Making it through the tough stuff

Art by Pamela Zagarenski, and can be found here

Recently, on my other blog, I wrote about a hectic amount of "life" I had managed to accomplish in August. It was one of those "scheduling" sort of months, where there is so much going on that it seems like the only way you can make it through the day is with a detailed list. Do you do that too? Only, for me, it was a list that had to carry me through a whole month! Whew, life sure was busy during August! But the important thing is that I made it through, and I even managed to enjoy myself during all that action.

I reflect back to a year ago when life was frantic, unpredictable, and had become unravelled. Days went by where I was not able to concentrate on anything, much less make a list. Our 17 year old son had just been plucked off the streets, hospitalized in cardiac arrest, and ultimately sent off to yet another rehab more than half way across the country. It would only be ten more days until his suicide attempt by hanging. The mayhem and crushing blow of how his addiction and resulting mental illness (or visa versa) took all of us down was like being hit by a tidal wave. Only, there was a small sense of seeing it coming... For the past 2 short months, we had been watching him unravel before our very eyes after returning home from 18 months in rehab. 

How do we make it through the tough stuff? How do we keep our wits about us when life gives us more than we can handle? How can we stay in a place of calm determination instead of retreating in fear?

Last week, I heard Brian Williams on the nightly news reporting from his home state of New Jersey, specifically Camden – a city he called the most dangerous in America. In the report, he interviewed J. Scott Thomson, Chief of the Camden County Police Department who said this:

“This city has the most resilient people you will ever meet. All they needed was something they could hold onto, something they could trust.”

In this city, said to have the highest crime rate in the country, Chief Thomson was part of a team who helped give them something to hold on to – hiring over 200 new cops, sending them out on bikes and foot patrol, organizing kids vs. cops basketball games. Chief Thompson was in the process of rebuilding hope and trust in Camden, and it was just what the townspeople needed. They need a leader to take them to a place where they can turn away from fear, find trust, and get busy getting back to a place of normalcy.

I have spoken about leaning in to the fear before. Even if we don't have a Chief Thompson in charge, it IS possible for us do it on our own. Here is how we make it through the tough stuff: We arm ourselves in the best way possible. We find a way to hold onto ourselves. 

Do we need more sleep? Take a quick nap before doing one. thing. more. Are we starved for self-soothing? Maybe it's time we take ourself out to lunch at our fav place- just you and me all alone, baby! A table for ONE! Maybe we are feeling shabby and unkempt.. (ugh, I have been there and it's not pretty!) I bet we can buy ourself something pretty that will lift our spirit... even if it costs less than $5. It's okay to do this. Really. I promise. But, maybe we are feeling so broken in spirit that we can't even begin to do anything for ourself. <Big hug to you> Do you have access to buying an app? I recommend Jesus Calling. Even if you aren't particularly religious. It works wonders for the soul. Here's the link to the daily reader app, and here's the online blog where the daily readings are posted, and the Facebook page can be found here. It's a great way to get quiet inside your soul, so you can get in touch with the deepest part of your heart, and what it is telling you. Oh. So. Important. Because your heart will be a Chief Thompson for you, and gently guide you back to a place of trust. 

Keep pressing on, Friend. This troubled day will not harm you. You have been through trouble before and you will get through this too. Take a deep breath, and give that trouble a big hard look. And tell that trouble that it will not get the best of you today!

xx

Val

PS. The other thing we can do is to needle felt. It has worked wonders for me!!!

HUGE Win #4 against my insurance company thanks to the Mental HealthParity Law

Each time our insurance company denies my son the care he needs, and I decide to report them to the CA State Insurance Commissioner for an inappropriate denial, I am stronger and more sure of myself. My immediate cause is more concretely etched in my mind, my words flow more smoothly, and my mind is keen to use any and every possible weapon to support my cause that I can.

My cause is a powerful one. I am a mom fighting for her son's life.

Fortunately, (and in the mysterious ways of the world, plus a caring friend's suggestion), it was put upon my path early in 2014 to attend a NAMI support class with my husband (learn more by clicking here). NAMI stands for the National Alliance on Mental Illness, which is an organization that provides the most up-to-date information on mental illness research and findings. My reasons to explore NAMI were many, but primarily to unite together as a family to be able to best support our son with his terrible depression, and addiction issues. We learned so much from this Family to Family group of classes, connected with others who were going through similar trials with loved ones, and found a new tool box for being able to relate to our son. Also, we found better ways to support our younger son during the regular upheavals our family was going through then, and continues to go through to this day. Our NAMI classes lasted for twelve weeks. We also attended a yearly event put on by NAMI called the "NAMI Walk", where we connected with local organizations offering even more support for families dealing with mental illness, and similar disorders of the brain. Powerful, powerful stuff...

So, NAMI is who I credit for fortifying my head with a whole armory of information that supports individuals with mental illness. This is where I learned about the Mental Health Parity Law.

