Accommodations at Work: What You Need to Know


Taken from   NAMI   which is located    HERE.

At the 2012 NAMI National Convention in Seattle this past June, Jenny Haykin, M.A., C.R.C., discussed what persons living with mental illnesses need to know about accommodations at work. In her informational session, Haykin explained different ways to go about asking for accommodations and whether accommodations are beneficial for individual work problems.

The workplace, where adults spend most of their time has many triggers that can unnerve workers and decrease productivity. Haykin explained that triggers “are stimuli that set individuals into a place where they aren’t happy.” Triggers for most people include change in the workplace, feeling out of control, conflict of values and rejection.

Haykin provided many factual examples of when asking for accommodations was successful and times when they were denied. Haykin explained that accommodations can sometimes address triggers but accommodations aren’t always the answer.

The first thing to take into account Haykin said, is whether your job fits your personality. “Individuals have to make the right choice in their choice of job,” noted Haykin. If an individual chooses a job where they have to make presentations but they have a fear of public speaking, an accommodation wouldn’t solve the problem; the job simply isn’t a good fit for the individual.

If a poor job or employer match is the problem, then accommodation will not solve the underlying problem.

The Americans with Disabilities Act, initially enacted in 1990 and amended in 2008, requires employers to provide reasonable accommodations to qualified individuals with disabilities unless doing so would cause undue hardship.

Haykin explained that if you as a worker are qualified for the position you hold and can do essential functions effectively, you can ask for an accommodation at work. An accommodation is anything that makes it easier for a worker to complete essential job functions. Some examples of accommodations include regulated breaks, interruption management, tailored communication methods and eliminating marginal functions.

If an individual wants to ask for an accommodation, Haykin suggested kindly letting the employer know you’re asking for an accommodation. “Your supervisor is the person who works with you to provide these accommodations, make theses interactions collaborative instead of putting your supervisor on the defensive,” she added.

Haykin also suggested coming to your supervisor with ideas. Some supervisors won’t have any ideas for you so you’ll have to bring your own. Haykin advises that individuals bring an open mind to your ideas and don’t demand things from your supervisor. They ultimately decide what will be implemented.

Haykin also encouraged individuals not be become discouraged if an accommodation doesn’t work the way it was planned. Finding the right accommodation is a trial and error process.

If accommodations aren’t working, and you need time off from your position, Haykin recommended qualified individuals take advantage of the Family Medical Leave Act (FMLA). If the employer in question has 50 other employees within 75 miles of an office, the employee has worked 12 months with the company and has worked 1,250 hours in the past year that individual qualifies for 12 weeks or 480 hours off from their position.

Haykin recommended using FMLA thoughtfully and only taking time off if it is really needed while giving employers as much notice as possible for extended leave.

Haykin concludes with the message that your job isn’t over if you cannot get an accommodation, job reassignment is another possibility if you cannot complete your essential job functions. If there is an open position in your company that you qualify for the employer is obligated consider you for that position.

Understanding an individual’s rights to accommodations and medical leave is crucial for those living with mental illnesses. Federal laws are there to assist workers with disabilities. Accommodations are a beneficial tool that can help reduce workplace triggers that can cause unproductivity. Understanding what can be done to assist you in your job can only benefit the longevity of your career.

For more information about accommodations, Haykin recommended the free services of the Job Accommodation Network.

