Research Investigates Whether Vitamin Folate Helps To Treat Depression

Medical News Today
Feb 3 2007

New research commissioned by the NIHR Health Technology Assessment (HTA) programme is looking into whether the vitamin folate can help in the treatment of depression. One in five people experience depression during their lives and only half of these people respond to antidepressant treatment.

Folate, a vitamin found in foods such as green vegetables, helps to produce chemicals that regulate brain functions, including mood, sleep and appetite. A Cochrane review concluded that folate may have a role as a supplement to other treatments for depression, but the evidence is limited and primary research is needed to test this.

“Antidepressants work by improving the way certain chemical messengers work in the brain and folate helps produce the chemicals needed for this process,” says Professor Ian Russell of the University of Wales Bangor.

“Low levels of folate from a poor diet or similar factors could worsen depression and stop antidepressants from working optimally.”

Researchers in Wales led by Professor Russell are set to conduct the biggest randomised controlled trial of its kind to test whether a folate tablet taken daily by people with depression will help their antidepressants to work better. In addition to their antidepressants, participants will be given either a folate tablet or a dummy tablet for three months. Researchers will ask them about the effect this has on their depression, and take blood samples to corroborate this.

“We welcome this research initiative into the potential of folate to enhance the effect of anti-depressant medication,” says Lindsay Foyster, Director of Mind Cymru. “If the research proves folate to be efficacious then an easily acquired simple supplement or an informed improvement in diet could make a significant contribution to the self management of depression.”

For more information visit:



1. The HTA programme produces high quality research information about the effectiveness, costs, and broader impact of health technologies for those who use, manage and provide care in the NHS. This is a programme of the National Institute for Health Research ( and is the largest and longest running of the national programmes with 340 projects published since its inception in 1993. About 50 are published each year, all available for download free of charge from the website. It is coordinated by the National Coordinating Centre for Health Technology Assessment (NCCHTA), based at the University of Southampton.

Visit for more information.

2. Mind (National Association for Mental Health) is the leading mental health charity in England and Wales and works to create a better life for everyone with experience of mental distress.

Visit for more information.

For further information please go to:
National Institute for Health Research And
University of Southampton

York uni expert calls for radical rethink for therapies

The Press (York)
Jan 19 2007

AN EXPERT in mental health at the University of York has called for a radical reform of psychological therapies across the country.

Professor David Richards, of the university’s Department of Health Sciences, said despite being “both effective and highly valued” by patients, no more than one per cent of people with anxiety or depression receive such therapy.

But, in a seminar to the Dr Foster Ethics Committee, he argued traditional treatments were not the answer.

Prof Richards said: “People with common mental health problems such as depression and anxiety tell us they want help which is convenient, acknowledges their own strengths and is culturally appropriate.

“We are now pioneering ways of helping people by recruiting new workers from the same culture, the same class and the same community as the people they serve. These workers operate in the community, with the community and for the community.”

In a pilot scheme in Doncaster, Prof Richards and his team have designed a new method of helping people with anxiety and depression. Within 24 hours of seeking help they are phoned by a new case manager, who organises a recovery programme based on education and self-help.

Almost all the treatment is delivered on the phone, making it quicker and more convenient for patients. More than 300 patients a month are being dealt with by the service.

He said: “In all public services, people have demanded greater visibility and higher quality. The police service and traffic management are examples where new support officers have been a resounding success. Our case managers are the community support officers of psychological therapy.

“The NHS now faces a choice between a system which will perpetuate existing inequalities versus a system which will embed psychological therapies in people’s own communities. It is a choice between investment in a system which has failed us in the past versus investment in change.”

Books prescribed to patients in UK

Wiltshire Times
Jan 15 2007

PATIENTS are being prescribed self-help books by GPs to complement more traditional treatments, thanks to an innovative new scheme in Wiltshire.

Designed to help patients cope with common psychological and emotional difficulties such as anxiety, depression and stress, it enables health professionals to prescribe highly recommended self-help books.

Books on Prescription is a partnership between Wiltshire County Council and Wiltshire Primary Care Trust.

The books have been chosen by doctors, psychologists and counsellors from those which have proved useful to patients in similar schemes across the country. The doctor issues a prescription’ for the recommended book, which the patient then takes to their local library.

All the county’s main libraries hold copies of the books, or they can be requested free of charge from any Wiltshire library.

The scheme falls within Wiltshire County Council’s goal to be the healthiest county by 2010.

Head of primary care psychology in Avon and Wilts Mental Health Partnership, Dr Liz Howells, said: “There is good evidence to support this scheme and it means GPs have more options to offer their patients.”

Tessa Cozens from Wiltshire Libraries said: “It is easy to borrow a book on prescription, even if you are not already a library member. Simply hand in your prescription and say you need to join.

“Think of your library as you would your local pharmacy – a place where you get a friendly, professional and confidential service,” she added.

For more details on any of Wiltshire County Council’s services, please visit

Depression: Ten Self-Care Strategies

Toronto Daily News
Dec 7 2006

There’s no quick fix for depression. Even if you are under medical care and taking antidepressant medication, improvement takes time.

There’s no quick fix for depression. Even if you are under medical care and taking antidepressant medication, improvement takes time.

The December issue of Mayo Clinic Women’s HealthSource offers five self-care strategies that can help you feel better and reduce the risk of recurrence.

1. Keep active. As little as 15 to 30 minutes of physical activity most days has been shown to improve mood. Long-term regular exercise can help prevent recurrence.

2. Eat well. A well-balanced eating strategy will help you feel better now and later as you battle depression.

• Eat more whole grains, beans and vegetables. They provide a longer-lasting energy source than processed baked goods and sugar.

• Eat regular meals, especially breakfast. Regular meals avoid the irritability and overeating that can come from skipping meals. Both can lead to worsening of depression.

• Increase your intake of cold-water fish such as salmon, halibut, tuna and bluefish. Research indicates that the omega-3 fatty acids in these cold-water fish may help reduce symptoms of depression.

• Avoid alcohol and caffeine, which can contribute to depression and anxiety.

3. Get adequate sleep if you feel depressed. Aim for eight hours a night, and be consistent with bedtime.

4. Control stress. Coping with depression is stressful enough, so try to limit other sources of stress.

5. If you need a break, take it, even if it’s just a day trip or weekend getaway.

6. Recognize stress signals and slow down. Is your stomach upset? Are you forgetting things or feeling extra irritable? Take notice of your signals and do something about it.

7. Stay connected. Make relationships a priority. Social ties give you a sense of purpose and meaning in life which is important when you suffer from depression.