The Federal Parity Law, which, beginning January 1, 2014, was amended and expanded under the Affordable Care Act. The Mental Health Parity and Addiction Equity Act of 2008 applies to most all forms of health insurance, and states the health plan should provide all medically necessary treatments for severe mental illnesses, including necessary residential care. Mental Health Parity and Addiction Equity information sheet as put out by SAMHSA can be found here.

There was absolutely no reason my son should be excluded from receiving the care he needs, for as long as he needs it. And, even though our insurance plan only covers 100 days of residential care each calendar year, the Mental Health Parity Law allowed for my son's residential care coverage BEYOND the 100 day mark! The cost of residential therapeutic care is so incredibly high, and when a family has basically gone bankrupt due to the high cost of this type of care in an effort to help a family member, it is a huge relief that there are government regulated systems in place so a family can get some sort of a financial break. Our cumulative savings for six months of care at this center were just shy of $100,000! That's ONE HUNDRED THOUSAND DOLLARS.

Wow. Just Wow.

These Laws and systems are available to everyone. Every state has a reporting agency for inappropriate actions taken by insurance companies. If your insurance company denies mental health or addiction coverage for a family member, even if your coverage does not specifically cover that type of care, you can fight this denial! Do not be afraid to ask questions, and stand up when things are not right. I never went into this being a whistle blower. I just know the difference between right and wrong. And, who will stand up for my son, his needs, and his rights, when he cannot do it on his own?

My next step? Becoming involved with NAMI in order to advocate for youth who struggle with Dual Disorders of the brain. I want to support these struggling teens and help their families navigate this difficult road. I am ready. I am willing. I will do what I can.

* To read more about the steps I took to fight my insurance company, please read this post: http://themominthearena.blogspot.com/2014/02/how-i-went-up-against-our-insurance.html?m=1

NAMI presents Marijuana and the Developing Brain

I would like to bring your attention to NAMI, the National Alliance for Mental Illness. Their programs are designed to help families of those suffering from a mental health condition. Mental illness touches every family. The educational information you receive through NAMI is the most up-to-date on the topic you're concerned about. You can get more information about NAMI by visiting NAMI.org.

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Marijuana and the Developing Brain:

New Risks and Realities for Ventura County 

with

Dan Hicks & Richard La Perriere

Ventura County Behavioral Health

  

Earlier this year, Dr. Nora Volkow, Director of the National Institute on Drug Abuse (NIDA) noted that there have been significant changes over the last 20 years in Marijuana. Levels of THC -- the main psychoactive ingredient in marijuana - have gone up a great deal, from 3.75 percent in 1995 to an average of 15 percent in today's marijuana. 

She notes: "Daily use today can have stronger effects on a developing teen brain than it did 10 or 20 years ago."

The potency of marijuana has increased to over 20% THC in the same time period, while availability and heavy use among adolescents have continued to rise.

This presentation will outline contemporary research on the effects of Marijuana on the teen brain, and address a range of issues now discussed across Ventura County, including availability, potency, modes of administration, levels of use, perceived harm, cognitive effects and local youth prevention strategies. 

Understanding the current local context of marijuana use and scientific studies on the effects of marijuana on the developing brain, the presenters will share views from the behavioral health field, including the risks of dependence, lasting cognitive declines, links between use and problem behavior, and implications for prevention and treatment.   

Please visit www.VenturaCountyLimits.org/initiative/marijuana

Dan Hicks is Manager, Prevention Services - Ventura County Behavioral Health Department. A graduate of Princeton University, Dan has been an alcohol and drug policy advocate for 20 years, working closely with city and county governments, public safety agencies, and retail alcohol establishments. He has facilitated policy discussions of among elected officials, police officers, parents groups and regional media, and helped establish Ventura County Limits - responsible prevention policies and practices locally.

Richard La Perriere has 20 years of experience with alcohol & drug treatment services, and is a Clinic Administrator in the Alcohol & Drug Programs at VCBH.

All General Meetings are Free and Open to the Public.

NAMI General Meetings are open to anyone interested in learning about mental illness. Speakers address a wide range of topics such as: research on schizophrenia and bipolar disorder, new medications, proven rehabilitation approaches, financial planning for families with a disabled member, early diagnosis and intervention, public and other community mental health services, disability benefits, etc.

Please contact NAMI Ventura County for more information on this program, and others like it by visiting this web page: http://bit.ly/1m7luTc

Guardianship vs. Conservatorship: Questions Answered

I have not been able to figure out the "why" behind my inability to find answers regarding obtaining a Conservatorship for my son within the state of California. I have literally spoken with hundreds of people looking for answers, from lay people such as volunteers working in the mental health field, to Educational Advocates who have a sound knowledge of helping one's child, to government workers calling Conservatorships and Probate their area of expertise, to attorneys who specialize in Probate Law. In a previous post (here), I wrote about my process in locating a lawyer to help me obtain a Temporary Guardianship for my son, however, once our Court Order was achieved, the information I received moving forward proved to be inaccurate. I will also clarify that the laws in the two states I dealt with (Texas and California) differ greatly. The information I discuss here is directed to dealing with Guardianships and Conservatorships within California, and outside the state of California.

