Friday, July 25, 2014

Angry and Tired

I am angry and I am tired. In a four day span this week in Helena this week, two of our young citizens (Ages 50 & 52) lost their lives due to the consequences of serious mental illnesses. One was a Son and a Father whose family will wonder every day for the rest of their lives what they could have done to prevent to prevent this tragedy. The other was a former neighbor, who in his teenage years, was a babysitter for my two sons. Many people do not realize that people living with serious mental illnesses have a life span 25 years shorter than those of us who are diagnosed as “normal.” Premature death can be due to accidents and suicides, but the adverse effects of psychiatric medications, while lifesaving, can result in obesity, diabetes and heart disease. It is a little known fact that people living with serious mental illnesses use tobacco to alleviate the symptoms of their illnesses. In fact, 44% of the people who use tobacco are the 6% of the population who suffer from serious mental illnesses.

Mental illnesses cannot be cured at this time. They are however very treatable if people can access appropriate treatment. Many people do not know that appropriate therapy and medication can alleviate the symptoms, but no treatment eliminates the symptoms. Mary Giliberti, J.D., Executive Director for the National Alliance on Mental Illness has said, “The reality is that the current treatments available for serious mental illnesses such as schizophrenia and bipolar disorder are palliative interventions, not curative. At their most optimal and effective use, they are able to improve functioning and allow some to experience recovery and community integration. For major mental illnesses, we are still waiting for discreet novel interventions that genuinely change the course on the illness and avoid lifelong disability and impairment. This includes the development of a new third generation of antipsychotic medications to treat psychotic disorders.”

I am angry that I live in a world that does not recognize serious illness as a legitimate disease. I am angry that people in a psychiatric crisis cannot access respectful, thoughtful, compassionate and caring treatment. I am angry that our jails and prisons are overwhelmed with people suffering from serious mental illnesses. I am angry that there are more offenders in the Montana State Prison receiving psychiatric medications than there are patients in the Montana State Hospital. I am angry at our elected officials, public health servants and mental health professionals who tell me that they understand, but very little changes or improves. I am angry at families who, because of stigma, shame and discrimination do not recognize mental illness or advocate for their family members. I am angry at people who live with serious mental illnesses who, because of stigma, shame and discrimination do not access available treatment.

Finally, I am tired of attending funerals for the children of families who have been lost due to serious mental illnesses. Remember, the enemy is the illness.

Dr. Gary Mihelish

NAMI Helena
618 Edgerton Road
Helena, MT 59602

Thursday, February 20, 2014

Sticking With Your Treatment Plan

Part Seven of Debra Hoppe's Recovery Series

The question of whether a person needs medication to help control their mental illness and what kind of medication should be used is extremely complicated. It’s important to work with a psychiatrist or psychiatric nurse that you trust to help you through this difficult process. Don’t expect results right away. Every person is different, so it will probably take a little while to fight out what works for you.

I can’t stress how important it is to stick to your treatment plan. I have bipolar disorder and have a hard time functioning if I don’t stick with my treatment plan. For instance, I once wound up in an inpatient behavioral health unit during an episode that began when I forgot to take my evening medication.

It’s also important to stick to your treatment plan, because it helps your psychiatrist to know how to treat your symptoms and helps you to know what to tell the doctor when they do examine you. All medications need to be monitored for their effectiveness and for side effects as well as the dosage and cycling of your disorder.

It’s also important to work with a licensed therapist to help you with daily skills and determining symptom cycles or patterns. Since I have been taking my meds properly I haven’t cycled in a month which is an improvement for me.

I take my medication the correct way and work with my therapist. I get the rest I need and watch what I eat. I also exercise on a regular basis. All these add up to a healthier me.

Thank you for continuing on with your treatment plan and next time we’ll be discussing how to keep busy. Take care and may God bless you richly.

Wednesday, July 31, 2013

Don't Give Up

By Debra Hoppe

Part Six

Giving up is a normal instinct that a person has so it is a struggle to do. I know that I am a strong person and have a will that is solid. I try to think of the positive aspect of life and carry on. I have lived through two comas and have been able to tell people about them so I can say I haven’t given up.

