Author: Torey C. Richards, LMHC

I'm a passionate Behavioral Scientist and Licensed Mental Health Counselor based in Florida. I've dedicated my career to unmasking the complexities of human behavior, mental health, and substance abuse. My journey in this fascinating field has led me to work extensively with a diverse range of individuals from those grappling with chronic mental illness and substance use to others navigating the trials of daily life. The opportunity to study the nuances of people's thoughts, feelings, and behaviors has been enlightening and truly rewarding. Moreover, guiding people towards transformational changes that break down barriers in their lives is a fulfilling mission I carry with me every day. Currently, I work at a level one trauma center with patients who have suffered unfortunate traumas. Previously, I held the reins as the Director of Mental Health at a county jail for over 8 years, a fulfilling role that offered unique insights into criminal justice and mental health. Additionally, I mentor the next generation of mental health professionals as a qualified supervisor, continuously inspired by their commitment and ambition. Beyond my professional endeavors, I'm a purple belt in Brazilian Jiu Jitsu, an avid reader and writer. I hope you'll join me on this voyage of discovery.
Popular Psychology

Mental Health Awareness Week: Miriam Carey And Postpartum Psychosis

by Torey C. Richards, LMHC3 Comments on Mental Health Awareness Week: Miriam Carey And Postpartum Psychosis

4071This week is Mental Health Awareness Week which was established by the U.S. congress in 1990 to recognize the National Alliance of Mental Illness’ efforts to raise the awareness of mental illness. It just so happens that last week’s police chase and subsequent shooting and killing of Miriam Carey has brought mental illness and postpartum psychosis into the spotlight.

What Is Postpartum Psychosis?

Many people have heard of postpartum depression, but not many people have heard of it’s evil sister, postpartum psychosis. When I was in graduate school I was so fascinated by postpartum psychosis that I actually did a 20 page research paper on the phenomenon.

It isn’t uncommon for women, after giving birth to feel down, sad or even somewhat depressed. This is what is known as “baby blues” and approximately 70-80% of mothers feel this contradicting negative thoughts and sadness after experiencing the joy of giving birth.

Many women don’t talk about it because they feel guilty or “bad” because of these feelings, but it’s important that they talk about the way they feel so that the “baby blues” don’t progress into something deeper like postpartum depression.

Postpartum depression basically is a much more intense and prolonged feeling of negativity, depression and mood swings when compared to the “baby blues”.  This can last weeks, months or even longer.

Postpartum psychosis is the most severe and extreme form of postpartum depression and not only does it typically include the intense sadness, negativity and mood swings of postpartum depression, but it also includes the onset of psychotic symptoms after childbirth.

An example taken from a personal experience I had dealing with a client I diagnosed with postpartum psychosis is that she was extremely depressed at times and then highly erratic and impulsive other times. She was extremely irritable and was having hallucinations which included voices and delusions that her newborn was evil and needed to be killed.

Like a lot of women who deal with the “baby blues”, postpartum depression and postpartum psychosis, she tried to hide the way she was feeling and mask her psychotic symptoms until it got to the point that she was about to drown her child in the bathtub. It was then she went to her family for help and was taken to the psychiatric hospital.

This particular young lady ended up being okay after treatment which included therapy and a brief period of taking lithium. Her child was subsequently raised by the maternal grandparents although legally this young woman still has full custody and spends time with her daughter often.

Postpartum psychosis is extremely rare which is one reason it is not often talked about and another reason many people who suffer from it try to hide it because they are struggling to try to understand exactly what it is they are going through and may feel alone.

Symptoms

Symptoms of postpartum psychosis Include, but are not limited to:

  • euphoria
  • overactivity (hyper)
  • decreased sleep
  • talkative (loquaciousness/hyperverbal)
  • flight of ideas
  • disinhibition
  • irritability
  • violence
  • delusions
  • grandiose thinking or behavior
  • religiously preoccupied
  • delusions
  • hallucinations
  • depression
  • mood swings
  • mutism

Other Famous Examples of Postpartum Psychosis

Melanie Blocker-Stokes

melanie&sam
Melanie and her husband Sam.

Although postpartum psychosis is rare, some popular cases include Melanie Blocker-Stokes, a successful pharmaceutical sales manager happily married to a physician.

On June 11, 2001 she gave birth to a baby girl and soon developed severe depression, stopped eating and drinking and no longer could swallow just four weeks after giving birth.

She became paranoid and thought her neighbors closed their blinds because they thought she was a bad mother and although she was in and out of several hospitals, was on several medications and even received electroconvulsive therapy, she killed herself by jumping off of the roof top of a Chicago hotel. Her daughter was only 3 and a half months old.