Devil’s Burden: Streams In The Desert, September 29th, 2012

“There remaineth, therefore, a rest to the people of God” Hebrews 4:9


 The rest includes victory, “And the Lord gave them rest round about; …the Lord delivered all their enemies into their hand” Joshua 21:44
“He will beautify the meek with victory” Psalms 149:). (Rotherham, margin)
An eminent Christian worker tells of his mother who was a very anxious and troubled Christian. He would talk with her by the hour trying to convince her of the sinfulness of fretting, but to no avail. She was like the old lady who once said she had suffered so much, especially from the troubles that never came.
But one morning the mother came down to breakfast wreathed in smiles. He asked her what had happened, and she told him that in the night she had a dream.
She was walking along a highway with a great crowd of people who seemed so tired and burdened. They were nearly all carrying little black bundles, and she noticed that there were numerous repulsive looking beings which she thought were demons dropping these black bundles for the people to pick up and carry. Like the rest, she too had her needless load, and was weighed down with the devil’s bundles. Looking up, after a while, she saw a Man with a bright and loving face, passing hither and thither through the crowd, and comforting the people.
At last He came near her, and she saw that it was her Saviour. She looked up and told Him how tired she was, and He smiled sadly and said: “My dear child, I did not give you these loads; you have no need of them. They are the devil’s burdens and they are wearing out your life. Just drop them; refuse to touch them with one of your fingers and you will find the path easy and you will be as if borne on eagle’s wings.”
He touched her hand, and lo, peace and joy thrilled her frame and, flinging down her burden, she was about to throw herself at His feet in joyful thanksgiving, when suddenly she awoke and found that all her cares were gone. From that day to the close of her life she was the most cheerful and happy member of the household. And the night shall be filled with music, And the cares that infest the day, Shall fold their tents like the Arabs, And as silently steal away. –Longfellow

Songs From My Youth

I came to Christ in 1976.  For so many years before that I was immersed in the music of the day.  It made me think about life and much of it impacted me greatly. These songs helped soften my heart to the Gospel.  I carried immense guilt for years after becoming a Christian as I still enjoyed this music which many thought was ungodly.  I no longer have that guilt and can listen to this music with no apologies. Yes, I believe God used it for a young man looking for answers that he found In the person of Jesus.  Allan

Song List

1.  Eve Of Destruction-  Barry McGuire

2.  Games People Play-  Joe South

3.  Signs-  Five Man Electrical Man

4.  Love Is All Around-  The Troggs

5.  Silence Is Golden-  The Tremeloes

6.  He Ain’t Heavy, He’s My Brother-  The Hollies

7.  For All We Know-  The Carpenters

8.  The Times They Are A Changin’-  Bob Dylan

9.  Teach Your Children-  Crosby, Stills, Nash & Young

10.  Monday, Monday-  The Mamas And The Papas

11.  You’ve Got A Friend-  James Taylor

12.  Old Man-  Neil Young

Homeland: An Upfront Look At Bipolar Disorder



Taken from NAMI   which is located   HERE.

By Courtney Reyers, NAMI Publications Manager

What happens when a leading character of a hit show is caught in a world of deception, high stakes and mental illness? Showtime network’s Homeland is the best example we’ve seen to date in its female protagonist, Carrie Mathison (played by actress Claire Danes). Season two of Homeland premiers this Sunday. Building off season one’s cliffhanger finale where Carrie voluntarily undergoes electroconvulsive therapy (ECT) to manage her major depressive episode (which was preceded by a manic episode that unraveled a case, but also cost Carrie her job at the CIA).

Recently, Homeland nabbed a SAHMSA Voice Award as well as six Emmy Awards just last week—including a best actress core for Danes as well as an award for best series writing. What’s so great about Homeland is its sensitive portrayal of bipolar disorder—the perks and the downfalls—as well as the stigma that goes along with mental illness. Carrie hides her disorder to keep her job, receiving meds in secret from her nurse sister, who is pretty much her sole source of support. When Carrie takes off for a long weekend without her medication, a manic-depressive episode follows as the storyline unfolds, much to Carrie’s credit.

Carrie figures out the twisted plot of terrorism and treason, but unfortunately has lost credibility because of her illness with her peers. The lines between reality and hallucination, lie and truth, “crazy” and “normal,” shift all over the place and have viewers questioning who the bad guys really are. The sympathy Danes’ acting prowess invokes, along with other cast members, does one of the best jobs of portraying mental illness in modern television today with compassion, clarity and responsibility attached.

NAMI spoke to one of Homeland’s lead writers, Meredith Stiehm, who has also written and produced for hit shows such as Cold Case, NYPD Blue and ER.

NAMI: Claire Danes does such a good job portraying bipolar disorder. As one of the writers, has personal experience with mental illness touched anyone on the writing team? MS: We ‘ve all had some experience with it. We’ve all swapped stories, because mental illness is not so rare. When you look back on things, you can identify them as symptoms as bipolar disorder or schizophrenia. Mental illness is really prevalent in our world and our society. We’ve all experienced it. [As writers on the show], we made it a real point to educate ourselves about bipolar disorder, and Claire did as well.