In an attempt to set the record straight, and to provide you with truly useful information you may be researching about Guardianships and Conservatorships, I invite you to read on. Please understand, the information I have written here is based on my direct experience in attempting to obtain a Guardianship/Conservatorship for my son. (Sidenote: we did obtain a Temporary Guardianship for our son while he was in Texas, which you can read about here. Since he has been returned to CA, I was able to obtain a Temporary Conservatorship of the Person for him on my own- without a lawyer. I am in the process of obtaining a Permanent Conservatorship of the Person for him, which will be used until he can prove that he is able to care for his needs).

First of all, I would like to offer a disclaimer regarding those who have helped me achieve all I have up to this point, in an effort to help my son. Their guidance has been invaluable to me, and in all likelihood, they may have given me information that I was unable to digest and interpret properly at the time. I do not have a law background, so some of these things are completely foreign to me, and take some time to understand.

Secondly, I respect the nature of Conservatorship Law, and the overall desire to not "imprison" or hold someone with a mental impairment against their will, provided they are able to take care of themselves. In my discussion here, I am referring to someone who is unable to provide for their own safety, care, and well being. More specifically, I  am referring to my own family's situation where our son, who turned 18 just two months ago, was determined to be an incapacitated adult, unable to provide for his daily care and needs due a mental health impairment. This determination was due to actions he took on his own, and based on a long history of depressive behavior, and from a Partial Complex Seizure Disorder. This means there are two regions in his brain where the neurons are not firing correctly, and information is not delivered into "long term storage". He doesn't seem to learn from his mistakes, and renegotiate the path, so to speak. (If you would like any more information on this, please read this post, or email me directly).

The definition between a Guardianship and a Conservatorship, as I understand it:
In simple terms, and within the state of California, Guardianships are used for a minor under the age of 18, and Conservatorships are for adults 18 and over. States outside of California use Guardianships beyond the age of 18. (You may want to do some research on the guardianship laws in your state.) Furthermore, in the state of California, there is something called an LPS Conservatorship, which is also referred to as a Mental Health Conservatorship, for people who cannot care for themselves due to a mental health impairment. LPS Conservatorships are normally initiated by a treatment center, and used for a short timeframe, just long enough to reestablish the person to a state of sound mental health. Regular Conservatorships are often used for a broader range of individuals, older people struggling with memory issues, or those unable to take care of their estate, as well as a wide range of other issues of which I am still unfamiliar, and am learning about as we speak. If your child has Autism, or a Spectrum Disorder, you may want to consider a Limited Conservatorship, or a Limited Guardianship in states outside of California. More info here on adults with autism outside the state of CA, or here on adults with disabilities within the state of CA.

Most everyone is very excited for their son or daughter to reach the Age of majority; age 18. But what happens when your child is grossly unprepared? If your child suffers from a brain disorder and (s)he cannot take care of himself, he or she may or may not be content to allow you to care for them. You need to be aware that you may need to put a legal system in place, so it is accepted and recognized that you remain their caregiver upon their reaching adulthood. Basically, upon the age of 18, the state will assume your child is legally competent in making his or her own decisions and taking care of his/her affairs, until it is determined your child is incompetent. Your child will be allowed to make their own decisions about any special services you have arranged for them, and can even make the decision to give up those services. It does not matter that your child does not have the capacity to understand what they are doing. 

Can I obtain a Guardianship/Conservatorship for my child?
#1: Is it reasonable to consider getting a guardianship or conservatorship order for my child?
This is something you should discuss with your child's health care provider, therapist, or psychiatrist. You should know that your child will need to have a treating psychiatrist fill out a form for the court in which they will state the child is incapable of taking care of themselves.

#2: County of Residence
When it became evident we needed to establish a guardianship for our son, we needed to enlist the help of his treating psychiatrist, and file all the court documents. Our son was living in the state of Texas at the time, and so it was necessary to go through the court system in the state and county where he was residing. That was hurdle number one that no one told me, but which it took me months to learn; You need to establish the guardianship or conservatorship within the county where your child is residing.

#3: Do I need to hire a lawyer?
In Texas, the courthouse in the county where my son was living wouldn't even speak to me without having a lawyer on board, so I had to hire a lawyer. Apparently, certain counties have different regulations than other counties. That particular county in Texas required a lawyer, while the nextdoor county does not. In fact, the lawyer I hired told me all along that I "could do this myself," but the courthouse clerks said otherwise. So, I recommend you call your local county courthouse, ask for the Probate Division, and ask if you will be able to file papers on your own, or if they require you work with a lawyer. (They will always push the work with a lawyer angle, just so you know) But if they say, "You are able to file the papers on your own" that means that you can do this without having to hire a lawyer.

#4. What papers do I need to file?
There is a website for that. You can google the courthouse in the county where you reside, and look for a link called "forms"or "common forms". There will be a link to the Probate Division, and from there you can explore the Guardianship division or the Conservatorship division. Let me warn you, there are lots of forms! You can also call the courthouse, and ask for the Probate clerk, and see if there's a packet of forms you can buy. Then, they are all organized for you. This is definitely the simplest way to get the necessary forms.