8. Recognize the importance of give and take. It’s true you should give of yourself in a relationship, but it’s also important to receive from others, especially when you are depressed.

9. Cultivate your spirituality. Studies have shown that believing in something larger than yourself strengthens your ability to cope with depression.

10. Avoid negative and unhealthy connections that might bring you down.

A Season of Suppers – Let’s help Meals on Wheels feed pets too!

Those who know me know that I’m a big believer in a better quality of life through the power of pet love, for the elderly and persons with disabilities. I’d like to ask you to consider giving to a wonderful program this holiday season, “A Season of Suppers,” which will provide pet food along with hot meals via the Meals on Wheels program.

A program like this has been on my Wish List for a long time. Wishes do sometimes come true. :)

More from Associated Press:

Nov 23 2006

FORT WORTH, Texas – When 87-year-old Lucille Mann knits, her 2 1/2-pound dog Pepper curls up beside her or nuzzles in her lap.

“I just don’t know what I’d do without her because she’s my life,” she said.

Realizing the two are inseparable, Meals On Wheels of Tarrant County not only delivers daily meals to Mann, but also drops off some pet food for her treasured Chihuahua.

About a fourth of the Fort Worth chapter’s 400 clients receive free pet food in addition to daily meals. The chapter started providing cat and dog food five years ago after volunteers noticed a growing number of clients feeding pets from their own plates.

This holiday season, the Meals On Wheels Association of America and Banfield, The Pet Hospital are teaming up to help needy seniors nationwide feed their pets.

They hope to collect 1 million pounds of critter vittles at 575 Banfield veterinary hospitals across the country during a two-month pet food drive called “A Season of Suppers.” Since the cause started earlier this month, donation boxes have been filling up quickly, so volunteers are already making deliveries.

“The holiday time is when there is a more acute awareness of people in need, especially seniors who may not have other relatives and are really more isolated than the general population,” said Sandy Campbell, president of Banfield Charitable Trust, the veterinary practice’s nonprofit organization.

Portland, Ore.-based Banfield and Meals On Wheels also are accepting monetary donations in hopes of raising $100,000 for the meal-delivery agency’s “We All Love Our Pets” program. The pet food program already helps seniors in Fort Worth, Fort Lauderdale, Fla., and Sacramento, Calif. and the agency would like to expand into other communities.

“It’s truly awesome they’re doing this,” said Janine Brown, program manager of senior nutrition services at the Sacramento County Department of Human Assistance. “Not only do seniors not have to share their food, which isn’t healthy for pets, but they can keep the limited amount of income for their medicine and electric bills.”

Elizabeth Escontrias and her brother, Manuel Valle, who live in Fort Worth, said their lives are enriched by their several cats and five small dogs, including a feisty 11-year-old Chihuahua named Bad Girl whose tongue always hangs out.

But feeding them is difficult on a fixed income, they said.

“I’d have to give them away if they (Meals On Wheels) didn’t help me,” said Escontrias, 68. “Our animals are just like family. They’re our little children.”

Meals On Wheels provides food for homebound people age 60 and older. Many are low-income, although there is no minimum income requirement.

Though the priority is providing meals to seniors — four in 10 Meals on Wheels chapters nationwide have waiting lists — the agency says the pet food program improves the quality of life for its clients.

“For most of our clients, their pet is probably the most important thing in their lives. It’s their family and the only friendly face they see,” said Enid A. Borden, CEO of Meals On Wheels Association of America. “That’s why this program is so important.”


On the Net:

Meals On Wheels Association of America:

Banfield, The Pet Hospital:

Free self help course now online through Jan. 3

Lincoln Today
Nov. 1, 2006

Your computer or laptop might not be the first place you’d turn to if you’re feeling depressed but thanks to charity, the Mental Health Foundation, help is literally at hand.

The Foundation has teamed up with interactive healthcare specialists Ultrasis to offer free access to an online self-help programme for anybody experiencing mild or moderate depression.

The programme launches today and uses proven Cognitive Behavioural Therapy practices that will allow users to go at their own pace learning self-help techniques to help them manage their depression.

The online programme should mean more people receive treatment, quicker.

Andrew McCulloch, Chief Executive of the Mental Health Foundation, said, “Cognitive Behavioural Therapy is widely accepted as one of the most effective and practical methods for treating depression, but not everybody is able to or wants to visit a therapist.

“Depression Relief is an online self-help programme that can be accessed anytime, enabling a person to use it at their own speed and in a place that suits them.”

The programme will be free to use for those aged 18 and over from today until January 3 2007.

Click here to access online program.

Free computerised CBT for depression online
Nov 6 2006
EHealth Insider

Free computerised cognitive behavioural therapy (CCBT) for depression has been made available online after a deal between software developers Ultrasis and the Mental Health Foundation.

The online self-help program, Depression Relief, is available for a free four-week trial from a link on the Mental Health Foundation website. The system is a cut-down version of Ultrasis’ Beating the Blues and will run between now and 3 January, 2007.

Moira Frasier, head of policy at the Mental Health Foundation, told E-Health Insider: “The Depression Relief website will be like a self-help group online, based on CBT principles and detailing alternative forms of therapy for help. It will allow users to check for help themselves, rather than spend a long time waiting for availability to see your hospital CBT therapy specialist.”

Ultrasis already work with the NHS using CBT with its Beating the Blues computer based treatment for depression. The software is initially being rolled out in Newham and Doncaster as part of a pilot scheme, with a view to full implementation across the NHS by March 2007.

The free Depression Relief software is a specially-created, patient-accessible version of the Beating the Blues software. It will allow users to go at their own pace through each step, learning self-help techniques to manage their own condition.

Frasier told EHI: “Often, you find that searching for therapy online doesn’t always give patients the best choices and recommends non-prescription drugs as remedies. Depression Relief will offer patients proper therapy and they can see other patients’ feedback as a motivation tool.”

Andrew McCulloch, chief executive of the Mental Health Foundation, added: “CBT is widely recognised as one of the most effective methods for treating depression, yet there is a major shortage of therapists. Most people who want to try CBT have to join long NHS waiting lists or pay to see a therapist privately.

“While online CBT is not a replacement for face-to-face therapy, we need to start investigating other supporting treatments that with mental health problems can use.”

Nigel Brabbins, chief executive of Ultrasis, said that they hoped the free trial would help to raise awareness of available CBT therapy options.

“We want people to know that the tools and techniques for prevention and treatment are available without having to wait to see a therapist. Cost-effective online programs need to be more widely available and we hope to reach as many people as possible through the Mental Health Foundation’s website who may want help when NHS services are not available.”

