Mental Health Recovery Newsletter

Contents

Recovery Topics:
Thoughts on The Beautiful Mind
Teens in Trouble
Words that can Help
Essential Components of Any Recovery Program For People Experiencing Psychiatric Symptoms By Ronna Keil

News from Mary Ellen and Ed including Upcoming Presentations

Resources by Mary Ellen Copeland

Free Resources

Introduction

Welcome to Mental Health Recovery Newsletter, begun in March 2000 and published quarterly from the office of Mary Ellen Copeland. This newsletter is for anyone who wants to learn more about recovering from uncomfortable, often disabling psychiatric symptoms. If you would like a copy of previous issues of this newsletter or would like to enter your subscription, please see the paragraph below. Subscription is free to individuals, by email or ground mail. Institutional subscriptions available: 50 copies for $25 plus mailing; 100 copies for $45 plus mailing. Please contact us and let us know whether we can send you the email version to save a tree. You may freely copy and distribute this newsletter, giving credit to Mary Ellen Copeland.

If you would like a copy of previous issues of this newsletter or would like to enter your free subscription, please contact the office of Mary Ellen Copeland by e-mail or click here.

A Special Note From Mary Ellen Copeland

These continue to be very hard days for all of us. Added to the difficulties of our daily lives, living with or supporting others who are experiencing very painful symptoms are the pressures and tragedies related to war and the huge disappointment and ensuing lack of trust caused by the corruption of a major multi-national corporation. I hope you will join me in my hopes and prayers that our world leaders will use peaceful means like negotiation and diplomacy to resolve the issues that are tearing the world apart--and that their decisions and actions will be for the good of all, especially the children.

Recovery Topics

Thoughts on A Beautiful Mind

I hope you have seen the movie A Beautiful Mind with stellar perfomances by Russell Crowe and Jennifer Connelly. If you haven't, I strongly encourage you to do so. We saw it twice and it was even more powerful the second time.

Those of us who have a psychiatric diagnosis or experience symptoms that are visible to others have been treated badly in our society for as long as any of us can remember. Far too often, the media has supported this stigma through sensationalizing news events and spreading information that is inaccurate, slanted or blatantly untrue. National, regional and local mental health agencies and organizations have mounted educational and advocacy efforts to reduce this stigma but it is not easy to counter the constant, but hopefully lessening, stream of negativity. I hope that this movie is the beginning of a major shift--where people who are having a hard time with difficult, painful and often disabling symptoms are treated with the dignity, compassion and respect they deserve.

This movie reinforced many of the things that those of us who are committed to mental health recovery strongly believe. We picked up the following.

People who experience these symptoms are some of the most brilliant people in our society--people who can find solutions to serious problems and whose talents enhance our lives. We can do the things we want to do and be the way we want to be. The world will miss out on our great potential if we don't have opportunities to recover or if we are mistreated or badly treated--as almost happened in this case.

Recovery is possible and, as the focus of mental health treatment changes to recovery, it is much more likely that people will get better and better and better instead of worse and worse (the common prediction in the past).

There are many roads to recovery--and each of us needs to choose our own road--the road we feel will work best for us.

Those of us who have these symptoms, even symptoms that persist, can learn to live effectively with or without our symptoms--that we can control our minds and sort out the difference between delusions and reality. We can devise innovative ways to address our symptoms and/or delusions so that they don't overtake our lives.

Being supported by loving family members, colleagues and the community, and being treated with dignity, compassion and respect helps. It may even be essential to, releiving symptoms. It helps us to recover and achieve our dreams and goals.

There is great value in having something that is meaningful to us to do.

There is a strong connection between stress and symptoms. Minimizing and managing stress are important to recovery.

Hospitalization and other invasive treatments often are not the best option and if we are open to using all the resources available to us, the outcome can be amazing.

If you have thoughts about the impact of this movie, let us know through our e-mail.