NAMI: Carrie’s decision to undergo ECT in the final episode is both agonizing and disturbing. Did the team worry about any backlash from viewers on this?
MS: I had some concern. It’s an extreme measure. A lot of people who aren’t familiar with modern treatment associate ECT with the “lobotomies” and treatment in the 1950s. ECT can be really helpful for depression. You don’t turn into a zombie. There is a lot of fear about it. During our research and from talking to people, we found that it’s really an effective treatment. It doesn’t hurt you and it’s a measured experienced.  We address the ECT right away those in the first episode of season two.

NAMI: Anything you can give us on season two?
MS: I’m not really sure how much I can reveal here. It’s fair to say that Carrie has this existing illness, and she manages it. I always feel that my responsibility, for her character, is to show somebody who is diagnosed with mental illness but is living with it. She can be an effective person in her professional and personal life, it’s not a wall that stops her from functioning.  It’s something you can treat and live with.

NAMI: What’s one of your greatest challenges as a writer, and what’s one of your biggest joys?
MS: What I like to write about is strong women in male environments, and that’s clearly Carrie Mathison. She’s in the world of the CIA and terrorism and spies, which is more commonly a man’s world. I love writing about women who manage that world who can figure out how to partner with the guys and be as essential as anyone else.

NAMI: When you’re creating something that can have a great effect on popular culture, where do you draw the lines between social awareness, entertainment and art?
There are certain things I know I would chafe at presenting for socially responsible reasons. But different artists have different feelings about it. It’s important to have female characters that are strong, effective, smart and uncompromised. In Cold Case, the lead was Lilly Rush who was a homicide detective and it was important to me that she be a respectable character. But this not my show, this is Alex [Gansa] and Howard [Gordon]’s show, so I don’t assert myself that way about these characters.

NAMI: Do you feel like you know more about mental illness since working on Homeland?
I’ve made it my business to learn more. I wrote Carrie’s psychotic break in the second-to-last episode. So I went to Princeton to sit in on a class of Leon Rosenberg, who has written about his own bipolar illness publicly. His guest speaker was Kay Jamison, who did a symposium. I got to spend some time with her and read her book, and really was able to make sure that we were being accurate, fair and honest about Carrie’s character. I have to give a lot of credit to Claire. She studied, very hard, it was important for her to portray Carrie’s illness responsibly and accurately.  After every take, she would come to me and ask me what do you think? She really cared about getting it right.

Youth With SUD At Increased Risk Of Bipolar Disorder

Taken from  Mental Wellness Today  which is located   HERE.

In a study of youth who have a parental history of bipolar disorder and who have a high-risk of developing a mood disorder themselves, about one-quarter of participants had a substance use disorder (SUD).

The study, completed by Anne Duffy and her team at the University of Calgary in Alberta, Canada, looked at 211 youth over the age of 12 with a parental history of bipolar disorder, to find that 24 percent of participants met the criteria for a lifetime of SUD.

In a mean follow-up-period of 5.2 years, researchers found the risk of developing a major mood disorder for those with a SUD was close to three times higher than those without. The hazard ratio (HR) was 2.99 for developing a major mood disorder, and 3.40 for developing bipolar. Having a SUD also meant an increased risk of psychosis.

In the Journal of Affective Disorders, the researchers report that “the early identification and prevention of SUD in this identifiable population of high-risk young people should be a major public health priority.”

Among participants who met SUD criteria [according to the Diagnostic and Statistical Manual on Mental Disorders] (DSM-IV)], the mean age of onset was 17.1 years, with the peak hazard age ranging from 14 to 20 years.

Significant predictors of a SUD were being male and a parental history of SUD. At 16.6 percent, cannabis was the most common substance abused, followed by alcohol at 13.7 percent. Researchers also found that 32 percent of those with an SUD had at least two lifetime diagnoses.

“The major findings of this study support that SUD is a major clinical problem occurring early in the evolving course of [bipolar disorder], during a very important time for neurological, cognitive, emotional and academic development,” reported Duffy et al. “This observation underscores the importance of further research to determine who in this vulnerable population develops SUD, and how this differs initially or at all from SUD in the general adolescent population.