Melanie always wanted to become a mother and it’s a tragedy that becoming a mother ultimately took her life. She had written in her journal before her death: “How can I explain to anybody how something has, literally, come inside my body…I’m no good to anyone. No good to myself.” 

She called some her friends and family and left what they now know were her final goodbyes and to her husband she left a note that simply read: “Sam, I adore you, Sommer and Andy, Mel.” Andy was her husband Sam’s son and her stepson and Sommer (Sommer Skyy) was her newborn child.

Her battle with postpartum psychosis helped congress pass the Melanie Blocker-Stokes Postpartum Depression Research and Care Act in 2010 aimed at increasing research, education and screening of postpartum depression and postpartum psychosis. Sadly not much has been done since it was passed, but this is the story that sparked me to write my research paper in graduate school and got me interested in postpartum psychosis.

Andrea Yates

Perhaps most famously there was Andrea Yates whose mental health seemed to deteriorate with each child she gave birth to. She had attempted suicide twice and was urged against not having any more children after being hospitalized in a psychiatric hospital after her fourth child. Never-the-least she gave birth to a fifth child and three months later she was hospitalized again twice and warned not to be left alone with her children.

However, one day she was left alone for only an hour and tragically drowned all five of her children. She’s currently committed to a high-security psychiatric hospital.

Miriam Carey

Miriam Carey was a 34 year old mother of a one year old little girl. She was a dental hygienist with plans on going to dental school. Last week she made the decision to drive from her home in Conneticut to Washington, D.C. Some reports say that she was mad with President Obama for listening to her phone conversations.

Miriam Carey
Miriam Carey

In any case, with her young daughter in tow, she drove to Capitol Hill, crashing into barricades around the White House, police cars and speeding recklessly down Pennsylvania Avenue before she was shot and killed by law enforcement after attempting to use her car as a weapon.

It’s unfortunate that Miriam Carey was shot and killed, especially with her one year old daughter in the car. After listening to her family talk on CNN last week talk about her struggles with postpartum psychosis and a family history of mental illness including schizophrenia, I wish something could have been done sooner although she was apparently taking medication for an unknown mental illness.

It’s possible that although her family knew she was having some mental problems, they didn’t know how severe they were or even what they were because she was most likely keeping them in the dark and the Health Insurance Portability and Accountability Act (HIPPA) keeps doctors and mental health professionals from being able to discuss a persons medical and mental issues with family members which helps explain why her family members and friends where all shocked that she was behaving so erratically and reckless especially with her daughter in the car. They were all shocked to learn that she had even driving to Washington, D.C. out of the blue.

They may have known she had issues, but never suspected that they were as severe as they turned out to be.

According to everything I have read as reported by her family members and her boyfriend, her main symptoms were paranoia and delusions. It’s a good chance that her mental health problems existed before she was pregnant and that her pregnancy exacerbated the condition and developed into postpartum psychosis.

For example, she could have been suffering from bipolar disorder or a mood disorder previously and possibly stopped taking her medication to prevent them from having side effects on the baby and then everything just snow balled out of control with the natural hormonal and mood changes that occur with pregnancy.

Many women who develop postpartum psychosis already have other underlying mental health issues

Her death however is not in vain as it helps bring attention to postpartum complications like “baby blues”, postpartum depression and postpartum psychosis so that maybe more women who are suffering silently will speak out and reach out for help.

If you or someone you know is suffering from postpartum depression of any kind, have them speak with their doctor. For more information visit http://www.postpartum.net/ or call 1-800-944-4PDD.

Abnormal Psychology, Popular Psychology

Blinded By Beauty: Ignorance Towards The Mentally Ill

by Torey C. Richards, LMHC1 Comment on Blinded By Beauty: Ignorance Towards The Mentally Ill

Alexander_AyannaYesterday while watching the local news, I saw a story about an officer who was called to an apartment complex after residents called bout a naked woman outside of her apartment.

Upon arriving, officer Ryan McIntosh found 20-year-old Ayanna Alexander outside of her apartment, but she had put on clothing by then.

Ayanna, who is an exotic dancer, told the officer that she was upset because she didn’t have a ride to work at Rachels, a local strip club.

The officer didn’t think Ayanna was impaired or had any other medical conditions, so he called his supervisor and got permission to drive Ayanna to work. He dropped her off and left, only to be called back shortly afterwards to a nearby restaurant after receiving a call about a naked woman thrashing the restaurant and disturbing patrons.