Teens in Trouble

A recent issue of Psychiatric News says that even though suicide is the third-leading cause of death among teens ages 15-19, most people underestimate the seriousness of this problem. Most of us do not want to think about it. It is not until it stares us in the face--a suicide attempt or the suicide of a family member, someone who we know or whose parents we know, that attention is paid. By this time it is too late. What can we do to reverse this troubling trend and prevent teen suicide?

Listen to our young people! Listen! Listen! Listen! Don't interrupt with advice, reminders, nagging, judgments, stories of what it was like when you were a kid, reminders of how good they have it, comparisons with their siblings or others, etc., etc., etc. Just listen and keep your mouth shut--this is especially hard to do when you disagree.

Don't nag. We as parents who want our kids to be presentable and do well, may nag and nag and nag. "Wash your hair, clean your room, turn down the music, find some decent friends, get a job, etc. etc. etc." That is all they ever hear from us--from morning until night. How would that make you feel? What is really important? Is a clean room so important? Why not just close the door? Can you set aside some time when it is Ok for the music to be loud? Does it really matter what your teen wears to school? If it's not going to have long term bad affects, forget it. Save your fire and use it for serious issues like drinking or using illegal drugs.

Validate their feelings. If they say they feel sad, respond with something like, "I am so sorry you feel that way. What can I do to help?" instead of something like, "With all the money we've spent on you, what do you have to be sad about."

Share ideas on how they can help themselves feel better when they are feeling badly. Things like playing ball, painting a picture, calling a friend, going to a movie, getting some exercise--things they like to do or have an interest in. Don't suggest taking out the rubbish or mowing the lawn when a teen is already having a hard time.

Give them lots of unconditional love and support. It is really hard for kids, as it is for all of us, when we are dealing with things like the break-up of a relationship, being bullied, getting bad grades, a major disappointment of any kind, on-going feelings of sadness, despair and desperation, low self esteem. You may not see them as serious issues but to a teen they can be very serious. Again, listen, listen, listen without interrupting.

Share an activity with a teen or group of teens. Take them fishing. Go for a hike. Have a picnic. Take them out to dinner or to a movie.

Stu Copans, an adolescent psychiatrist, and I wrote and self published, The Adolescent Depression Workbook. Because this book was found to be both popular and effective, a revised second edition is being published by Brookes Publishing. It is called
Recovering from Depression: A Workbook for Teens and will be available March 15. You can put a copy on hold by contacting this office and it will be sent out to you as soon as it comes in.

A committee sponsored by the state of New Hampshire has developed a curriculum for teens that is based on the WRAP model called ONE STEP UP: A Teen Program for Walking into Wellness. Pilots of this project are being arranged and I hope it will be widely available in the near future. It will be a tool for helping young people talk about their feelings and taking action to help themselves feel better. It is hoped that this program will give kids the tools they need to prevent or relieve troubling symptoms throughout their lives.

Motivation: The Courage to Live Creatively   
By Richard Weingarten, M.A., RPRP

Richard Weingarten is the Director of Consumer Initiatives and Education at the Connecticut Mental Health Center in New Haven. He wishes to acknowledge the editorial assistance of Flo Conway and Edward Mattison on this article

In my teens and twenties motivation seemed like my strongest suit. But when I suffered from depression in my thirties and forties, I, oftentimes, had no energy, no will, no hope and no motivation. When I was depression-free, I found that I was motivated and could engage in doing things that motivated me all the more. I could and did schedule in activities that I'd force myself to go to even if I was depressed because I knew I'd feel better getting out of my apartment and being around people. Nevertheless, I had to struggle constantly to pick myself up and get my life going again after a day or two of depression. What follows are the many ways I motivated myself and found motivation when I wasn't totally incapacitated by my illness.

Motivation, for me, was first, wanting to live an exciting and interesting life; second, wanting to be an interesting person; third, being dissatisfied with my situation or myself; fourth, being willing to do the hard work every day to develop discipline and good work habits and last, but not least, having the courage to engage my imagination and live creatively. These were the things that motivated me during the years when I was ill, unemployed or underemployed. I saw each day as an opportunity and challenge to make the best, most interesting day I could for myself.