A person has to set goals in their life and stick to them. Goals are hard to accomplish but that is one of the reasons you don’t want to give up. Another reason is that it only hurts you and the people around you. I know it is hard but when the chips are down I just pick myself up and dust myself off and get with the program. It will be beneficial for all concerned if a person sticks it out and completes the goal at hand.

Another reason to not give up is your self esteem. Your self esteem is one of the main things a person has that carries them through in life. If a person is having a bad day with their self esteem try looking at yourself through the eyes of another person and see what you come up with. You might be surprised with what you see.

Self esteem is important to all concerned because it affects not only you but the people around you. I have a high opinion of myself. I guess that is why I haven’t given up. I have a family that is proud of me and a boss that is happy with what I am doing. That is all that matters right now so I manage to make the best out of every situation that comes my way.

I want to thank you for taking the time to read what I have to say and I hope that I have been an inspiration to you. Take care of yourself and please don’t give up. It is important to stick with it and you will be a better person for it. Next time I will be talking about sticking to treatment.

Monday, July 1, 2013

Gary Mihelish Receives NAMI's National "Distinguished Service" Award and is Elected to the National Board

NAMI Montana is incredibly happy to announce that Dr. Gary Mihelish received NAMI's national "Distinguished Service Award" for 2013. This is NAMI's highest award. Past recipients of the Distinguished Service Award include Congressman Patrick Kennedy and Dr. Joyce Burland. Dr. Mihelish is a longtime leader of both NAMI Helena and NAMI Montana. He helped lead the charge for mental health parity in the Montana legislature and has been a teacher of Family-to-Family with his wife Sandra for over a decade. Dr. Mihelish has also been a means of support and information for desperate families across Montana that didn't have anywhere else to turn.

Dr. Mihelish was also elected to NAMI's national Board of Directors. This will allow him to bring his passionate service for people who live with mental illness and their families to a nationwide platform. This is a critical time for mental illness advocacy in America and we are extremely happy that Dr. Mihelish will be helping lead the fight.

Wednesday, June 26, 2013

Update on Legislative Study of Montana's Public Institutions

NAMI Montana friends:

I wanted to give you a quick update on the legislative study of Montana’s public institutions. The Children, Families and Health and Human Services Interim Committee met yesterday. This was the first public testimony on the study that NAMI Montana worked with Representative Jenny Eck to create.  I’m more than a little biased but it was a really promising start. There are great legislators from both parties on this Committee and they are already well-versed in mental illness policy making issues.  The heads of DPHHS and the Department of Corrections both said that the study was going to be essential in reviewing current practices and designing for the future.

We’ve got a lot way to go with this process.  (See the rough study plan here -  It’s going to be a lot of work, but there is a big potential pay off in creating a more compassionate and effective treatment system for Montana’s future.  Special thanks to Representative Jenny Eck  who carried the study bill. Patty Jacques and John Wilkinson whose incredible testimony yesterday about their families helped put the issue in extremely real and tangible terms. 

Click on this link,, to receive email updates about this Committee to see how you can stay involved.


Matt Kuntz

Executive Director
NAMI Montana

Wednesday, June 19, 2013

Suicide Motivation and Neural Circuits: Connecting the Studies

by Matt Kuntz
Executive Director
NAMI Montana

Note: I've underlined certain sections of this article to clearly link similar analyses in various research. All of this underlining is my own and a should not be ascribed to the quoted individual.

A University of British Columbia research team just completed a systematic analysis to help understand the motivations to commit suicide. The study, led by UBC PhD candidate Alexis May, was published by Suicide and Life-Threatening Behavior – the official journal of the American Association of Suicidology. (Read the study's official press release here.) The study was based on 120 participants who recently attempted suicide. The results suggest many motivations believed to play important roles in suicide are relatively uncommon. For example, the researchers found that suicide attempts were rarely the result of impulsivity, a cry for help, or an effort to solve a financial or practical problem. Of all motivations for suicide, the two found to be universal in all participants were hopelessness and overwhelming emotional pain.

This study's participants were Canadian outpatients and undergraduate students, but it is important to note that the motivations behind the participants' suicide attempts mirror the findings in a similar study of United States’ soldiers. In that analysis, researchers from the the University of Utah questioned soldiers who had attempted suicide. Out of the 33 reasons the soldiers could use to describe their motivation to committed suicide; all of the soldiers included one in particular — a desire to end intense emotional distress. (Read more about that study here.)

