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Global Mental Health Conference in Johannesburg

• February 09, 2018

I had the honor of participating in the Global Mental Health Summit in Johannesburg these past two days - simpy amazing. This is the first time in a conference with professionals that I've seen people with lived experience featured with equal prominence. Loved the theatrical production done by Talisman Foundation with different representations of OCD, addiction, anxiety were presented as people with vaiying colored wigs. You can see in the photo where the person tells her OCD to  go away!!

Met some incredible people, which I will write about once I have a little more time. For the curious, my speech is attached. I had to clip it, they only allowed me 5 minutes to speak. About half way through my talk, I realized I had only one minute left. So, here is what i would have said if I had a little more time:

In September of 2001, when most of the United States watched two planes crash again and again into the twin towers, I sat in a locked psychiatric ward waiting for my first round of electroconvulsive therapy, ECT. I was certain my life was over. I was certain I had nothing left to offer my children who were 5 and 7 at the time, my husband or my community. I was so certain of this, I drove my car into the garage and let the engine run for 90 minutes.

Depression almost took my life despite access to the best medical care available.  This crisis could have been averted if I had understood three things: 1) how to be more resilient 2) the early warning signs of depression 3) a better way to assign treatment.

In January of 2001, I went to my family physician. I’d lost a quarter of my body weight, couldn’t sleep; my appetite for both food and life had vanished. My thinking felt slogged, my sense of humor -- GONE. These are classic signs of depression, but the illness went undetected. My doctor did some blood tests told me I was fine.

My sister-in-law labeled my symptoms depression, not a professional. I sought out a psychologist, who  took me to a psychiatrist, who assigned medications. Within weeks, with 10 medications and no change to my brain, I knew I was incurable.

After the third suicide attempt, I had ECT. A small burst of electricity to my brain saved my life. Nothing in my life had changed, yet suddenly my self-imposed death sentence seemed, well, crazy.

Professionals guided me as best they could, but they lacked tools to be anything but reactive. Friends, family and self-reflection became my best barometer for warning signs.  We learned what created my crucible for illness: stress, lack of sleep and food, an injury that kept me from exercising, lack of sunlight, too much alcohol, isolation, overwork, overplay and no value placed on rest. Life lived as a speeding train needs only a pebble on the track to crash. And I crashed.

For the book tour for Struck by Living I came up with a Top Ten common-sense wellness list. You can see links on the slide behind me and you can find this list at the end of the books we gave away yesterday. This list is not prescriptive; what works for me might not work for you. HOWEVER  - many of us wait until we get sick to think about what we need to stay well. I encourage you to define your own list, write it down and protect it. It is far easier to maintain health than recover from illness.

Even though I went to my primary care doctor, he lacked two tools to help me. 1) he had no means to detect depression/bipolar disease in early phases. My depression went untreated long before 2001 2) once detected, he lacked a scientific means to assign treatment. If my primary care physician had a blood test or brain scan that said “Yep, she’s depressed and needs a dopamine-based antidepressant or even brain stimulation, more sunlight, alternative exercise and some kind of purposeful work” – I could have avoided the trajectory of illness that almost took my life.

Mental illness is a chronic disease. Like diabetes, mental illness is best managed with the right medicine and small, consistent lifestyle habits to ensure long-term health.

Our family foundation provided the initial funding for the Center for Depression Research and Clinical Care at UTSW in Dallas, led by Dr. Madhukar Trivedi. Trivedi studies large groups of people to discover what causes them to become ill, what helps them get better and stay well longer. He believes, as I do, in personalized medicine. We have to get more proficient at matching the right treatment to the person instead of forcing a generic approach on everyone.

Dr. Trivedi has forged partnerships with 19 primary care facilities. He developed a depression screen software program called called Vital Sign6. Every patient coming into the primary care for any issue or wellness check, completes VitalSign6 each time they visit. Like blood pressure or respiration, mental health is a vital sign and should be measured routinely. Trivedi is also doing a longitudinal resilience study with teens utilizing YAM – Youth Aware Mental Health.

Just like any disease, the earlier one can catch a problem and correct it, the higher the chance of recovery.

If the answer is so simple early detection and management, why is depression increasing? I can’t speak for other countries, but in the United States, in youth in particular, there is a common-sense disconnect between the body and mind. There is also an illusion of inclusion and exclusion that accompanies our digital world. Combine this with a plethora of new choices about what and who one can be, it is not surprising that depression is on the rise.

Cultural shifts have provided more freedom and opportunity, but also disconnection and disorientation. People are more mobile, no longer cemented in a home town where extended family lives. These were the people who provided unconditional love and support when things got rough. They also cast us in roles we didn’t like or that held us back. Now, we must create our own support structures – hard to do when mobility and freedom are so highly prized. Relationships take time, sacrifice and compromise. In our high-speed, mobile world, young people lack the time, understanding or examples of true relationships.

These are the things I would suggest in order to help today’s young:

1. Training that the mind, body and spirit are inextricably linked. Sleep, exercise, proper nutrition are critical to sound existence. This can be done by community leaders as the work of Dr. Vikram Patel has shown, not necessarily clinical experts.
2. Teach students about the impact of alcohol and drugs on dopamine and the self-defeating cycle of dopamine deprivation.
3. Create or practice cultural rituals, understanding social connection reduces stress.
4. Teach the importance of self regulation and calming through meditation and therapy
5. Use the arts (music, visual arts and theater) as a means for social connection and self expression.

In The Book of Joy, Bishop Desmond Tutu talks about the importance of Ubuntu – an idea that we are all connected. Ubuntu requires we connect in a genuine way, give to others, receive care, take chances, succeed, fail, recover and heal. Our human trinity of mind, body and spirit must be nurtured and challenged to stay whole. This concept is lost in a digital world that focuses only on the mind and fingertips. As big as our brains might be, we are still mammals.  We are nurtured through our senses. The most effective healers know this innately.

Thank you for the honor of sharing my story with you today. No doubt every one of you has helped someone who has suffered from mental illness. Perhaps they have forgotten to thank you. Let me thank you for them. People like me need people like you to recover and stay well. Your work is a gift.

 

Will post the actual speech once I load it up to YouTube. Special thanks to my friend Maria Beys who came with me and was my cheerleader and videographer!

 

Julie