#5: How do I know if I'm doing this right?
Yep, I hear you. I would never have known what to do if I didn't have witness to all my Texas lawyer did for me, and I was able to follow in her suit. I you cannot afford to hire a lawyer, maybe you can pay to have a Paralegal help you. They are used to filling out all the forms, can have a service provider serve the necessary forms for you, and file the forms at the courthouse. That is another option you have in getting the forms properly filed.

*Disclaimer: The information I share here is intended to be used as an information gathering tool only. I am not a lawyer, nor am I affiliated with a lawyer. I am writing this based on my direct experience with obtaining a Temporary Guardianship of the Person, a Temporary Conservatorship of the Person, and a Permanent Conservatorship of the Person. Probate Laws differ all across the county. If you are in need of additional guidance, I recommend contacting a lawyer who specializes in Probate Law.

Here are some additional links for more information on a few of these topics:
Conservatorship: click here
Guardianship: click here
LPS Conservatorship: click here and here

Challenge fear

Yesterday I was fearful. Today I got answers. Now my path is clear, and I can continue moving forward.

I received a phone call yesterday afternoon that caused the pit of worry in my stomach to bubble and boil. By the time evening came around, I was fairly paralyzed by this, but I focused on staying present. So, I sat with the fear. I looked at it sternly, and told it it wasn't going to own me. I reassured myself that I had come through worse things before, and I would come through this one too.  

Life is funny like that. Life throws us curveballs when we least expect it. The trick is in knowing how to respond to the curve. 

For me, staying calm is a necessity. If I become anxious, the planning part of my mind seems to shut down, and I let that tornado of emotion and fear ruin my sanity. Really... who has time for that? When things are going south, and fast, the time to stay sane and grounded is now.

Here's a look at my fear checklist:

 - Listen carefully to what's being told to me. Stop and ask questions in order to get the full scope of what's being said. Make sure to ask if I can call them back should I have further questions later on. Get their phone number if I need to.

 - Allow to feel the emotions that wash over me. Acknowledge that I am fearful, or angry, or whatever the emotion is I'm feeling. Recognize the symptoms my body is eliciting. Accept this, and tell myself this is normal.

 - Tell myself I have nothing to lose by waiting to take action until the morning (when possible).

 - Get a good night sleep, which often involves Tylonal PM. I am not too proud to admit this :o) Nothing good comes from waking up at 3am and lying awake steeped in worry for half the night.

 - In the morning, I often have a very good and workable plan of action. 

 - As soon as possible, put those plans in order. Make those phone calls in a calm, clear manner, and be thankful that the good nights sleep is serving you well. And, that the answers you are getting are a direct result from carefully following these very necessary steps you've taken. Now, there is a new plan of action.

My relief is an amazing feeling! I realize how much I've grown in all of this. And that is a very good thing.

Don't let our country go to pot

I am very concerned that the collective consciousness in our society today seems to be one that supports the legalization of marijuana. It seems this level of acceptance is rampant across many different factions of society; a variety of age ranges, different levels of education, and various positions of stature within society. In fact, I was listening to NPR last week, and heard a very antiquated sounding congressman (he had an "old man" wobbly sounding voice, I'm sure you've heard this) speaking of the needs for our government to finally legalize marijuana, that marijuana should be given the same standards as were used to legalize alcohol. Two states have already legalized marijuana, and boast in the news headlines how their state is "finally getting out of debt", they are making so much money from sales tax on marijuana.

It's funny, but the only people that I have spoken to who are adamantly against the legalization of marijuana are the family members of alcoholics, addicts, and family members of those suffering from mental illness.

If every person in the United States who is in favor of legalizing marijuana had an addicted or mentally ill family member who they love and care for turn to marijuana for a life coping skill, they might think differently about how marijuana impacts our society. Please try for a moment to put yourself into this scenario: If your loved one (your teen son or daughter, or your college aged cousin, niece or nephew, or your husband or wife) started out by occasionally smoking pot, then began to abuse marijuana where they begin checking out of life by not doing anything EXCEPT staying in their room and smoking marijuana, you may become alarmed. If you tried to help your loved one by getting them into a drug treatment program, and even drug tested them, and you stand by helplessly as your loved one turns to harder drugs, because those drugs don't show up as easily on a drug screen. Now, maybe your loved one, who was always such a great person, regularly lies to you. You feel like you are losing touch with them. (What is happening???) Now your loved one is dealing with shame, humiliation and depression, because that is what happens to the brain when people abuse drugs. You stand by helplessly and watch your loved one fall into a hopeless pit that is now governed by a drug addiction and a newly diagnosed mental illness. Your loved one may fall apart emotionally, mentally, they may leave home, steal from you, even turn on you like they never knew you. Where has the person you love disappeared to?? You feel so helpless as you stand by. They may attempt suicide, they may kill someone. They may kill you.

This may sound drastic, but it happens every single day in our society.