Added the researchers: “This information would then lend itself to the development of specific early and perhaps preventative interventions targeting the underpinnings of SUD in HR populations, and may have relevance for prevention in the adolescent general population.”

Source: News Medical

A Call For Caution On Antipsychotic Drugs



Taken from the  New York Times  which is located    HERE.

You will never guess what the fifth and sixth best-selling prescription drugs are in the United States, so I’ll just tell you: Abilify and Seroquel, two powerful antipsychotics. In 2011 alone, they and other antipsychotic drugs were prescribed to 3.1 million Americans at a cost of $18.2 billion, a 13 percent increase over the previous year, according to the market research firm IMS Health.

Those drugs are used to treat such serious psychiatric disorders as schizophrenia, bipolar disorder and severe major depression. But the rates of these disorders have been stable in the adult population for years. So how did these and other antipsychotics get to be so popular?

Antipsychotic drugs have been around for a long time, but until recently they were not widely used. Thorazine, the first real antipsychotic, was synthesized in the 1950s; not just sedating, it also targeted the core symptoms of schizophrenia, like hallucinations and delusions. Later, it was discovered that antipsychotic drugs also had powerful mood-stabilizing effects, so they were used to treat bipolar disorder, too.

Then, starting in 1993, came the so-called atypical antipsychotic drugs like Risperdal, Zyprexa, Seroquel, Geodon and Abilify. Today there are 10 of these drugs on the market, and they have generally fewer neurological side effects than the first-generation drugs.

Originally experts believed the new drugs were more effective than the older antipsychotics against such symptoms of schizophrenia as apathy, social withdrawal and cognitive deficits. But several recent large randomized studies, like the landmark Catie trial, failed to show that the new antipsychotics were any more effective or better tolerated than the older drugs.

This news was surprising to many psychiatrists — and obviously very disappointing to the drug companies.

It was also soon discovered that the second-generation antipsychotic drugs had serious side effects of their own, namely a risk of increased blood sugar, elevated lipids and cholesterol, and weight gain. They can also cause a potentially irreversible movement disorder called tardive dyskinesia, though the risk is thought to be significantly lower than with the older antipsychotic drugs.

Nonetheless, there has been a vast expansion in the use of these second-generation antipsychotic drugs in patients of all ages, particularly young people. Until recently, these drugs were used to treat a few serious psychiatric disorders. But now, unbelievably, these powerful medications are prescribed for conditions as varied as very mild mood disorders, everyday anxiety, insomnia and even mild emotional discomfort.

The number of annual prescriptions for atypical antipsychotics rose to 54 million in 2011 from 28 million in 2001, an 93 percent increase, according to IMS Health. One study found that the use of these drugs for indications without federal approval more than doubled from 1995 to 2008.

The original target population for these drugs, patients with schizophrenia and bipolar disorder, is actually quite small: The lifetime prevalence of schizophrenia is 1 percent, and that of bipolar disorder is around 1.5 percent. Drug companies have had a powerful economic incentive to explore other psychiatric uses and target populations for the newer antipsychotic drugs.

The companies initiated dozens of clinical trials to test these drugs against depression and, more recently, anxiety disorders. Starting in 2003, the makers of several second-generation antipsychotics (also known as atypical neuroleptics) have received F.D.A. approval for the use of these drugs in combination with antidepressants to treat severe depression, which they trumpeted in aggressive direct-to-consumer advertising campaigns.

The combined spending on print and digital media advertising for these new antipsychotic drugs increased to $2.4 billion in 2010, up from $1.3 billion in 2007, according to Kantar Media. Between 2007 and 2011, more than 98 percent of all advertising on atypical antipsychotics was spent on just two drugs: Abilify and Seroquel, the current best sellers.

There is little in these alluring advertisements to indicate that these are not simple antidepressants but powerful antipsychotics. A depressed female cartoon character says that before she starting taking Abilify, she was taking an antidepressant but still feeling down. Then, she says, her doctor suggested adding Abilify to her antidepressant, and, voilà, the gloom lifted.