In February 2006, the National Institute for Clinical Excellence recommended Beating the Blues and another package called FearFighter for people with mild panic and phobia.


Pardon me while I break from ECT stuff and scream: WORLD CHAMPIONS ST. LOUIS CARDINALS!!!!

I’ve waited 24 years for this – the last time Cards won the series, I happened to be living in the former Soviet Union and had no TV, no news. My only link to the west was VOICE OF AMERICA and that’s where I learned it.

Cardinals baseball: I LIVE FOR THIS!!!

YADI YADI YADI! (And I’ll always love Jim Edmonds…woo hoo!)
Congrats to my beautiful Cardinals. Detroit – be proud of what you’ve done…you’ll be back. Detroit rocks!



Free online self-help program from UK MH Foundation – through Jan. 3, 2007
Sept. 26, 2006

From the 1st November to 3rd January, visitors to the Mental Health Foundation’s website will be able to get free access to Depression Relief – an online self-help program that uses Cognitive Behavioural Therapy techniques. The program is being made available by Ultrasis, the healthcare company that developed Beating the Blues, the only computer based treatment for depression recommended by the National Institute for Health and Clinical Excellence (NICE) for use in the NHS.

Used by Primary Care Trusts in the United Kingdom and employee healthcare providers in the United States, Depression Relief is suitable for anyone experiencing mild or moderate depression. The confidential program allows users to go at their own pace, learning self-help techniques which can help them manage their condition.

“Cognitive Behavioural Therapy is widely recognised as one of the most effective methods for treating depression, yet there is a major shortage of therapists,” said Andrew McCulloch, Chief Executive of the Mental Health Foundation. Most people who want to try Cognitive Behavioural Therapy have to join long NHS waiting lists or pay to see a therapist privately. While online CBT is not a replacement for face-to-face therapy, we need to start investigating other supporting treatments that people with mental health problems can use.”

“Mental health problems can have a negative impact on the well being of any one of us. We want people to know that the tools and techniques for prevention and treatment are available without having to wait months to see a therapist,” said Nigel Brabbins, Chief Executive of Ultrasis Plc. Cost effective online programs need to be more widely available and we hope to reach as many people as possible through the Mental Health Foundation’s website who may want help when NHS services are not available.”

Visit between 1 November 2006 and 3 January 2007 to get free unlimited access for four weeks. You will need broadband access to the Internet. Depression Relief has been designed for those aged 18 and over. The Mental Health Foundation strongly recommends that people should seek professional medical advice if they are concerned about their mental health.

Doctors prescribe self-help books

The Scotsman
Sept 6, 2006

SELF-HELP books are being made available on prescription in an attempt to tackle depression, eating disorders and other mental-health issues.

The scheme allows patients to borrow the books anonymously from local libraries for up to six weeks. The initiative has been introduced in Fife and Glasgow, and if successful it is likely to be extended to other health authorities across Scotland.
Click to learn more…

Depression is the most common condition recorded by family doctors in Scotland.

Statistics show that more than 300,000 Scots visit their doctor each year because of stress or depression.

But it is estimated that 75 per cent of people with depression do not seek treatment.

Experts believe part of the problem is that many people – especially young men – are too embarrassed to ask for help.

They hope prescribing the books will allow many people with mental-health problems to treat themselves in privacy, without the need for attending therapy sessions.

The books offer complete step-by-step treatment programmes, including exercises, self-assessments and diary sheets.

Alan Freeburn, a psychologist with NHS Fife, said that similar schemes running in Wales had been very successful in treating comparatively minor mental-health problems.

He added: “Libraries are already well stocked with self-help books, but many people are unaware of the range that is available, or which one would be right for them.

“It can be very embarrassing for people to go into a library or bookshop and pick a self-help book off the shelf, or ask for a particular book.

“With a prescription they will be able to get books from the library very discreetly.

“The books will also allow people to begin overcoming their condition in the privacy of their own home. That, in itself, is often a major factor in helping people overcome mental-health problems.”

Funding for the project is split between local health boards and council-run libraries.

The scheme is confidential, with libraries barred from disclosing who is borrowing the book or what it is about.

The book loan can be renewed for a further six weeks if the patient requires.

Mr Freeburn said: “People feel empowered by treating themselves, rather than simply relying on a psychologist.

“The books can also often help people avoid lengthy waiting lists for therapy sessions, and will hopefully nip problems in the bud quickly before they become more serious.

“When we were setting it up here in Fife we canvassed opinion among GPs, and the vast majority were in favour of it and said they would use it,” Mr Freeburn said.

“The books cover everything from eating disorders, anger management, low self-esteem and depression, to helping a child cope with bereavement.

“The first scheme of this kind was set up in Cardiff a couple of years ago, and all the indications are that it has been very successful down there.

“We are confident that success will be replicated here.”

Doctors in Fife are also able to prescribe exercise classes in local leisure centres to patients.

Jim Brennan, Fife Council’s community services spokesman, said that only titles included on an approved list of self-help books could be prescribed by doctors.

He added: “We are hopeful that allowing doctors to prescribe these books will help overcome some of the stigma that is attached to mental-health issues.

“Depression is a major problem across Scotland, and anything that helps tackle it should be welcomed.”

New figures released last week showed that Scotland has the highest suicide rate in Britain, with both the male and female rates almost twice that of south of the Border.

The Office for National Statistics report also found that areas of Scotland dominate the list of places in the UK with the highest rates.

Shetland was revealed as having the highest suicide rate for men, while women in Glasgow were the most likely to kill themselves.

Experts said exact causes for the regional differences were unknown.

Cathedrals of Decay

August 19

Juli Lawrence

This isn’t exactly about electroconvulsive therapy, but it’s too moving to fail to acknowledge and praise this site…and the artist.

I’m also not quite sure what category to put it in, so I’m going to put it in self help. For some, this site could be cathartic. For others, a warning: it could trigger bad memories.

Can there be pure beauty in the midst of despair? I’ve always thought that much of Kurt Cobain’s music came from the depths of his own hell. Yet his music was some of the best music (at least in my opinion) ever. I say the same of Beethoven. Sylvia Plath. Hemingway.

A woman on the East coast has found comfort and healing in photography, specifically pictures of decay. This website moves me, as do the photographs. I imagine myself with a camera in some of the places I’ve been, particularly a state hospital called Anna State Hospital (Choate) in extreme Southern Illinois.

Many of these photos could have been taken there, though the place still functions. It embodies the term snake pit. The outside looked almost surreal; lovely, manicured grounds with huge old trees, a fountain (I think I illegally splashed in it just to annoy the staff, but maybe that was somewhere else), and even old-fashioned garden swings.