Many of these situations started out with the victim just "trying a little pot". Many teens buy pot from someone walking straight out of a "medical marijuana" clinic. That card carrying person is using the medical marijuana "system" to flat out deal drugs. Legalizing pot will do nothing about keeping it out of the hands (bongs) of those suffering from addiction. Legalizing pot will just allow our society to rationalize another situation that will likely deal a catastrophic blow to our youth, and those who struggle with addiction and mental illness.

And, BTW, pot is a gateway drug. Yes, pot changes the brain's chemistry by tricking the brain into wanting more of the drug, to keep getting high, to check out so one doesn't have to face the mayhem his/her behavior is causing. Yes, people develop the desire for a more intense high, and they will move from smoking pot to other drugs.

There are a few other causes for alarm due to the legalization of marijuana that I would like to mention.

1. Do you recall in the second half of the 20th century, most college attendees were young men? Now, consider the statistics for college attendance for American males vs. females. Roughly 60% of American college applicants and attendees are young American women now, as compared to young American males. Dropping out of both two and four year colleges, compared with not dropping out, will be associated with higher rates of substance used in adolescence, greater increases in use during the transition to college, and increases in marijuana use… in the post high school period. More info on this can be found here and here.
2. Marijuana use in teens cause a significant, irreparable drop in IQ. Teens who begin using marijuana before the age of 18, and before the brain is fully developed are more vulnerable to damage from drug use. Please reference these important facts in a 2012 study out of Duke University, which can be found here. I can verify this fact first hand. My son, at age 13, had an IQ of 127, as measured on a set of intellectual tests administered by his school district. Last summer, after another set of intellectual tests administered by a well known neuropsychiatrist, his IQ measured at 97. That is a FULL 20 POINT reduction in IQ.
3. Risk seeking behavior in the teen years coupled with drug use lead to delays in the transition to adulthood. Young men are said to be closer to the ages of 25-28 years before they successfully transition out of the parental home, marrying and starting a family.  Research shows that neurological changes due to drug use and deviant behavior explain some of the increased risk taking and sensation seeking in adolescence, and that the brain functions regulating emotions and self-control may be late in developing relative to cognitive functions. Read more here.   

(Note: I would also like to point out, for anyone who may be reading this and might suggest my son's brain problems may be due to excessive drug use, that his brain disorder was in place at his birth. Just so the "powers that be" are reminded that his educational testing showed discrepancies that were evident in early testing administered during his elementary school years.)

Thank you for listening. I welcome all comments, however, please do not go all "high and mighty" on me regarding the legalization of marijuana unless you are dealing with an addicted or mentally ill family member. And even then, I may not agree with you. But I do listen, and am generally very reasonable.

Another notch in the mom belt

Well, I say you can try to put a worried mother down, you can try to get her out of the way, you can try to put a ton of obstacles in her way, but no matter what you do, there is absolutely no way to stop her.

Rather, there is no stopping me.

In all reality, any child oriented business that wants true and lasting results should find a mom who cares deeply about their cause due to what her child is going through, and they should hire that mom. They should pay her the best money they can afford. Then, step back, and watch the results. Cause, that mom, she will get results. Yep. She will.

My latest notch in the "mom belt" happened yesterday. Exactly 18 years from the day my son was born. I didn't give my son a big birthday party. I didn't give him a car, or an expensive trip abroad. What I gave him was the gift of Guardianship. And, even though my son felt defeated, and probably a part of him felt like he is still in "jail" because he needs to stay in a structured program for a while longer, it is a huge win for our family, AND it is an incredible gift for our son. It allows us to buy more time to allow his brain to mature and heal, for him to continue to recover from the harm caused by his hands, and by the way his brain works that he cannot control. More time for the medication we started him on a year ago to allow his brain to make the necessary connections so he can realize his true potential. Yep, this mom knows best.

Guardianship of a person is not easy to get. I talked with lawyer after lawyer. I hounded every mental service group, and County Mental Health person I could get to speak to me on the phone. I called our local NAMI chapter and asked for referrals. I talked to therapists, psychiatrists, attended Depression support groups, got names, numbers... called departments, chapter presidents, PEOPLE. I told my son's story time and time again. I presented a mountain of evidence. I worked on this nonstop for months. Nobody said they could help me. Nada... nothing. I got nowhere.

And then I called the NAMI chapter in Texas, because that's where my son was located. And, finally, I was put in touch with a mom who is a lawyer, who has a brother and a son who suffer from mental illness, and she said the words I was desperate to hear. She said, "Yes, your son needs help, and yes, I will help you get a Guardianship for your son." And, that's what we did.

So, my son is not yet out of the woods. But today he is good. Today, he returned to the structured program where he did so well last year, and he will finish high school there. He will be allowed to mature in a therapeutic environment, with people who know him, love him, and will continue to support him in the way he needs to be supported. 

And today, my mom heart is so incredibly happy. 

xx

Val

Is drug addiction a mental illness?

Last night, I attended an Oscar party with a group of older women I don't know very well. I know the woman who hosted the party, but none of the others who were there. So this just means they don't know me, and my passion to fight the "addiction illness" fight. Because that's what I'm fighting for here, just so we're clear :o)

At the section of the Oscars where they mourn those who have passed away in the last year, the topic of conversation turned to the tragic passing of Philip Seymour Hoffman. One woman said, "He did it to himself." I couldn't help but to respond that drug addiction is a mental illness. He no more wanted to do that to himself (fatally overdose himself on a toxic combination of drugs), but he couldn't help NOT doing that to himself.