The officers arrived at the restaurant to find Ayanns with no pants or underwear on and during questioning by the police, she removed her shirt and bra and said she wanted to go to jail.

Ayanna was charged with disturbing the peace, indecent exposure and trespassing.

The problem I have with this is, not many people in their right minds, especially an “attractive” 20-year-old woman would just strip naked and cause havoc. To me, this just screams mental illness from the start, rather it is bipolar disorder or something else, but from the start of this story i felt like this woman should have been taken to the hospital for a mental evaluation, not taken to work and just dropped off.

Even after the second incident, instead of taking her to jail, I still feel like she should have been taken for a mental evaluation. Something clearly isn’t right. Maybe it is drugs, who knows? The officer said she didn’t seem impaired, but her behavior was abnormal and he didn’t do a urinary drug screen to rule out she was on anything.

Also, he was obviously not a Crisis Intervention Team officer or had much training, experience or exposure to mental illnesses or he would have recognized that this woman was in need of help, not a ride to her place of employment.

I’m not necessarily blaming the officer for not being trained properly, but I am blaming him for being ignorant and perhaps even blinded by an attractive female and wanting to do the “nice” thing by giving her a ride to work instead of truly investigating the incident.

At the hospital I work at it’s not uncommon for officers to bring us young, attractive, 20 something year old women they find naked running or walking through the streets or just sitting in the middle of the road. Nine times out of ten these women are not under the influence of any drugs or alcohol, but are suffering some type of mental break.

Often times it’s their first psychotic episode and they go on to be diagnosed and treated for bipolar disorder (most commonly), and other times they are people with long histories of mental illness.

The late teens and early twenties are the prime ages for the development of bipolar disorder and it’s not uncommon for people to present with symptoms of erratic, impulsive and irrational behavior for the first time around 20.

If this woman is simply arrested, charged and then released, she will get no help and eventually spiral out of control again, but maybe next time she won’t run into a naive officer who is trying to be nice, but maybe a predator or someone else who instead of helping this lady may victimize her or she may do something much more reckless and dangerous than taking off her clothing and throwing food in a restaurant.

Sometimes it’s hard to recognize and start treating the first symptoms of a mental illness, but to me it’s common sense that if you come across a naked, exotic dancer who gets paid to take her clothes off, doing it for free outside in the daytime, something isn’t right and the two most likely culprits are drugs and mental illness.

If the officer quickly decided she wasn’t impaired or had a medical conditions, why didn’t he take her to rule out a mental health condition other than ignorance? This is a problem on many occasions, but especially when you consider that the jails and prisons in our country today house many more mentally ill people than all of the mental hospitals, clinics and institutions combined.

Untrained officers come in contact with mentally ill people on nearly a daily basis and often times the result is tragic (numerous officer related shootings involving mentally ill people is what sparked crisis intervention team training for law enforcement officers), or they are arrested or simply ignored.

In this case, two out of three happened. Her mental condition was ignored and then she was arrested.

Taking Control of Your LIfe

10 Mindfulness Techniques You Can Start Using Today

by Torey C. Richards, LMHCLeave a Comment on 10 Mindfulness Techniques You Can Start Using Today

IMG_148084419922650Most of us spend a lot of time feeling pain, guilt or regret about our past and anxiety about our future. We can get so wrapped up in this past and future thinking that we don’t even enjoy the present moment we are living in.

Mindfulness is a form of self-awareness that helps brings us back to the present moment. It is taken from mindfulness meditation which is based on Buddhist meditation principles. It the past decade or so it has become very popular, especially as part of dialectical behavior training which has been successful in treating borderline personality disorders.

The basics of mindfulness helps us to pay attention to the present moment and disengage from the mental clutter and chatter that is almost always filling our minds.

How many times have you found yourself at a party, in a meeting, on a date even playing with your kids and yet while you are physically there, mentally you are somewhere else. You are in your head, dwelling on your past, thinking about the future and not living in that very moment. We have so much going on in our lives today that it’s hard to live in the present.

We are with our spouses, but thinking about everything we have to do at work tomorrow so we aren’t really hearing what they are saying or we are doing a task we do regularly, but are just going through the motions and not really paying attention to what we are doing (which is one reason accidents happen).

I have to admit that there have been many times when listening to a client that my mind will wonder. I’ll start thinking about my past, I’ll start thinking about what I have to do later that day and before I realize it, I’ve missed a good portion of what that client was talking about (it’s bad I know, but it happens… therapist are human too). I have to fight with myself sometimes to stay in the present, to not allow the clutter and chatter in my brain to take me anywhere else, but to remain in the here and now which takes practice.