On the inside, however, it looked like these pictures. Decay. Despair. Wounded souls.

And yet there’s something enchanting about this website, and I’ve been drawn there again and again.

If you aren’t haunted by bad memories – or at least think you can stand it – go there and spend some time.

The mechanisms and therapeutic actions of meditation

Dr Simon Whitesman

South African Journal of Natural Medicine
August 2006

Over the last 40 years meditation has been increasingly utilised in the context of Western health care to generate relaxation, enhanced awareness of mind-body phenomena and insight into the nature of the mind and its relation to the body.

While the use of meditative disciplines is deeply integrated into the culture and psyche of the East, it is only recently that this profound and ancient practice has gained a foothold in the West, initially on the fringes of society, and currently as an accepted self-help tool in both psychology and medicine. Much of this diffusion has occurred through the investigation of meditative practices by medical and behavioural scientists, and the consequent recognition that enormous therapeutic benefit may be derived through its regular utilisation.

Meditation is defined as the self-regulation of attention from moment to moment. While many schools exist, there are essentially two forms: concentration (one-pointed) meditation and mindfulness meditation, or an integration of these two. Concentration meditation implies the focusing of attention on a single focus, such as the breath or mantra (a Sanskrit sound), while mindfulness meditation is the application of attention to the present moment in a changing field of awareness. Generally speaking, the capacity to retain awareness in a changing field requires an initial stabilisation of attention, therefore concentration forms the basis for the effective application of mindfulness.

Concentration meditation elicits a psychobiological state that is characterised by specific neurological and peripheral physiological changes associated with cellular/molecular relaxation. This state, often termed the relaxation response, is mediated predominantly (although not exclusively) by the hypothalamus, a collection of neurons in the basal forebrain. This neural locus is a significant junction between the brain and the rest of the body and is central to the generation of the stress response. The peripheral biological effects of concentrated awareness are perceived systemically through an impact on a variety of neurotransmitters, neuropeptides and hormones and their cellular receptors. For example, researchers have shown that concentration meditation reduces the sensitivity with which noradrenaline binds to its receptor on white blood cells.

Because the neurotransmitter noradrenaline is central to the stress response, this line of research suggests that meditation utilises similar pathways to the stress response, but significantly, the impact of these molecular/cellular changes is therapeutic rather than pathogenic as would be the case in chronic stress.

The clinical effectiveness of concentration meditation has been described in diverse disease processes including hypertension, ischaemic heart disease, carotid atherosclerosis, arrhythmias, asthma, anxiety, chronic pain and infertility. Generally speaking the impact has been in the direction of symptom reduction, but has also been shown in some cases to reverse partially the pathophysiological mechanisms underlying the disease process.

Mindfulness meditation, the second broad form of meditative practice, presupposes a concentrated attention as a foundation on which a deeper exploration of mind-body phenomena may be explored. For example, enhanced momentary awareness allows a broader range of choice to bring about conditioned modes of functioning: distressing states may be held in awareness and responded to with a spacious perspective rather than a mindless repetition of habitual patterns of reactivity. Interestingly this clinical observation is borne out by brain imaging studies that have shown that the pathways between the emotion-processing limbic brain region and the rational, reasoning prefrontal cortex are optimised in mindfulness meditation.

Clinical studies have shown the value of the cultivation of mindfulness in a variety of chronic disorders including anxiety, chronic pain syndrome, fibromyalgia, psoriasis, depression, and the stress associated with malignant disease. Significantly, long-term follow up studies have shown a maintenance of therapeutic gain at 3 and 4 years, which lends credence to the practical applicability of mindful attention in the context of a modern lifestyle.

A final caveat regarding the therapeutic application of meditation is that these self-regulatory strategies, as for any intervention, should be viewed as a component of a broad approach to disease management in which externally generated (medication, surgery etc.) and internally generated healing responses are integrated to optimise the therapeutic outcome.

Mind Freedom Weekly News Hour

Tune in every Tuesday at 1 ET (12 Central, 10 am Pacific) for the Mind Freedom Weekly News Hour, hosted by David Oaks.

You may email comments and questions throughout the show.

Be part of a non-violent revolution in mental health. 

Acupuncture can work

Acupuncture can work, and it’s not just wishful thinking

U.S. News & World Report Stacey Schultz

There is nothing New Age about the Lincoln Hospital Recovery Center in New York’s South Bronx. Broken glass glitters outside the main entrance, where drug-addicted men and women wait in line for the clinic to open at 7:30 a.m. Inside, the decor is institutional drab. Yet the treatment of choice might seem more at home among the hot tubs of Marin County: a set of small acupuncture needles in each ear. Psychiatrist Michael Smith, who runs the clinic, says acupuncture helps addicts overcome their cravings. “It has a relaxing effect,” he says. “The person feels comfortable, more able to listen and cope.”

Acupuncture is no longer just an upscale alternative treatment. It is turning up in drug-abuse centers–over 700 of them nationwide– dental clinics, cancer centers, and gynecologists’ offices. Millions have tried it to relieve hard-to-treat conditions such as pain, headaches, nausea, and addictions like smoking. The National Institutes of Health estimates that as of 1996, 70 percent to 80 percent of insurers covered at least some of the costs. Even some doctors, who are typically wary of alternative medicine, are learning the ancient Chinese technique. The American Academy of Medical Acupuncture (AAMA), an organization of doctors with acupuncture training, has more than doubled its membership since 1995 to over 2,000.

Yet while some doctors have become converts because they see real benefits in their patients, many remain deeply skeptical, saying there’ s little scientific evidence about how acupuncture might work–or whether it really is effective. “You could throw away 95 percent of the studies,” says David Mayer, a professor of anesthesiology at the Medical College of Virginia in Richmond, “because they are all so poorly designed.” But that may be changing. One study, published last week in the Journal of the American Medical Association, showed measurable benefits in women nauseated from chemotherapy; the other, in the August Archives of Internal Medicine, presented evidence that acupuncture blunts cravings among cocaine addicts. Meanwhile, other research is unmasking how the treatment might affect the brain. The findings are moving acupuncture much closer to the mainstream. But so far, the studies show it works best as an adjunct to conventional therapy– not as a substitute.

Pins and needles. In 1997, the latest year for which numbers are available, acupuncture visits exceeded 5 million, mostly for muscle and joint pain. In multiple sessions over a few weeks or months, a practitioner typically inserts hair-thin needles to a depth of less than an inch at prescribed points on the body–and sometimes just on the ear. The needles, which can be twirled or attached to electrical stimulators, are left in for about 20 minutes. A treatment may cost $100 or more.