I've always liked people and helping people except for the early, reclusive years of my illness. Helping someone gave me a good feeling about myself. So taking an elderly neighbor to a medical appointment even when I wasn't feeling that great helped me feel connected to my neighbor and to myself. I was also motivated to take care of my personal needs (food, exercise, adequate rest and sleep, hygiene and grooming) as I had developed these into habits since high school.

In the process of taking care of my basic needs, I made friends with people. At the supermarket where I shopped for example, I made friends with the produce clerk, the girl behind the fish counter and the cashier at the check out counter. So shopping was a pleasant experience for me, and I looked forward to going there. I did the same thing at the health club where I worked out. When depressed I forced myself to go for a workout knowing that I'd feel better afterwards.

I love to write. When I was struggling to get myself going in the mornings, I wrote letters to friends. With each friend, I had a "thing" to write about. With one friend it was the movies, with another it was things of a spiritual nature. I also love knowledge, and I went to lectures whenever I could. Asking a question of the lecturer was also a motivator, giving me a good feeling about myself that often lasted a day or two.

Sundays were my best days. I experienced spiritual uplift at morning church services and with my friends during the Fellowship Hour. After lunch I went to the art museum and went on their "Gallery Walks." A regular group of people went on the "Walks" each Sunday, and we became friends and often had tea or coffee after the tour, with the docent from the museum sometimes joining us.

Before I became ill I was a news reporter for a wire service agency. This experience, and my interest in current affairs, made me a voracious reader of newspapers and magazines. I suppose if I were a cat fancier, I'd read magazines and books about cats. But I read The New York Times cover to cover every Sunday. I'd done this religiously since I was an undergraduate. Sometimes when I read a book review, I'd write down a quote that
appealed to me, or I'd go to the library in search of a book that had gotten a good review. Like an actor or a singer - or a writer -I learned where to find motivation and I went looking for it.

Motivation, then, is definitely not genetic or automatic like many people think. Rather, it is a way of thinking about your personal resources - what inspires you, what you like in yourself and others - and building on those strengths. Motivation comes from reaching out and connecting with people. It means tackling the hard problem of motivating yourself one day at a time. It means learning to initiate things in your life. Like a leaf riding an eddy in a stream, I followed my interests until I was picked up by the mainstream.

The desire to be an interesting person with an exciting life requires steady habits and good discipline. All of this, I know, is part of the secret to being motivated and living creatively.

WELLNESS TOOLBOX

Personal responsibility is key to using any wellness tool. It is up to you to notice how this tool is making you feel, to decide whether or not you want to use it, and how much use of this tool is best for you.

Changing our Attitudes and Habitual Responses
by Mary Ellen Copeland

"The last of the human freedoms -to choose one's attitude in any given set of circumstances." (Victor Frankl: Man's Search for Meaning) I found this quote to be very meaningful to me at this time. While tragedy may take away much of what you have, you are in charge of how you think.

In the past when I started to notice symptoms or early warning signs--things like feeling a bit anxious, forgetting more than usual, having a hard place in my chest or not feeling like getting up, my usual response was to "catastrophize". I would say things to myself, like "Oh no, not again". "You are going to get so depressed you won't be able to go to the wedding". "You'll never get that job now". "This is just going to get worse and worse and worse". "This is all my fault because I ate junk food all day yesterday". "Everyone will think I am a failure and desert me".

Now I have realized that this response--my attitude--rapidly worsens my symptoms and perhaps even causes my worries to become reality. Through practice, I have learned to respond in a different way. First, when I notice symptoms, I do just that. Notice them. No catastrophizing. Next, I check out my Early Warning Signs action plan in my WRAP and do the things on it. In addition, if I have time, I check my list of Wellness Tools to see if there is anything else I can do to help myself. Things like work on my quilt, go birding or chat with a friend. Then I stay with the symptoms for as long as I have them without being anxious for them to go away--just being patient and giving myself a chance to heal. I know that it is OK to be uncomfortable for a while. It's no big deal. And that's it. It really works.