According Dr. Craig Bryan, the coauthor of that study, the soldiers tried "to kill themselves is because they have this intense psychological suffering and pain."

Beyond college students and soldiers, the New York Task Force on Life and the Law (New York Task Force) issued a report in May of 1994 stated that "the common stimulus to suicide is intolerable psychological pain." That report cited Dr. Edwin Shneidman's book, Some Essentials for Suicide and Some Implications for Response, which was published in 1986.

The accumulation of multiple decades of research into populations as varied as college students, soldiers, and people with terminal illnesses seem to generally agree that suicidal thinking and actions are a response to intense psychological pain. As someone with a brain wired to occasionally do battle with that demon, I agree with that analysis.

The unavoidable follow-on question is "What causes psychological pain so intense that suicide appears to be the only option." The New York Task Force provides that, "Contrary to popular opinion, suicide is not usually a reaction to an acute problem or crisis in one's life or even to a terminal illness. Single events do not cause someone to commit suicide."

The Task Force further specified that "Studies that examine the psychological background of individuals who kill themselves show that 95 percent have a diagnosable mental disorder at the time of death" Since serious mental disorders can generally be defined as disruptions in neural circuits, the logical conclusion is that there is something within the neural circuitry of a suicidal person's brain that causes them to experience extremely high levels of emotional pain - beyond the scope of any environmental stressors occurring in their life.

Neuroscientists are working to develop a better understanding of the process behind these deadly neural circuitry disruptions. After examining eighteen different studies, researchers from the University of California San Francisco proposed a tentative neural network for psychological pain that involves the following sections of the brain: the thalamus, anterior and posterior cingulate cortex, the prefrontal cortex, cerebellum, and parahippocampal gyrus. (See the abstract of their article in Brain Imaging and Behavior from March 2013 here). The proposed network has significant overlap with the neural network utilized when we experience traditional physical pain.

Take a minute to process that information. The neural circuits that transmit the feeling of physical pain such as a person's hand being on fire are similar to the circuits that transmit feeling of emotional pain. It's not surprising that a disruption in that powerful of a system in the brain would lead to the number one cause of disability in the world, depression, and potentially suicide.

It is hard to pinpoint what causes these neural disruptions and those causes may be different for different people. Genetic susceptibility, emotional trauma, brain injuries, and substance abuse are all potential contributing factors; especially when combined together.

There is no miracle cure for these devastating neural conditions, but recovery is possible through effective treatment and lifestyle changes. Life doesn't have to be a fight for survival.

***   ***
If you're experiencing suicidal thoughts and deep psychological pain, please call 1-800-273-8255. If you're worried about a loved one, call that number to learn about what you can do to get them help.

Thursday, June 13, 2013

A Written Letter: An Undervalued But Essential Advocacy Tool

Navigating through the mental illness treatment system can be difficult. It can be especially troubling when trying to find care for a loved one who so deeply enmeshed in symptoms that they cannot care for themselves.

With privacy laws and everything else, it’s hard to know who you can even talk to.

Outside of a crisis situation where someone’s life is immediately at risk, the most effective tool to express your about your or your loved ones treatment is also the simplest. Write a letter.

Write the treating clinician a letter describing what you’re worried about, why you’re worried and what you think should be done. If you don’t feel comfortable making specific recommendations, just tell them that you’re worried and ask if the treatment team can review the situation to make sure it’s being handled properly. It’s that simple.

If you don’t receive a response, wait a week or two and then send them another one. And then another one. Make sure to always keep a copy for your records.

Be polite, yet be specific about what you’re worried about and why. Don’t forget to put your name and contact information on the letter.

The same technique also works with city and county attorneys if the situation has become so dire that a 
commitment might be necessary. Or, with institution administrators if your or your loved one is not receiving effective treatment in their facility.

A written letter serves two purposes. The first is to let the person know about the issue. The second to build up a record in case something bad happens. Both of these purposes are important tools to utilize to help you or your loved one get effective care.

To find out more about mental illness, advocacy, and recovery go to

p.s. Please share this video with your friends and family to help them understand the power of writing letters in mental illness advocacy.