For some people, the effects can be dramatic. Juan Londono, 68, who monitors substance abuse for the Harris County Health Department in Texas, had recurring lower-back problems. One bout “was so bad I felt suicidal,” he says. His wife encouraged him to try acupuncture, and “by the end of the week, I could do almost everything.” Not everyone gets that kind of relief. Dan Kent, a 31-year old data manager in Portland, Ore., suffers from a herniated disk in his lower back. Acupuncture treatments over the past few months have given him “partial relief, ” he says. “It isn’t groundbreaking.”

Why does acupuncture work for some and not others? Traditional Chinese accounts say acupuncture aids the flow of energy, called qi (pronounced chee), along pathways in the body. Barry Beyerstein, a professor of psychology at Simon Fraser University in Burnaby, British Columbia, dismisses that as “ancient nonsense,” and many doctors agree. Until recently, they tended to credit any benefits to the power of suggestion–the so-called placebo effect. Acupuncture treatments involve invasive needles, long sessions with a practitioner, and an aura of exoticism–all likely to provoke a strong placebo response. Last week’ s JAMA article, however, suggests that more is going on. The researchers studied 104 breast-cancer patients who were undergoing chemotherapy. Some were given standard antinausea medication; others got the drugs plus either electrically stimulated acupuncture or a “sham” treatment on acupuncture points that aren’t meant to treat nausea. The sham group had fewer vomiting episodes than those who received no acupuncture at all–a placebo effect. But those who got electroacupuncture did better still, implying a real physical benefit.

Natural painkillers. Brain studies are beginning to show what that might be. One mapped brain activity with functional MRI and found that stimulating an acupuncture point on the little toe, used for eye disorders, triggers activity in the brain’s visual cortex. “There is no question it is working through the nervous system,” says Zang- Hee Cho, the study author and a radiologist at the University of California- Irvine. Other research suggests that acupuncture may trigger the release of endorphins, the body’s natural painkillers, and other brain chemicals. That effect might explain how acupuncture fights nausea, say researchers in the JAMA chemotherapy trial. And Arthur Margolin of Yale University School of Medicine, an author of the August addiction study, says acupuncture activates the “parasympathetic” part of the nervous system, which has a calming effect that reduces cravings.

The new work is swaying some doubters. “I’m willing to concede that acupuncture is more than a placebo,” Beyerstein says. Yet while it may offer real benefits for pain, nausea, and addiction, practitioners also tout it for many other conditions where studies are just beginning, including depression, carpal tunnel syndrome, and menopausal symptoms. “The claims are greatly overblown and oversold,” says Beyerstein.

Still, most experts agree that acupuncture is safe when provided by a certified practitioner. Referrals can be found at, the Web site of the National Certification Commission for Acupuncture and Oriental Medicine, or through the AAMA, at 800-521-2262 and

If you choose acupuncture, have a doctor, not an acupuncturist, diagnose your condition, and stay under a doctor’s care while receiving treatments. Even Michael Smith, who is certain that acupuncture has benefited the addicts he works with, advises caution. “As a magic bullet,” he says, “acupuncture is not much good.”

‘Beautiful’-but Not Rare-Recovery

‘Beautiful’-but Not Rare-Recovery
John Nash’s Genius Is Extraordinary. Recovering From Schizophrenia Is Anything But.

By Sandra G. Boodman
Washington Post Staff Writer
Tuesday, February 12, 2002; Page HE01

The end of “A Beautiful Mind,” the Oscar-nominated movie based loosely on the life of Nobel Prize winner John Forbes Nash Jr., depicts the Princeton mathematician’s emergence from the stranglehold of paranoid schizophrenia, the most feared and disabling of mental illnesses. Moviegoers who have watched the cinematic metamorphosis of actor Russell Crowe from the disheveled genius who furiously covers his office walls with delusional scribblings to the silver-haired academic perfectly at home in the rarefied company of fellow laureates in Stockholm might assume that Nash’s recovery from three decades of psychosis is unique.

But mental health experts say that while Nash’s life is undeniably remarkable, his gradual recovery from schizophrenia is not.

That contention is likely to surprise many people, including some psychiatrists, who continue to believe the theory, promulgated a century ago by Sigmund Freud and his contemporaries, that the serious thought and mood disorder is a relentless, degenerative illness that robs victims of social and intellectual function, invariably dooming them to a miserable life in a homeless shelter, a prison cell or, at best, a group home.

Psychiatric researchers who have tracked patients after they left mental hospitals, as well as a growing number of recovered patients who have banded together to form a mental health consumer movement, contend that recovery of the kind Nash experienced is not rare.

“The stereotype everyone has of this disease is that there’s no such thing as recovery,” said Washington psychiatrist E. Fuller Torrey, who has written extensively about schizophrenia, an illness he has studied for decades and one that has afflicted his younger sister for nearly half a century. “The fact is that recovery is more common than people have been led to believe. . . . But I don’t think any of us know for sure how many people recover.”

The notion that Nash’s recovery is exceptional “is very pervasive even though the facts don’t support it, because that’s what generations of psychiatrists have been taught,” said Daniel B. Fisher, a board-certified Massachusetts psychiatrist and activist who has fully recovered from schizophrenia for which he was hospitalized three times between the ages of 25 and 30.

“Many of us who have spoken about our recovery are confronted with the statement that you couldn’t have been schizophrenic, you must have been misdiagnosed,” added Fisher, 58, who holds a PhD in biochemistry and went to medical school after his hospitalizations.

The belief that recovery from schizophrenia occurs only occasionally is belied by at least seven studies of patients who were followed for more than 20 years after their discharge from mental hospitals in the United States, Western Europe and Japan. In papers published between 1972 and 1995, researchers found that between 46 and 68 percent of patients had either fully recovered they had no symptoms of mental illness, took no psychiatric medication, worked and had normal relationships or were, like John Nash, significantly improved but impaired in one area of functioning.

Although the patients received a variety of treatments, researchers speculate that the improvement may reflect both an ability to manage illness that accompanies age coupled with the natural decline, beginning in the mid-forties, in the levels of brain chemicals that may be linked to schizophrenia.

“One reason nobody knows about recovery is that most folks don’t tell anybody because the stigma is too great,” said Frederick J. Frese III, 61, who was hospitalized 10 times for paranoid schizophrenia in his twenties and thirties.

Despite his illness, Frese, who considers himself “definitely not fully recovered but in pretty good shape,” earned a doctorate in psychology and was, for 15 years, director of psychology at Western Reserve Psychiatric Hospital in Ohio, the state’s largest mental hospital. Frese holds faculty appointments at Case Western Reserve University and Northern Ohio Universities College of Medicine.