Sleep
by Jill McGann

(Description of how Jill learned to sleep on her own after fourteen years on sleeping medication)

Two years ago I ran out of medication options for management of mania and depression. I decided to take full responsibility for my health. My psychiatrist was wonderfully supportive but now I was on my own searching for anything and everything that might provide the right management tools for me to achieve wellness. I took daily inventory of my emotional, physical, intellectual, and spiritual state. I began to make progress using the very management tools you describe in your books.

As I slowly gained control of my waking hours I was inspired to reclaim my sleeping hours as well. My sleep was not refreshing because I was so drugged. I wanted to be free to sleep like the rest of the world.

By this time I was really working on balance through exercise, yoga, and stress management techniques.

I started by reducing my medication by very small increments over the course of eight months. If I ever went without good sleep for three days I would go back up to the previous dose and try again to reduce the dose after I was well rested. Since I was taking so much medicine this was indeed a slow process. As I reduced my medicine to minimal amounts I really hit a wall. I pushed through this with pure determination. I was "soloing" but it was not a pretty sight. I just couldn't get the signal to my brain to gracefully "turn off".

I consulted with a psychiatrist that takes a more natural approach to mental wellness and he started working with my specific chemistry issues. I changed my diet and the supplements I was taking. By increasing my seratonin levels in the evening I can now get to sleep most nights. Sure, I have the normal sleepless nights that other people experience but most nights I am in bed and asleep by nine and wake up refreshed at five. Voila!! This has been a great lesson for me to learn. Just because things have been a certain way for a long time doesn't mean that things can't change. Change is always possible. It just may take some time.

Help Wanted

Are you gainfully employed? Too many mental health consumers are told they'll never work again. Let's challenge this disheartening stereotype. I am putting together a book of "Consumer Voices in the Workplace." I wouldlike to hear from other consumers who have managed to maintain their careers while coping with psychiatric symptoms. Please e-mail me, Ellen Alderton, at
elalists@hotmail.com or call me at (703)548-1968. Thank you!

A note of apology

A person e-mailed me and said that he found my title Keeping Well When the World has Gone Crazy in the special edition of the newsletter to be stigmatizing. I was so overwrought about the world situation when I wrote that article (and continue to be) that the word crazy seem to really fit. But if even one person finds it to be stigmatizing, I will not use that word again in any context. My apologies to anyone who was offended by it.

Quotes in the New Zealand native Maori language

Carolyn Doughty from Christchurch, New Zealand came to Vermont in September to attend the Mental Health Recovery Training for facilitators. She said in the native Maori language "Tangata Whaiora" means a person seeking wellness.

And from another New Zealander, Gwen Fuergeson from Auckland,
Akakoa he uaua , kia kaha, kia toa, kia manawanui
Although there may be difficulties, be strong, be brave, be patient and take heart.

NEWS from Mary Ellen and Ed

After a very busy fall with travel to New York City, Indiana, Connecticut, the United Kingdom, Ireland, Arizona and New Zealand, we plan to limit our travel to the northeast region in the next several months to recoup and catch up. Our current schedule for the next few months includes:

Upcoming Presentations

• March 23--recovery presentation at the Institute for Living in Hartford, CT.

• April 2-4, Refresher Course for Mental Health Recovery educators here in Brattleboro, VT. If you are currently teaching Mental Health Recovery and Wellness Recovery Action Planning, we encourage you to attend. Last year's event was very exciting, filled with mutual support for the important work we are all doing, innovative ideas and discussions of the challenges we face in doing this important work. Of particular focus will be new ways of dealing with crisis and post crisis planning. Richard Hart, A Recovery Educator from West Virginia brought the issue of post crisis planning to my attention. He said the issue of recovery from a crisis was important for people in a group he facilitated. It is so easy to relapse at this time when of "post crisis" when everything feels so fragile.

• April 16-18, Mental Health Recovery and Wellness Recovery Action Planning Facilitator training in Michigan.

• April 20, Six hour institute on Wellness Recovery Action Planning as part of the three day conference of National Artists for Mental Health, Inc., in Schenectady, NY. We are delighted to be presenting at this conference as it is so clear that recovery and feeling well support artistic expression. If you are interested in attending, call 1-866-866NAMH or check the website at www.namh.org.