Is drug addiction a mental illness? Yes, it is. Habitual drug use leads to addiction, in that the drug changes the brain in fundamental ways. A person's normal hierarchy of needs and desires is disrupted, as the brain substitutes new priorities connected with obtaining and using the drug. The resulting compulsive behavior weakens the brain's ability to control impulses, even despite negative consequences. These are the same behaviors that are the hallmark of other mental illnesses.

When my son received a "dual diagnosis," (now referred to as a Co-occurring Disorder) I wasn't exactly sure what that meant. Soon, I came to understand that meant he was suffering from two mental disorders at the same time. In my sons case, he suffers from a major depressive disorder, and a drug use disorder. He also has a complex partial seizure disorder, Marfan's Syndrome, and a host of other problems due to the Terbutaline he was exposed to while in utero. But, the main focus of my concern today is the dual diagnosis, and how the depressive disorder and drug use disorder affect each other.

Comorbidity, (which by the way, is a terrible name. Couldn't they have chosen a less disturbing root word than 'morbid'?) is a term used to describe two or more disorders or illnesses occurring in the same person at the same time. They can occur at the same time, or one after the other. Comorbidity implies there are interactions between the illnesses that can worsen the course of both. For my son, this is a lethal situation. Though he knows he struggles with drug seeking behavior, and understands he has a depressive disorder, his brain is wired to seek the drug, even at the risk of his own demise. So, apparently, "comorbidity" is the perfect way to describe such a condition.

Although drug use disorders commonly occur with other mental illnesses, this does not mean that one caused the other, even if one appeared first. It is often difficult to distinguish which came first. Research shows that abusing drugs may bring about symptoms of another mental illness. Increased risk of psychosis in vulnerable marijuana users suggest this possibility. It may be that a person suffering from a depressive or other disorder seeks to self-medicate with drugs to temporarily relieve their symptoms, and their brain is quickly rewired towards addiction in the process. There are also shared risk factors such as predisposed genetic vulnerabilities that may make a person susceptible to both addiction and other mental disorders, or having a greater risk of a second disorder once the first appears.

There is also the concern that drug use disorders and other mental illnesses are developmental disorders. That means that they often begin in the teen years or even younger - periods where the brain experiences dramatic developmental changes. Early exposure to drugs of abuse may change the brain in ways that increase the risk for mental disorders. And, early symptoms for a mental disorder may indicate an increased risk for later drug use.

How does one treat this type of comorbidity? Treatment calls for a comprehensive approach that identifies and evaluates both disorders. Anyone seeking treatment for drug abuse/addiction or another mental disorder should be checked for both and treated accordingly. Several behavioral therapies have shown promise for treating comorbid conditions. These approaches can be tailored to patients according to age, specific drug abuses, and other factors. Some therapies have proved more effective for adolescents, while others have shown greater effectiveness for adults. Some are designed for families, and groups, others for individuals. Make sure to check with your health care professional to make sure they are familiar with treating addictive disorders.

Much of my information in this post came from NIDA (National Institute on Drug Abuse) Information and Facts, which I learned in a Family to Family class I'm taking offered by NAMI (National Alliance on Mental Illness).  For more information on these and other facts having to do with Comorbidity, addiction, and other mental disorders,  please visit the NIDA web page by clicking here.

How I went up against our insurance company twice, and won

If you knew me in person, you might think I can't "go up" against anyone. I'm nice like that. But when something goes wrong and it's not my fault, or when someone attempts harm on another that doesn't deserve it, well, I kind of boil up inside. 

So, when my insurance company - who will remain nameless for the sake of not wanting to be hand slapped (or worse), denied my son's treatment at his current RTC(Residential Treatment Center)... well, I boiled over. It kind of went like this:

1. I got the news from my son's treatment center that his care had been denied by our insurance company. Now this is a very big deal. Treatment at this center is approximately $15,000.00 per month. Yes, that's fifteen THOUSAND dollars PER MONTH. A month of treatment goes by remarkably fast. Now try paying that out of pocket.
2. I let the natural course of things take place by filing an appeal with my insurance company.
3. The appeal was also denied by said insurance company, so
4. I organized myself by compiling dates, facts, doctor's reports, anything I could get to support my son's cause, and 
5. I wrote a letter that felt like I was writing a term paper for my college "major". This time, it took me over a week to write this letter. When I did this last year, it took about 2 months. Okay, this isn't exactly my area of expertise.
6. And then I took that letter and all my supporting reports, and I reported my insurance company to the California Department of Insurance.

Once you report your insurance company to the Dept. of Insurance, they will review your case and the supporting information you send them, and determine if your case is eligible for an Independant Medical Review. If they determine it is, your case will be assigned to an impartial investigative reviewer who is an expert in their field. In my case, it was a board certified psychiatrist, actively practicing in his field, who also holds special certification in the areas of treatment under review. 