He has been married for 25 years and is the father of four children as well as past president of the National Mental Health Consumers Association. These achievements are hardly consistent with the prognosis Frese was given at 27, when a psychiatrist told him he had a “degenerative brain disorder” and would probably spend the rest of his life in the state mental hospital to which he had recently been committed.

Not Everybody Recovers

No mental health expert nor any of the eight recovered schizophrenia patients interviewed for this story would suggest that recovery or even marked improvement is possible for all the 2.2 million Americans afflicted with the confounding illness that typically strikes in late adolescence or early adulthood.

Sometimes schizophrenia, which is believed to result from an elusive combination of biological and environmental factors, is simply too severe. In other cases medications have little or no effect, leaving people vulnerable to suicide, which claims more than 10 percent of those diagnosed, according to epidemiological studies.

For others, mental illness is complicated by other serious problems: substance abuse, homelessness, poverty and an increasingly dysfunctional mental health system that favors 10-minute monthly medication checks, which are covered by insurance, over more effective but time-consuming forms of support, which are not.

The improvement seen in many schizophrenia patients as they reach their fifties and sixties generally affects only the most acute psychotic symptoms such as vivid hallucinations and imaginary voices. Patients rarely revert spontaneously to the way they were before they got sick, experts say, and many in whom the disease burns out are left with the emotional flatness and extreme apathy that also characterize schizophrenia.

While a growing number of mental health workers agree that recovery occurs, there is no consensus on how to define or measure it. Academic researchers typically adhere to a strict definition of recovery as a return to normal functioning without reliance on psychiatric drugs. Others, many of them ex-patients, embrace a more elastic definition that would encompass people like Fred Frese and John Nash, who continue to have symptoms they have learned to manage.

“I’d say there’s a gradation of severity of illness and a gradation of recovery,” said Francine Cournos, a professor of psychiatry at Columbia University who directs a clinic in Manhattan for people with severe mental illness. “The number of people who wind up completely symptom-free and without relapse is probably small. But everyone we treat we can help.”

A Bleak Prognosis

In 1972, Swiss psychiatrist Manfred Bleuler published a landmark study that appeared to refute the teachings of his eminent father, Eugen Bleuler, who in 1908 coined the term schizophrenia. The elder Bleuler, an influential colleague of Freud’s, believed that schizophrenia had an inexorable downhill course, much like premature dementia.

His son, curious about the natural history of the disease, tracked down 208 patients who had been discharged from one hospital an average of 20 years earlier. Manfred Bleuler found that 20 percent were fully recovered, while another 30 percent were greatly improved. Within a few years research teams in other countries essentially replicated his findings.

In 1987 psychologist Courtenay M. Harding, then at the Yale University School of Medicine, published a series of rigorous studies involving 269 former residents of the back wards of Vermont’s only state mental hospital, where they had spent years. Widely considered to have been the sickest patients in the hospital, they had participated in a 10-year model rehabilitation program that included housing in the community, training in jobs and social skills and individualized treatment.

Two decades after they completed the program, 97 percent of the patients were interviewed by researchers. Harding, a former psychiatric nurse who expected only modest improvement, said she was stunned to discover that about 62 percent were judged by researchers to be either fully recovered they took no medication and were indistinguishable from people who had no diagnosable mental illness or functioned well but had not recovered in one area. (They took medication or heard voices.) A study comparing the Vermont patients to a matched group in Maine, a state with much more parsimonious mental health services, found that 49 percent of the Maine patients had recovered or improved significantly.

So why has the almost universally gloomy prognosis for schizophrenia persisted in the face of convincing empirical evidence to the contrary?

“Psychiatry has always clung to a narrow medical model,” observed Harding, who directs Boston University’s Institute for the Study of Human Resilience. “Psychiatric dictionaries still do not have a definition of recovery,” but speak instead of remission, which “carries the heavy time bomb of impending illness,” she observed.

Columbia’s Francine Cournos, an internist as well as a psychiatrist, agrees. “A lot of research is done in academic settings, and a lot of people who get seen there are sicker,” she said. “And if you’re working in a state hospital, all you ever see are the sickest patients.”

Psychiatrists traditionally have not made a distinction between symptoms and the ability to function, Cournos added. “It’s important to remember that there is a difference between the two. We’ve had patients here who are very high-functioning and psychotic, including a woman who ran a very high-powered executive program but at work wouldn’t write anything down. She coped by memorizing everything she had to do because it drowned out the voices.”

Tale of Two Former Patients

The lives of Dan Fisher and Moe Armstrong illustrate the possibilities of recovery. The two men have a lot a lot in common: They are neighbors in Cambridge, Mass., they are the same age, they both work with psychiatric patients, are well-known mental health advocates and they both have been hospitalized for schizophrenia. By any measure, Fisher has recovered completely. Armstrong is the first to say he has not.

Fisher’s unusual odyssey from schizophrenic to psychiatrist embodies the most optimistic vision of recovery.

For the past 28 years, Fisher said, he has taken no psychiatric medication. He has not been hospitalized since 1974, when he spent two weeks at Washington’s Sibley Hospital. He has been married for 23 years, is the father of two teenagers and shuttles between a community mental health center where he has worked as a psychiatrist for 15 years and the National Empowerment Center, a nonprofit consumer organization he helped found a decade ago. A few weeks ago he attended a White House meeting on disability issues.

Fisher was first diagnosed with schizophrenia in 1969. Armed with an undergraduate degree from Princeton and a PhD in biochemistry from the University of Wisconsin, he was 25 and investigating dopamine and its role in schizophrenia at the National Institute of Mental Health when he suffered his first psychotic break.

“I put more and more energy into my work, and I literally felt that I was the chemical I was studying,” said Fisher, who recalled that he was desperately unhappy and that his first marriage was unraveling. “And the more I believed my life was being run by chemicals, the more suicidal I felt.” He was hospitalized briefly at Johns Hopkins Hospital, where his father was on the medical faculty, given Thorazine, a powerful antipsychotic, and soon returned to his lab.

The following year Fisher was hospitalized again, this time for four months at Bethesda Naval Hospital, across the street from his lab. A panel of five psychiatrists diagnosed him as schizophrenic and he left his job. After his discharge from Bethesda, Fisher decided that he had to make some radical changes. He jettisoned his once-promising career as a biochemist and decided, with the encouragement of his psychiatrist and his physician brother-in-law, to become a doctor so he could help people.