The ad omits critical facts about depression that consumers would surely want to know. If a patient has not gotten better on an antidepressant, for instance, just taking it for a longer time or taking a higher dose could be very effective. There is also very strong evidence that adding a second antidepressant from a different chemical class is an effective and cheaper strategy — without having to resort to antipsychotic medication.

A more recent and worrisome trend is the use of atypical antipsychotic drugs — many of which are acutely sedating and calming — to treat various forms of anxiety, like generalized anxiety disorder and even situational anxiety. A study last year found that 21.3 percent of visits to a psychiatrist for treatment of an anxiety disorder in 2007 resulted in a prescription for an antipsychotic, up from 10.6 percent in 1996. This is a disturbing finding in light of the fact that the data for the safety and efficacy of antipsychotic drugs in treating anxiety disorders is weak, to say nothing of the mountain of evidence that generalized anxiety disorder can be effectively treated with safer — and cheaper — drugs like S.S.R.I. antidepressants.

There are a small number of controlled clinical trials of antipsychotic drugs in generalized anxiety or social anxiety that have shown either no effect or inconsistent results. As a consequence, there is no F.D.A.-approved use of an atypical antipsychotic for any anxiety disorder.

Yet I and many of my colleagues have seen dozens of patients with nothing more than everyday anxiety or insomnia who were given prescriptions for antipsychotic medications. Few of these patients were aware of the potential long-term risks of these drugs.

The increasing use of atypical antipsychotics by physicians to treat anxiety suggests that doctors view these medications as safer alternatives to the potentially habit-forming anti-anxiety benzodiazepines like Valium and Klonopin. And since antipsychotics have rapid effects, clinicians may prefer them to first-line treatments like S.S.R.I. antidepressants, which can take several weeks to work.

Of course, physicians frequently use medications off label, and there is sometimes solid empirical evidence to support this practice. But presently there is little evidence that atypical antipsychotic drugs are effective outside of a small number of serious psychiatric disorders, namely schizophrenia, bipolar disorder and treatment-resistant depression.

Let’s be clear: The new atypical antipsychotic drugs are effective and safe. But even if these drugs prove effective for a variety of new psychiatric illnesses, there is still good reason for caution. Because they have potentially serious adverse effects, atypical antipsychotic drugs should be used when currently available treatments — with typically fewer side effects and lower costs — have failed.

Atypical antipsychotics can be lifesaving for people who have schizophrenia, bipolar disorder or severe depression. But patients should think twice — and then some — before using these drugs to deal with the low-grade unhappiness, anxiety and insomnia that comes with modern life.

Dr. Richard A. Friedman is a professor of psychiatry at Weill Cornell Medical College in Manhattan.

Suicides Now America’s Leading Cause Of Death By Injury: Study

Taken from the Huffington Post which is located   HERE.

Around the time of recession rocked the United States, its population experienced a disturbing shift: Today, suicide takes more American lives than any other form of injury.

Between 2000 and 2008 motor vehicle crashes were the leading cause of death by injury, but suicide surpassed car crashes in 2009, according to a recent study in the American Journal of Public Health. The switch is the culmination of a decade-long trend; the rate of death by suicide increased by 15 percent over the past ten years, while the unintentional motor vehicle crash death rate dropped by 25 percent during that same period.

The study didn’t specifically factor in economic conditions, but many have speculated that the downturn may be responsible for a boost in suicides in America and around the world. In Greece, the suicide rate for men rose by 24 percent between 2007 and 2009, according to The New York Times. Suicides motivated by economic crisis grew by 52 percent in Italy in 2010.

In England, unemployment may be tied to more than 1,000 suicides, according to a recent paper in the British Medical Journal.

In the U.S. the correlation between the boost in suicides the current economic downturn hasn’t been definitively established, but the rate of suicides in America did increase during past periods of economic crisis, like the Great Depression, the 1970s oil crisis and the recession in the 1980s, according to data from the Center for Disease Control cited by the Washington Post.

Tragically, there are plenty of anecdotal examples of “economic suicide” in the country. A Tennessee man lit himself on fire earlier this year after finding out he wouldn’t be getting financial help from a private organization. And in May, a California man shot and killed himself in the midst of a legal battle with Wells Fargo, while he faced the prospect of foreclosure.