• May 6-10 and 20-24 Mental Health Recovery and Wellness Recovery Action Planning Facilitator Trainings in Brattleboro, VT. The fall training will be September 9-13.

Educational Opportunities

Mental Health Recovery Correspondence Course

The four-part Mental Health Recovery Correspondence Course is a great way to learn mental health recovery and how to develop a Wellness Recovery Action PlanT for yourself and/or to share with others. It meets the prerequisites for attending Mental Health Recovery Seminar II: Facilitator Training. If you want to attend the Facilitator Training in the spring, this is a good time to begin the Correspondence Course.

In areas where several people are taking the correspondence course, participants are gathering, usually once a week, to discuss and work on the assignments together. I have found that this works very well. If several people in your area are taking, or considering taking the Correspondence Course, you might consider this option.

The course includes reading and written assignments, projects, activities and phone discussion with the instructor. The three texts for the course are: The Depression Workbook, Living Without Depression and Manic Depression, and Wellness Recovery Action PlanT. The cost is $200 per participant, plus the cost of any texts you need to purchase.

Mental Health Recovery Seminar II: Facilitator Training
May , 6-10 2002, Brattleboro, VT
May 20-24, 2002, Brattleboro, VT
September 9-13, 2002 Brattleboro, VT

It's time now to begin making your plans to attend the 2002 Spring facilitator training. Over 250 people have attended these training in the last several years. The training has given them the skills and strategies they need to teach mental health recovery skills and strategies including Wellness Recovery Action Planning to individuals and groups.

Anyone who has met the requirements for the training is welcome. You can meet the prerequisite for this training if you have taken a basic Mental Health Recovery including WRAP training or have completed the Correspondence Course described above. Contact Mary Ellen's office to see if you qualify or have questions about your qualifications.

The cost of this seminar is $900, including the new Facilitator Training Manual. Add your travel and personal expenses.

Mental Health Recovery Seminar III Refresher Course for Facilitators
April 2-4 2002

Anyone who has completed Mental Health Recovery Seminar II is encouraged to come to Brattleboro for an intense three days of problem-solving and strategizing to 1. increase your knowledge and skills, and 2. to plan strategies for educational opportunities and career building. Topics to be addressed include quality assurance, responding to disasters, working with people with special needs, advanced directives and post-crisis planning, networking and program administration.

The cost of this training is $450.

Information on Resources by Mary Ellen Copeland

Resources are important because they help you discover new skills and strategies for addressing problems and issues and for working on recovery. They can also reinforce things you already know. In addition, they can be a lifeline if you can't or choose not to go to a group or be involved with an agency, and you are working toward recovery on your own. Given the range of options available, resources are a very inexpensive option that are widely available. Often agencies and hospital programs purchase the resources we have developed for the people who use their services.

In our first newsletter, two years ago, I included a complete list of the resources Ed and I have developed to support the Mental Health Recovery and WRAP Program. I wanted to repeat it, adding several new resources, for your easy reference. There are many other resources that may be useful to you as well. I have included an extensive list of resources that others have found to be helpful on the website at www.mentalhealthrecovery.com.

The following resources are available through our website at www.mentalhealthrecovery.com or by contacting our office by mail, e-mail or phone. Many of them are also available at bookstores.

2nd Edition The Depression Workbook: A Guide to Living with Depression and Manic Depression has been extensively revised to reflect new thoughts and information on mental health recovery. This easy to use workbook that will guide you through the process of beginning recovery from all kinds of psychiatric symptoms. It includes directions for developing a Wellness Recovery Action PlanT.

Living Without Depression and Manic Depression: A Guide to Maintaining Mood Stability is the perfect follow-up book to The Depression Workbook. It is based on a study of people who had gotten well and stayed well for several years--meaning that they didn't have any hospitalizations and that symptoms did not significantly interfere with their day to
day activities.