In 1976 Fisher graduated from George Washington University School of Medicine, then moved to Boston to complete a psychiatry residency at Harvard. He passed his board exams and began practicing at a state hospital and seeing private patients. In 1980 his career as a consumer advocate was launched when he disclosed his psychiatric history on a Boston TV talk show. A decade later he helped found the National Empowerment Center, a resource center for psychiatric patients funded by the federal Center for Mental Health Services.

“I’m sure it helped me that I came from a professional family and I was educated,” Fisher said of the factors that led to his recovery. “What helped me recover was not drugs which were one tool I used it was people. I had a psychiatrist who always believed in me, and family and friends who stood by me. Changing my career and following my dream becoming a doctor was very important.”

Moe Armstrong Eagle Scout, high school football star, decorated Marine has come a long way from the nomadic decade that began when he was 21, following his psychiatric discharge from the military after combat in Vietnam.

Between 1965 and 1975, Armstrong said, he lived on the streets of San Francisco, in the rugged mountains of Colombia and in his parents’ house in southern Illinois, “where I wore a housecoat and told everyone I was St. Francis.”

He received no treatment but developed an addiction to alcohol and drugs.

In the mid-1970s, Armstrong sought mental health treatment through the Veterans Administration. He managed to stop drinking and using drugs and moved to New Mexico, where he graduated from college, earned a master’s degree and became known as a mental health consumer advocate.

In 1993 he moved to Boston and became director of consumer affairs for a nonprofit company that provides services to the mentally ill. Six years ago he met his fourth wife, who has also been diagnosed with schizophrenia; the couple lives in an apartment they bought several years ago.

For Armstrong, every day is a struggle. “I have to continually watch myself,” said Armstrong, who has taken pains to arrange his life in a way that minimizes the chance of a relapse. He takes antipsychotic medication, eschews movies because they often make him feel “over-amped” and tries to be in “supportive, gentle, loving environments.”

“I have many more limitations than other people, and that’s very hard,” Armstrong said.

“And I had to give up the notion that I would be Moe Armstrong, career soldier, which is what I wanted to be. I think I’ve recovered as much as I have because I’m still the guy that’s the scout, looking for the way out.”

Overcoming the Impossible: My Journey Through Schizophrenia

by Ronald Bassman, Ph.D.

Psychologist Ronald Bassman, once diagnosed and treated for schizophrennia, brings new hope to patients and families.

Psychology Today
Feb 2001

The seclusion room was empty except for a mattress covered in black rubber on the concrete floor. They lowered me onto the mattress and turned me on my side. I fought their grip on my ankles and wrists, but they were too strong and experienced. I quit struggling and stared at the wire-encased ceiling light. I couldn’t see the nurse when she came in aid, “Get him ready.” They quickly pulled my pants and underwear down to my knees. I winced at the violent thrust of the needle. I tried to prepare myself to fight the onslaught of the thought-dulling, body-numbing Thorazine.

They waited for the drug to take effect before they stripped me of my clothes. I was left naked in the seclusion room, and no explanations were given. They did not tell me how long I would stay there.

Three decades have passed since I’ve had any kind of psychiatric treatment, yet the memories remain. Even after more than 20 years of work as a licensed psychologist, the nightmares have not disappeared. The dreams of endless wanderings through gauze-shrouded hospital corridors, the disembodied screams, and the smothering restraints and seclusion were not overcome by my successes. Those haunting memories only ended when I was finally able to use all of my experiences, when I was able to stop hiding my psychiatric history, and when I could speak publicly about my own treatment and transformation. Now I understand the importance of sharing what I learned from living and working on both sides of the locked door.

I am just one of many who have suffered psychiatric torments from an inadequate and often destructive mental health system. The journey that brought me to this place of credibility enables me to offer my experience not only to those who have the power to bring about change, but also to those who feel powerless and need inspiration. My good fortune allows me to challenge the prevailing psychiatric model. When you become a mental patient, you are no longer regarded as a whole person with an individual mix of strengths and weaknesses.

When I was discharged from the hospital I was told I had an incurable disease called schizophrenia. The doctor told my family that my chances of being rehospitalized were very high. is medical orders were directed at my parents, not me, and stated wit an absolute authority that discouraged any challenge. He predicted a lifetime in the back ward of a state hospital if his orders were not followed.

“He will need to take medication for the rest of his life. For now, you need to bring him to the hospital weekly for outpatient treatment and he must not see any of his old friends.”

I was devastated.

The hospital doctor put me into a coma five days a week for eight weeks by injecting me with insulin. Those 40 insulin treatments combined with electroshock blasted huge holes in my memory, parts of which have never returned. I ballooned from 140 to 170 pounds; I appeared the clown in clothes that no longer fit. My already damaged self-image had plummeted to an unrecognizable depth, and the heavy doses of Thorazine and Stelazine made me feel like I was walking in slow-motion under water.

Was the doctor joking? Not see my old friends? How was I going to face them and explain what had become of me? Did anyone really think that I was capable of making new friends? I was sure that they would have nothing to do with me. But the most disturbing of all the orders was to hear him say that I would never be free of the hospital’s control.

My best friends were once locked up in mental hospitals and fought their way back. We are psychiatric survivors. Some believe that psychiatric survivors defy the odds. Or maybe we were never really mentally ill, just misdiagnosed. After all, they say schizophrenia is a lifelong disease. Such reasoning makes my peers and me look like exceptions. Among our large group of closeted ex-patients are lawyers, teachers, mechanics, doctor carpenters, plumbers and psychologists. We are your neighbors, ministers and friends, living and working in your communities. Many thousands choose not to reveal their past.

People diagnosed with schizophrenia in Third World countries have higher rates of recovery than those who live in First World nations. Why is this?
I choose to speak and write about my experiences so that others who have been diagnosed and treated for serious mental illness will be able to see new hope and possibility. After speaking engagements, I often get call and letters from people who at thankful that someone is speaking out They hide their past just as I did, but go on with their lives without anyone but their friends and families knowing about their psychiatric histories. Sometime psychology students ask for advice about whether they should disclose their past

They are stung by the insensitivity and misinformation perpetuated in their programs. But those students suffer silently. They know it is not in their best interest to disclose their histories if they expect to succeed.

For the past five years I have presented psychiatric survivor concerns at lectures and symposiums at the American Psychological Association’s annual convention. I have tried to connect with other psychologists who have been diagnosed and treated for major mental illness. At the annual conventions, I hold a meeting for psychologists who have psychiatric histories as well as those who are interested in serious mental illness. I have tried to make it a safe place for people to meet without feeling that they are at risk of being exposed. They can choose to participate as an interested psychologist if they feel uncomfortable about revealing their experiences.