And, guess what? My appeal worked! The independent review determined that the services were and are medically necessary for treatment of my son's medical condition, AND the insurance company's denial of services will be overturned. Woop woop!

Even though I don't want my son to be someone who needs extensive care - in fact, I really just want him to be normal and healthy. BUT, if he must remain in extended care and treatment, he is entitled to the services we pay for through our insurance company. That this insurer denies necessary treatment for my son is appalling to me.

That any insurance company denies necessary treatment, or gives people the run around so they just give up, it makes my blood boil. It is just not right.

And I know this happens all the time. 

So, if this is something you are dealing with, I encourage you to take action now. Don't think it's impossible (that's how I used to think). Let me tell you that you can do this too. 

In fact, I have been successful not once, but twice. Last year's denial reversal amounted to an approximately $40,000 award towards our son's care!  

In an effort to help you out, I want to offer the following tips that might give you some guidance:

• Get super organized. Take over the kitchen table if you need to. Just start early enough so you can finish by dinner :o) Organize all your papers, letters, reports, denials, etc. Put them in a binder, or several binders in order of the dates, most recent first. Use post it note tabs to help label your papers.
• Write out a Timeline of everything that has happened. I started with my son's prenatal care (since that's when the trouble began). Make 2 columns with the dates in the left column, and the event in the right column. Get as specific as you can with the details. This counts when the reviewer is looking over your case, and wants to gain understanding of what you or your family member has dealt with.
• Ask the treating doctor to write a letter on your behalf stating why the treatment IS medically necessary.
• Write a letter to your state's Department of Insurance. I contacted them ahead of time so I had someone lined up who could help me. I directed my letter to this person. In the letter, be very specific about what you need; tell them why the denial is wrong, and the reasons why this type of care is medically necessary. End the letter by specifically stating that you want the denial overturned and for the insurance company to pay for the necessary care. 
• Compile your letter, denials from your insurance company, doctor's reports, and your timeline together. Make copies of everything you send. (Put these copies in your notebook for safe keeping) Make sure you fill out any necessary forms the Dept of Insurance requires. Send your packet to the Dept. of Ins. via certified mail, return receipt requested.
• If this seems overwhelming to you, you can hire a lawyer to help you prepare a packet that you can submit to your state's Dept of Insurance. 

Good luck, and remember: You can do this!

Fog bank

Today started out as a beautiful sun-shiny day. Then a fog bank rolled in. Within about 20 minutes, the sun disappeared and it felt like living in thick, soupy, foggy London. Fog horns blaring, all kinds of mayhem going on out on the bay. Well, this is to be expected when you live on an island at the coast, right?

What is interesting to me is the symbolism going on here. Let me explain...

Here I am, going along through my life just fine. Well, at least relatively fine. My current mindset is good. I am clear on my direction. I'm attending support meetings. My husband seems ok. My younger son seems to be in a good place right now. My older son is in treatment.  I'm back to fighting the insurance company for his continued placement. All good, right? 

And then the dang fog bank descends....

On January 20, 2014, it was exactly 4 months and 4 days until my son's 18th birthday. And I know exactly what the instigating fear factor of my current "fog bank" was; MLK Day. It was on this day 18 years ago that I began my hospitalized preterm labor with my son. My life changed forever that day. 

"All progress is precarious, and the solution of one problem brings us face-to-face with another problem." -Martin Luther King, Jr.

Looking back to Jan 20, 1996, I was faced with a very big problem... For it seemed my pregnancy was in very big trouble. I had landed in the hospital in "preterm labor" and my doctors had told me to go home, that they couldn't stop my labor, and that I would soon deliver a baby that was too little to be able to survive. Well, the outcome to this story was good. My son wasn't born for another 4 months and 4 days, and he was about as perfect and healthy as he could possibly be, given his very challenging start in life. 

But what I didn't know then was that the drugs I had to take to remain pregnant, (Intravenous Terbutaline) had been acting like a toxin to my baby's developing brain. So, now, fast forward 18 years, and we learned my son suffers from a Partial Complex Seizure Disorder, Marfan's Syndrome, severe depression, and other health ailments due to this in utero drug exposure. Using illegal drugs as a coping mechanism is about the worst thing my son can do. Illegal drugs affect him negatively, and seem to increase whatever is going on with him (anxiety, depression, euphoria, etc). In the past, doing drugs have always led him to the same cliff: suicide.

18 years ago, I was hopeful. Today, I'm not sure what I am, but I know residing inside my heart is a very big stumbling block: Fear. For my son, being on his own is a train heading for disaster.

Most days find me pushing this fear away. Some days find me with my hands on my hips, staring it down, and daring it to rule me. Lately and frankly, for quite some time, I have been reasoning with myself that I have no control over my son, that there are many forces greater than me, and who am I to be able to rule another person's life and will with my own? Do I think I am a God, or what??! (let's just ignore my answer to that question for the time being!) No, but in that, I am turning to God for help with my son...

