigorous marketing
by pharmaceutical corporations
In Blaming the Brain, by Michigan State University professor of
psychology, Elliot Valenstein, PhD, evidence is provided that the
current emphasis on prescribing psychiatric drugs, is, in part, due
to vigorous and continuous marketing on many levels, from
pharmaceutical corporations, from the 1960s through the present.
Marketing practices are sometimes unethical or misleading.

Big Pharma by Jacky Law. Creative Commons License

 Drug Cocktails
Drug cocktails, when a patient is prescribed 3 to 10
different types of medications, can leave a person largely
incapacitated and feeling groggy most of the day.

Photo: RayNata – Creative Commons

 Effects of “Drug Cocktails”
One middle aged woman who had been
diagnosed with bipolar disorder, found
herself on a vigorous drug regimen
within several years of her diagnosis.
She was prescribed 9 different drugs to
the point that she began to lose her
memory and coherence.

Her husband said, “I am losing my wife,” not due to the mental

illness, but due to the serious side effects of the “drug cocktails”
that she was being prescribed. He felt constrained by his health
insurance to pursue other options.
Drunk or “high” on psychiatric drugs

Some have said that they “feel drunk” on

pharmaceutical drug treatments. One
who was treated in a psychiatric facility
in Newark, NJ stated that the psychiatric
drugs made him “high”.

"Girl Drinking Wine" by Dundee

Photographics –
www.freedigitalphotos.net
 Side Effects and Complications
from psychiatric drug treatment warrant

1. Education of the
client/patient and
their family
2. Freedom of
choice in treatment
and

3. Vigorous
attention to This presentation does not provide details on all of the
serious side effects or deleterious effects of psychiatric
effective non- medications, which are researchable, but side effects are
pharmaceutical serious enough to warrant freedom of choice in treatment,
approaches and vigorous attention to effective non-pharmaceutical
approaches.
Sleeping Businessman At His Desk" by imagerymajesti
 Two Doctors
Two Approaches
• A man comes to the doctor with a back problem.
One doctor recommends

Surgery The other doctor recommends a less invasive

Surgery photo courtesy of arztsamui. Fitness Men
measure involving exercise and massage before
Stretches His Leg" by photostock - Free Digital considering surgery.
Photos.com
The less invasive measure works
Within 6 weeks the back problem has largely
been relieved and surgery is avoided.
(true experience)

Back Pose Of
Male Doing
Exercise" by
imagerymajestic
- Free Digital
Photos.com
 Similar with mental health
By focusing on non-pharmaceutical solutions involving
positive lifestyle adjustments, developing coping skills,
developing social relationships and practical areas of life,
the “more invasive” pharmaceutical approach can often be
circumvented. A better long-term outcome is the result. A
better short-term outcome often often results as well.

“Teach Skills Not Pills”

 Part IV
Psychiatric Facilities and Professional
Approaches Towards Reduced
Emphasis on Pharmaceuticals
Gaining Autonomy with Medication
(GAM)
In Quebec Canada this movement, (GAM), in
association with mainstream psychiatric services, is
giving adults with mental health disorders a measure
of self-determination over their treatment, with good
results.

Many in the program have recovered from their serious

mental health disorders and have been able to
manage their mental health disorder without
medication, or experience their mental health
disorder go into remission.

Regroupement des ressources alternatives em sante mentale du

Quebec http://www.rrasmq.com/gam_guide.php
Some patients desire to
reduce or eliminate their
psychiatric drug regimen.
As an example, using this method, one
professional with bipolar disorder was able
to successfully cut back her lithium dosage to
a non-therapeutic level, about 1/3 of the
dosage recommended by her doctor, and
remain stable. Thus, it eliminated many of
the greivious side effects she was
experiencing. Against her doctor’s advice,
but she insisted. Telephone conversation,
January 2013. Sacramento, CA.

Taking Back Control (GAM method).

Acknowledging that some may feel totally comfortable with their current
psychiatric drug treatment, and do not wish to make any changes, others
might strongly desire to cut down on, and others may desire to cut out
completely taking psychiatric drugs.
All three personal choices are valid and possible.
 Others with Bipolar I, Bipolar II
and Schizophrenia
• Have reduced
• Or come off completely psychiatric
drugs

maintaining stability and good mental

health, according to the lead social
worker of the Quebec GAM program.

Taking Back Control: My Self

Management Guide to Psychiatric
Drugs is used as a guide in this
process.
 The book
Taking back control:
My Self management Guide
to Psychiatric Medication,
used in conjunction with
Gaining Autonomy with Medication (GAM)

serves as a balanced guidebook for those who

wish to reduce the amount of psychiatric
medication they are on, or who wish to try to
cut out psychiatric medication from their
treatment. It is being used successfully and
safely by adjunctive professional mental
health service providers in Quebec in
conjunction with mainstream psychiatric
treatment.
 This publication was funded by the Quebec
Ministry of Health and Social Services (MSSS)

http://www.msss.gouv.qc.ca/en/
 Benefits
* Better Quality of Life
* Greater Short-Term Success
* Better Long-Term Outcomes
* Lower Relapse Rate

Professional mental health facilities

which address the issues discussed in this
presentation such as is being accomplished in
the Quebec, Canada mental health system, are
of value and in the patient’s best interests,
contributing to a better quality of life for the
client and their family.

Mother And Children" by photostock

Medical needs associated with psychiatric
drugs that psychiatric hospitals can address

• Some need to safely detoxify from

prescription drug over-prescription.

• Many who have addressed core issues

contributing to a mental health disorders
would like to try coming off psychiatric drugs,
but are afraid to.
 Cutting down on and coming off
psychiatric drugs
• While most psychiatric hospitals are designed to
prescribe treatment, professional facilities are
also needed to assist some to cut down, manage
or come off of treatment, in a balanced and
professional, orderly and safe way.
 Effective Mental Health
Treatment includes
• Education • Self help
• Bibliotherapy • Lifestyle changes
• Prevention • Developing Coping
Skills
 Recovery and education

Patients/clients should be aware that there are

balanced and helpful sites and books, which provide
suggestions and resources that can help many to
improve, and some to fully recover from a wide
range of mental health difficulties and disorders.
 Good Self Help Resources
There are many excellent self help resources online for depression
and bipolar disorder, as well many excellent self help books.

Depression and Bipolar Support Alliance

 Self help webpages, sites
The AYCNP features pages on self help for depression,
bipolar disorder and other mental health disorders.
HELPGUIDE.ORG
Has excellent information on effective
bipolar disorder self-help
Books from the Association for Natural Psychology
 Thank you
for considering this information
The Association for Natural Psychology is
pleased to provide you with a small library of
self help books for your staff and patients.