Over the years, psychologists have come to our meetings and talked about their experiences as mental patients. Some disclosed their past for the first time. But in this organization comprising more than 130,000 members, with an annual convention that draws between 20,000 and 30,000 psychologists, only 15 have felt safe enough to reveal their histories.

Do we recover or are we transformed by our experiences?

Some of us think of ourselves as recovering or recovered. Others like myself see it as a process of transformation. Like other psychiatric survivors, I feel dutybound to share what helped and hurt me so that we may eliminate the ineffective treatments and abuses of the mental health system, and help make our communities more supportive and inclusive.

Yet how does one climb from the depths? Research from around the world documents high rates of complete recovery from schizophrenia. The most extensive study, known as the Vermont Longitudinal Study, followed patients for an average of 32 years. Lead researcher Courtenay Harding of the University of Colorado studied the most “hopeless” patients diagnosed with schizophrenia: the feces-smearing patients who barely dressed themselves and had forgotten how to tell time. Harding reported that 30 percent of these patients had fully recovered. These ex-patients were symptom-free, employed, had a social life and did not take medication.

During my own struggles it would have been extremely helpful to have known of this optimistic research. Yet even with such remarkable findings, the common belief remains: Recovery is rare or impossible. In forums and presentations, I’ve shared these research findings and found that most people are surprised by the results.

Another study conducted by the United Nations through the World Health Organization found that people diagnosed with schizophrenia in Third World countries have higher rates of recovery than those who live in First World nations. Why is this? The thinking has been that families in underdeveloped countries need each member to be productive. Therefore, there may be greater tolerance for people who look and act differently. These people are necessary to their families and community. They have value.

What makes recovery and transformation possible? Unlike the research on recovery rates, there is little quantitative research on what promotes recovery. To determine what is helpful, we are guided by qualitative research gathered from people willing to share their stories.

In the Vermont study Harding asked people, “What really made the difference in your recovery?” Many of them answered similarly. They looked down at their feet, shuffled around and said something about a person who told them that they have a chance to get better. Having someone believe in them translated into hope. Without hope, death can establish a foothold. Hope fights fear and nurtures courage. It inspires vision and the work required to realize the unattainable.

Pat Deegan, a psychologist and psychiatric survivor, was diagnosed with schizophrenia at 17 and hospitalized nine times. She is currently director of education at the National Empowerment Center in Lawrence, Massachusetts. When Dr. Deegan talks about recovery, she often tells a story about how her traditional Irish grandmother reached out to her. When she was discharged from the hospital, Pat spent days sitting in a chair doing nothing but smoking cigarettes and drinking Cokes. Every day, her grandmother came in and asked her if she wanted to go to the grocery store with her. It was not a demand, just an invitation for company. For months Pat refused. One day she agreed to go with her grandmother, but stipulated that she would not choose anything or help in any way. It was a beginning. Her grandmother valued her company and believed that she could do more.

It isn’t one person or incident or clinical intervention that is critical for change to occur. Instead, it’s a complex process. One essential factor is keeping the spirit alive. Connecting with others helps: Receiving respect and warmth breaks through the isolation and helps you feel worthy and alive.

Deep in the recesses of our being there are safe sanctuaries, secure hiding places for salvageable dreams. Anger sustains our stubborn refusal to accept others’ dire predictions. Anger protects our hopes and dreams.

Author and international lecturer Judi Chamberlin writes proudly and sardonically about having been a noncompliant patient. Noncompliant patients receive the worst and potentially most harmful treatments. We have been locked in seclusion, placed in restraints, chemically and physically straitjacketed, lobotomized, shocked and beaten because we protested too much. If we were lucky enough to escape permanent damage, anger helped us. It helped us fight for our rights and shun the role of lifelong mental patient.

Anne Krauss, a psychiatric survivor working in the mental health field in New York tells an illuminating story of the effects of suppressing anger. She worked as a peer advocate in a state psychiatric hospital, and on one occasion she was in the ward talking with a patient for whom she was an advocate. Knowing that her complaints were legitimate, Anne listened respectfully to the woman as she angrily complained about not getting what she wanted. At the time, a psychiatrist assigned to the ward who knew both Anne and the patient walked over and placed himself between the two women. He faced Anne and said, “You know, some people just don’t know that they should not be angry with people who are trying to help them. They would get along much better if they showed more respect.” After he walked away, Anne resumed the conversation. The woman was no longer lucid. She ignored Anne, and began talking to the voices only she could hear. Anne was stunned by this example of the price paid when you are forced to bury your anger.

When emotion is actually felt and expressed, you suffer the staff-imposed consequences. If you cry, you’re considered suicidal. If you’re angry you are aggressive and dangerous.
Darby Penney is director of the Bureau of Recipient Affairs for the New York State Office of Mental Health. In her cabinet-level position, she supervises a staff of 14 and reports directly to the commissioner of the world’s largest mental health system. Darby tries to infuse her work with survival lessons she learned during her stay in psychiatric hospitals. In the hospital you are asked to talk about your feelings, but when that emotion is actually felt and expressed, you suffer the staff-imposed consequences. If you cry, you are considered suicidal. If you’re angry, you are aggressive and dangerous. And if you are laughing too happily, you are manic and need to be sedated.

Each of us defies set formulas. The timing and options are different for each of us. What is helpful is the right to take risks-the opportunity to fail or succeed, as well as the freedom to make decisions and choices. Without risk, without choice, the whole process is perverted into, stabilization and maintenance at best and incarceration at worst but never growth and development.

When people who have been diagnosed and treated for serious mental illness work and play side by side with others, they will be seen and valued for who they are with all their strengths, weaknesses and foibles. By demystifying madness, we can begin to appreciate the beautiful gifts that diversity offers to everyone.

Remaining hopeful and envisioning a future of growth and development.

Having the right to choose – without it there is no motivation.

Knowing that you are not a label or diagnosis. You are a living, changing person – not an object.

Speaking for ourselves. When others speak for us we are devalued.

Establishing our own homes in the community where we can choose our roommates or live alone.

Acknowledging the need for friends, peers and intimate relationships.

Realizing that peer support and self-help keeps us grounded and connected.

Protecting and nurturing the spirit within us.

Knowing that all things are possible and that to be alive is a miracle.

Other essentials include: safe niches, natural supports, reconciliation with family, self-discipline and will, belief in oneself, successful experiences, meaningful work, psychotherapy, and the passage of time.


The Heroic Client
Barry L. Duncan and Scott Miller

Unequal Rights. Discrimination Against People With Mental Disabilities and the Americans With Disabilities Act
Susan Stefan