"Strive to trust (God -or your higher power) in more and more areas of your life. Anything that tends to make you anxious is a growth opportunity. Instead of running away from these challenges, embrace them, eager to gain all the blessings (He) has hidden in the difficulties. If you believe that (He is) sovereign over every aspect of your life, it is possible to trust (Him) in all situations. Don’t waste energy regretting the way things are or thinking about what might have been. Start at the present moment—accepting things exactly as they are—and search for (His) way in the midst of those circumstances."*

So, today I am reminded of this. And instead of running away from my fears and challenges, I know in my heart that I have the power to do this... again. 18 years ago, I learned that my problem... ur, growth opportunity (staying in bed for 4 months and 4 days, and acting like a human incubator for the baby growing inside of me) took me to places I never dreamed I'd go. They weren't easy places, in fact they were the hardest places I'd ever had to go to. Places with names like Patience, Humility, and the big one: Not Being Able To Do Exactly What I Wanted (aka Sacrifice). Those places taught me big lessons. They let me know I could DO THIS. That I could take this Growth Opportunity, and make something Big of it. (Like a healthy baby)

So, now, as I glance up, I see the glorious sun has returned, and the fog has moved on. And I realize my mood has also improved. If I can just remember to Trust, to be strong in my heart with what I know is true, and encourage my fears to exit stage left.... well, I know that everything will work out just fine.

And I will go forth today with those reminders, carry Faith in my heart, and find renewed hope. Yes!

* Exerpt from Jesus Calling, January 22.

Boundaries

It's my word for this new year. Boundaries.

Because...

Yep. 

I am a giver, a fixer, a doer, a holder-upper. To certain people in my life more than others.

And I'm good at getting walked on. Especially by those certain people. Um humm... Like all over.

But that's my doing too, and I accept that. In a weirdly passive way I can derive comfort from knowing I am needed. And I can take solice in knowing I am a helper-sort. And in a push-it-under-the-cushion way, I relish knowing that I can make things happen for them, to get things done.

But it is finally time to stop it.

Rather, it is finally time to embrace what I am doing, and own it. Be better about being manipulative and covert. Really, it's about approaching life honestly and looking it straight in the eye. Or heart. It is taking responsibility for my own stuff. And saying no to what is not mine to own. It is not feeling abandoned by myself if I stop manipulating, or threatening. About letting go of the need to manipulate or threaten. About forging through old thinking patterns and trying to do things a whole new way. About staying awake and alive to my own needs. To be disciplined with myself. To ask for support when I need it. To allow others to rely on me without expecting payback. To give more, from my heart, when I know it is right, and true.

To give more. In a limited, little bit selfish way.

And to NOT give, when it's necessary to hold back. That's going to be hard for me.

But this is what I am going to try for.

It's all I can ask of myself. Just try a bit of this each day.

Pretty soon, I'm sure it's going to stick like glue.

Then I will be a boundary whiz.

:o)

Mental Hell

In case you're not aware of it, I want to share with you that there actually is such a thing as "Hell on Earth." it is located in a place called Mental Illness. If you are aware of this fact, I am sorry. You may be struggling yourself, or know a loved one who is. I am here to commiserate with you. It is Hell for everyone involved.

It has been two terrible weeks since my 17 year old son tried to take his life. He is suffering from a deep and profound depression, brought on by the stress of returning home after 18 months of residential treatment.  He was much more fragile than we realized, we just didn't recognize the danger signs until it was much too late. His pain wasn't obvious to us.  I don't want to beat myself up over this, but as a "fixer mom" I feel completely crushed by this entire situation.

This last week has been so difficult and challenging for my husband and myself, as well as our younger son. I can't imagine how it is for our older son. He is back in Texas, at Meridell Achievement Center, the place where they helped him so much last year. 

His mood is as black as the moonless sky. 
I pray he can find his way out of this.

As if it's not enough to live with this pain and sorrow seeping through every pore of my body, it's compounded by "miscellaneous people" I've been forced to talk with when these things happen. The insurance case managers (somehow now we have THREE), all shocked and speechless once I get to this part of the story: "suicide attempt." (Dang it... They are supposed to be calling me and offering support!) The new therapist I needed to interview because our family is in crisis, hearing the edginess in his voice as my story keeps unravelling towards the unthinkable. (I did NOT set an appointment with him.) The judge in the courtroom who is incredulous that we aren't bringing our son home for the holidays. I wanted to stand up and shout in the courtroom, "CERTAINLY YOU PEOPLE HAVE DEALT WITH MENTAL ILLNESS BEFORE???" And finally, the IEP team who have fought so gallantly against giving my son an IEP over the last 10 years now begrudgingly offer up the help my son has so desperately needed. I can't even type the things I want to say to them....

One of the crisis people I spoke with told me to not be discouraged by the recent happenings with my son. We know more now about the help he needs, and we can better focus the care he receives at this point moving forward. I just keep holding onto these words and pray she is right.

And so now I feel compelled to take up a new mission. My twitchie hand is on the handle... I feel the sword coming out of the sheath. My target? Mental health, and how it is so wrongly pushed under the rug in our society. Something must be done. Things have got to change.