After Mental Health Crisis, Well-Being Is Possible Again, But It’s Probably Not Going To Come From A Prescription Pill


At a recent medical conference, I was surprised to hear a speaker knock the recovery movement in mental health. The presenter implied that there was something bad, and inherently “political” about the consumer movement, where people with mental illness advocate for themselves and push for full recovery. I wondered what was wrong with wanting to be fully well.

I’m sure someone on the inside of the physicians organizations could explain this to me- bring me up to speed on what I’m not seeing. Probably it’s a matter of “us” and “them.” “Us” physicians are being accused of not providing “them,” the healthcare consumers (patients) with opportunities for full recovery. And heck, that hurts our feelings because we really are doing the best we can over here.

The psychiatric profession cares about recovery, but on the whole I think we may be focusing on the wrong road to get to it: Neuroscience. Our research focuses on finding the specific brain areas involved in diseases, and the genes that encode those diseases, all to help us create better medications so we can cure mental health conditions. Neuroscientific discovery is vital to improving treatments for mental health conditions, no doubt. But mental health is bio-psycho-social and spiritual. Getting well isn’t just a function of neurotransmitters and circuits in the brain.

Psychiatric physicians need to acknowledge the importance of the recovery movement without the narrow focus on biology. After a mental health crisis or a break, well-being is possible again, and it’s probably not going to come from a prescription pill bottle. The pills will help in many cases, to turn off problem nervous system activity. And yet they won’t make people well.

Real recovery is about picking yourself back up when the time comes, and that comes from courage and hope.

Hope doesn’t come from the doctor’s symptom checklists, or from tweaking meds at every appointment because we think that’s the job description. What is the prescribing psychiatrist’s role, then, in helping patient achieve a true place of recovery? We need to have hope for our patients. We need to offer a perspective of experienced wisdom, and show them that we know it can get better.

Recovery in mental health leans largely on the psychosocial and the spiritual aspects of well-being. When symptoms are managed, recovery stems from rebuilding courage, through the hope we reflect back to our patients.

Posted on December 18, 2017 .

When Our Kids Fail


I spend a lot of time in sessions with parents, and in my writings as well, encouraging parents of adults to let go. We cannot rescue our kids, especially after they become adults. We have to let them find their way. But sometimes that is really hard to do, especially when they fail.

“Jake” is a kind-hearted, highly intelligent high school senior with a mix of poor organizational abilities and social anxiety. His parents came to talk to me recently, because Jake has had a lot of failures lately, and his parents hurt for him deeply. He fails classes because he misses deadlines, even when he understands the coursework. He won’t be getting credit for his math class this year. And he’ll be starting his adult life on the heels of repeated disappointment in himself. He started a job, and was fired for his awkward interactions with customers and for forgetting important steps in his workflow. His parents are facing the fact that there may be nothing they can do. They put Jake in treatment. He sees a therapist. But he still has problems and he doesn’t seem to function up to his potential. His parents are accepting that they may have to watch him struggle and fail, and they are simply going to have to accept it.

Failure is a normal part of life. Someone is going to get cut during tryouts. Someone is going to bomb the test. We can’t all win at everything all the time. And yet, the knowledge that failure is expected doesn’t prevent the parent of a kid who fails from feeling helpless and maybe responsible for the failure.

Parents raise kids and throughout development, try to teach them the skills they need. When failure happens, parents often wonder if they left out some vital lesson.

            Did I not teach her to strive harder? To give her absolute best?

            Maybe I should have hired a tutor for the SAT.

            Perhaps I let him down by leaving him to figure this out on his own.

While it’s natural for parents to care and to hurt when their children hurt, it’s also important to remember that failure isn’t something to be avoided. Not only is failure inevitable, failure is a great teacher. Failure is often necessary for children, teens, and new adults to truly learn what they need to know. Without failure, they may not grow.

So we have to let go and let them fail. Even when it’s scary or painful. Even when we are parenting a kid who seems to lose more than others.

Jake has many strengths, and his recent failures can help him find the career and the life that fit best for him. He’ll be okay, as long as his parents continue to see him as capable and lovable.

What can we do when our kids struggle and fail? We can love them unconditionally and walk through it with them. That’s all we can do, but for a kid facing failure, it’s everything.

Posted on December 11, 2017 .

Cousins Getting Along in the Holidays-- 8 Reminders for Kids


Supporting children's mental health is all about teaching skills, and supporting successes. Walking kids through experiences and teaching them how to handle themselves builds resilience. And the holiday season provides ample opportunity for teaching lessons about community and relationships.

December is a time for family festivities, as we all travel over the river and through the woods to see family. The holiday season is full of family gatherings, and for kids and teens, that means getting together and getting along with people they barely know (but are supposed to love). Since cousins and other family members may not be the kinds of personalities kids understand, conflict is all too common.

A little advanced planning and discussion can go a long way towards placing kids in the right mindset to ensure everyone gets along, however. And having a successful family get together builds skills for healthy relationships all year long. Here are 8 things to discuss in advance, to help the kiddos have maximum fun with minimum drama this December:

1.     Cousins may be your favorite kinds of people, or they may not be. You still have to get along.

2.     Include everyone. It’s a rule.

3.     Get ready to adapt. Whatever you are accustomed to at school or with your friends, time with rarely seen family is bound to be different.

4.     Put yourself in other peoples’ shoes. This goes a long way toward helping you be kind and considerate.

5.     Think before you act. This, too, is a rule.

6.     Mind your tone. Sometimes you want to organize the kids or direct them toward an activity, and they aren’t listening. You still need to be respectful and polite.

7.     Be prepared to compromise. You won’t always get your way in any group.

8.     Take a little quiet time to regroup when you need it.


Posted on December 4, 2017 .

Mental Health in the Holidays


The holiday season can be tough on mental health. For those who struggle with symptoms or a specific diagnosis, the holidays may not feel as joyful as they do for others. Here are ways the holidays can be difficult:

1.     Gatherings can lead to feeling trapped

Crowded or enclosed activities can be stressful, and may feel like something to best be avoided.

2.     Trying to act “normal” when you don’t feel that way

Holiday festivities are supposed to be fun, and some mental health symptoms are far from joyful experiences. It can be stressful to show up at a holiday event and attempt to participate for the benefit of everyone else.

3.     Broken families gather, too

The holidays can be stressful when family and friends have been a source of hurt or abuse in the past. When hurts or abuses occurred in private, it can be difficult for other loved ones to understand why seeing a certain family member is a source of distress.

4.     Celebrations often involve over-indulgence in food and drink

For those with addictions or eating disorders, or for those with an intense sensitivity to unhealthy behavior, watching people eat and drink to excess can feel overwhelming. Being pressured to join them can be too much to bear.


How can we help support our loved ones who struggle during the holidays?

1.     Be flexible

If your loved one is suffering this holiday, remind yourself that he or she may need accommodations. They may not be feeling festive, and that’s okay. Don’t let your desire for a joyous holiday make you impose your ideal on others.

2.     Shield from difficult encounters

When you know your sister has a toxic relationship with your mother, or that your cousin was abused by a grandparent, you can help by keeping them apart when they both attend a family gathering.

3.     Don’t pressure them to participate

Sometimes our loved ones just aren’t up for the celebration. It can even make them worse to force themselves to join. One of the best ways to be supportive is to give permission not to participate.

4.     Offer alternative ways to celebrate

Instead of coming to a big gathering, offer a quiet one-on-one for your loved one with a mental illness. Agree that gifts are unnecessary if that helps, or connect in a non-holiday fashion, by simply stopping by and talking for a while.

Posted on November 27, 2017 .