As a matter of fact, during group therapy, being in the present and being mindful are two of my 10 rules. Often times when one group member is talking, some of the others will drift off to their own issues, their own regrets over the past and anxieties about the future to the point that they can’t offer support and encouragement to the group member who was speaking because mentally they weren’t there.

Here I’ve listed 10 ways to help you start being more mindful and to start living in and enjoying the present moment today.

  1. One Minute exercise: sit in front of a clock or look at your watch for exactly one minute and focus all of your attention only on your breathing and nothing else. Sounds simple, but your mind will tend to rebel and try to fill itself with all kinds of past and future thoughts. Resist it, focus simply on your breathing for one minute. Once you have this down pat you can start extending it by another minute up to five minutes or even longer!

  2. Take a shower. Showers can be relaxing and can be a mini vacation away from everything and everyone else. Feel free to use your imagination and picture yourself standing under a tropical waterfall.
  3. Speaking of water, sticking your hand in some warm water and concentrating on the sensation on your skin is not only a great way to bring you back to the present, but it is also helpful for de-stressing because it brings your brain a sense of comfort. If you aren’t near any warm water try rubbing your hands together to get a similar affect.
  4. Listen to music, calming music preferably and music you’re not familiar with is best, but really listen to it, not just the words, but the sounds of the instruments and the rhythm of the beat. Even familiar music can sound new again when you truly are present with it.

  5. Mindful Eating: Most of the time when we eat, we aren’t really paying attention to what we are doing. We are distracted by our mind, the television or anything else. In mindful eating, you sit down with no distractions, paying full attention to every bite you select and put into your mouth being aware of its color, how it smells, how it taste, the different textures, how it feels in your mouth. You may be surprised at how your food actually tastes different once you slow down and focus on it and possibly, how little of it you actually need to fill full. If trying this for an entire meal is too hard, try doing it for the first two bites of each meal.

  6. Mindful Walking: This is similar to mindful eating accept you take a walk and allow yourself to only focus on what is happening right now. How the ground feels beneath your feet, how the wind and/or sun feels on your skin, on how the leaves look and sound on the trees, even observing other people. It’s also good to pay attention to your breathing as you walk to help keep you present and centered.
  7. The acronym R.A.I.N. is used to describe a more advanced technique for when you are feeling unpleasant emotions where “R” stands for recognizing when a strong emotions is present, “A” is to acknowledge the emotion (instead of denying or running from it), “I” is to investigate where the feeling is coming from by checking in with your mind, body and feelings, and “N” is to non-identify with what’s there, meaning to not allow the emotion to define you or control you, but to understand that it is just another passing emotion that doesn’t have to control you. RAIN is about staying with your emotions and then letting them go, not dwelling on them or doing things to try to escape them, but acknowledging them and then allowing them to leave. It can be challenging to stay with your emotions and still let them go which is why this and the next technique are both considered advanced, but once you practice and can use them effectively, they can be life changing.
  8. Most of the time before we know it, our minds are racing, we are thinking about the past, the future, anxious, and just going through the motions of our daily routine. This is when we need to find time to S.T.O.P. which means to Stop what you are doing, if only for a minute, Take a breath and pay attention to your breathing, allowing it to flow in through your nose deeply and out through your mouth fully. You can try imagining breathing in a cloud through your nose and blowing it back out through your mouth. Observe your thoughts, feelings and emotions. Know that you can observe them, but they are just thoughts, feelings and emotions, that doesn’t make them facts they are not permanent. Often times recognizing, observing and letting thoughts, feelings and emotions go will work much faster than any psychotropic medication can in alleviating anxiety and depression. Lasting proceed with something supportive and positive such as talking with a friend or exercising.
  9. Un-tunnel your vision. A lot of times when we are stressed it’s because we are focusing on a single point that eliminates or obscures all other options. Try extending your arms all the way out until you form a “T” and then wiggle your fingers. Slowly bring your arms back in until your fingers are insight and then extend them again. Repeat this. Playing with your peripheral vision can help your brain to remember to expand and to remember that their are other options and possibilities other than that single point it’s currently focusing on that’s causing you stress.
  10. Come up with your own ways to be mindful and in the here and now! There are so many different ways we can practice being in the moment and there is no better way than finding something that works best for you.

A lot of our discomfort comes from worrying about the future and beating ourselves up about the past, but the past is gone and the future has not happened yet. Living happens in the moment we are in right now so taking some time to remember that and appreciate the present will definitely make our entire life experience richer.