Both the video Coping with Depression, co-produced by Mary Ellen Copeland with William Hood, the Strategies for Living with Depression and Manic Depression audio tape reinforce the information in The Depression Workbook and Living Without Depression and Manic Depression. It is hard to remember how to help yourself when symptoms are most severe. These resources provide reminders in ways that are easy to assimilate.

Winning Against Relapse: A Workbook of Action Plans for Reoccurring Health and Emotional Problems is a detailed description of the Wellness Recovery Action PlanT process for staying well, for identifying and responding to symptoms and for developing an intensive crisis plan. It includes information on working with groups and on developing these plans for people with special needs.

WRAP: Wellness Recovery Action PlanT is a simplified users guide for developing a Wellness Recovery Action PlanT. This book is being used by individuals and in support groups, mental health programs and hospitals around the country. It is now available in a Spanish Version, WRAP-Spanish Version- Plan de Accíon para la Recuperacíon del Bienestar and a version for people who have a dual diagnosis, WRAP: Wellness Recovery Action PlanT for People with Dual Diagnosis.

Two other formats for learning about and developing a Wellness Recovery Action PlanT- Winning Against Relapse Program, a step by step WRAP audio tape which is great for individual or group use and for people who would prefer to hear rather than read the instructions, and WRAP on CD-ROM so you can easily download both the instructions for developing WRAP and forms you can fill. The CD-rom includes instructions and forms for a teen version of WRAP as well.

I had originally hoped that everyone facilitating a recovery group, workshop or seminar based on my work would attend a Mental Health Recovery Facilitator Training. However, I have learned that this is very impractical and that limiting the spread of this information is not in anyone's best interest. Therefore I have revised the Facilitator Manual: Mental Health Recovery including WRAP, the manual we use at the facilitator training, into a curriculum, so that anyone who likes to teach and work with people can easily teach mental health recovery and Wellness Recovery Action Planning. It comes with a CD-Rom for making all of the transparencies I use in my workshops and lots of hand-outs that can be copied and distributed.

The Adolescent Depression Workbook which I co-authored with Stu Copans is still available. However, on March 15, a revised version, Recovering from Depression: A Workbook for Teens is coming out.

Mary Ellen Copeland co-authored the book Healing the Trauma of Abuse: A Gentle Woman's Guide with Maxine Harris of Community Connections in Washington, DC. It describes a weekly lesson process that women can use to relieve the effects of trauma in their lives, either when working closely with a counselor, or when - as many women must do - working on their own.

The Loneliness Workbook gives you the tools you need to cope with and relieve loneliness and develop a strong system of supports.

The stress created by worry is often a trigger that leads to a worsening of symptoms. Worry is a constant companion for many of us. The Worry Control Workbook is full of ideas on how to relieve the worry in your life.

The second edition of Fibromyalgia and Chronic Myofascial Pain Syndrome: A Survival Manual that I co-authored with Dr. Devin Starlanyl is now available. It is filled with the most up-to-date information on how to deal with these chronic pain conditions. People who suffer from these debilitating conditions consider this book to be their "wellness bible".

Free Resources

The booklet, Recovering Your Mental Health: A Self-Help Guide, is available free from the Center for Mental Health Services. We developed this booklet with the assistance of a focus group of ten people from around the country--people who are working on their own recovery. The first 18,000 copies have been distributed and the second printing of 35,000 copies is now available. People are really hungry for mental health recovery education. You can get free copies from the Knowledge Exchange Network (KEN) by calling 1-800-789-2647 or through www.mentalhealth.org. Refer to booklet SMA# 3504.

There are many helpful and supportive articles and resources on the website at www.mentalhealthrecovery.com or www.maryellencopeland.com.

Join the egroup "mentalhealthrecovery" . Share your experiences and get ideas, advice and support from others with similar problems and issues. Go to www.yahoogroups.com. Then do a search for mentalhealthrecovery. It will pull up two sites--one that is the Mary Ellen Copeland group and one that is in the UK. You may want to join both. Then follow the instructions to register and participate in the group. There have been many lively discussions over the last few years.

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