Abnormal Psychology, Taking Control of Your LIfe, Therapist are Humans Too

Sensitive People: Absorbing Other People Emotions

by Torey C. Richards, LMHCLeave a Comment on Sensitive People: Absorbing Other People Emotions

Teenage girl looking thoughtful about troublesI’m highly sensitive to other people emotions and energy. I have been for probably all of my life, but it is something I have just become aware of in the past few years. I can be having a good day, feeling happy and all it can take is an interaction without someone close to me, to bring me down.

When I discovered this sensitivity, it was quite alarming. It seemed like my mood and even the way I felt about myself were dependent on how the people around me were feeling and even how they felt towards me at that moment. You can imagine the amount of stress, anxiety and uncertainty it would cause me and often times I didn’t understand why. Looking back I think I thought that they’re mood and feelings had something to do with me. It took a lot of introspection before I realized a few things:

  1. Rarely if ever did the other persons mood, feelings or behavior have absolutely anything to do with me and,
  2. I can not control other people’s feelings.

A large part of it boiled down to control. I wanted everyone around me to be happy, to like me, to treat me the way I would treat them, and when they didn’t, I automatically assumed it was my fault and whatever joy or happiness I had would go away and turn into either self-blame, dysthymia or anger, especially when the people were close to me such as a girlfriend or close friend.

It took a long time for me to start working on not allowing other people emotions to affect mine, and honestly it is something I still struggle with on nearly a daily basis. Some days are better than others and when I do find myself losing my inner peace to someone else’s energy, I get discouraged because I know it’s not about me and that I can’t control their emotions nor should I allow them to have power over mine.

I learned however that if I beat myself up too bad for allowing someone to move me from my inner peace, I end up doing more emotional harm than good because I become negative towards myself for being “weak” or even “stupid” (negative self-talk never helps and is almost always a recipe for increased anxiety and depression).

I’m starting to realize that one way to stop giving so much power to other people over my emotions is by not expecting things from them that they can not give me, such as unconditional love, unconditional positive regard or fulfilling any of my various needs that can only be filled by me and God. By not expecting those needs to be met by others I have taken back much of my power, but still at times, it’s a struggle just like when trying to undo any bad habit physically or mentally.

Some Negatives to Being Hypersensitive

As I stated above, being hypersensitive to other people emotions makes it very easy to be affected by others emotions, usually not for the better. This can be very draining and overwhelming and can easily lead to anxiety and depression. This can cause us to withdraw so that we can process and deal with our emotions, which other people may not understand and take it negatively that we need time and space alone, especially since we live in a culture that devalues sensitivity. Lastly, hypersensitive people may have unrealistic expectations of perfectionism towards themselves (i.e., everyone is supposed to like me).

Some Positives About Being Hypersensitive

Just like most things that are negative, there are of course positive things about being hypersensitive emotionally. I think evolutionarily it helps us to pick up slight shifts in someones temperament or even the energy around us. I’ve been in rooms where everyone around me was talking, yet no one noticed the sudden shift in tension, or how someone else became emotional, angry or nervous during a certain topic. I would sometimes leave those situations knowing more about a person I didn’t even talk to just by watching the subtle changes in their expressions.

I think being hypersensitive to other people emotions help me to be more in touch with my own emotions. I’m always amazed at how many people aren’t in touch with their emotions and as a counselor, often it’s my job to help them to get in touch with their true emotions so that they can start living a real, authentic life. We hide from our emotions, mask our emotions (even from ourselves) and often don’t know why we feel or act in certain ways because we are not used to being in touch with that part of us. Hypersensitive people are almost always, sometimes neurotically checking in with their thoughts and emotions.

I think being hypersensitive also leads to being more creative, to being able to express ones emotions more through music, art, dance, poetry and writing for example. It also makes us more empathetic to others which in the field of mental health is a must.

Some Tips for Hypersensitive People

  1. You have to recognize and acknowledge that you are absorbing other people emotions. I’ve been doing it for years and until I actually realized it, I wasn’t doing anything different to try to stop it.
  2. When you start feeling a certain way after an encounter with someone, ask yourself if what you are feeling is really your emotion or theirs. You’ll be surprised to find out that most of the time it’s not yours and if it’s theirs then immediately release it. This alone will make you feel better most of the time.
  3. Remember that you are not responsible for nor can you control other people emotions so don’t worry over it because in doing so, you’ll just be absorbing it into your own emotional state.
  4. Identify what/who is making you feel a certain way and try to distance yourself if you can. If you can’t, go back through steps 1 to 3. Sometimes it’s a particular friend or group of coworkers that are the main source. Putting some distance between you and them can help alleviate the problem.
  5. When you start to feel overwhelmed by other people emotions, even if you can’t get away, try mindfulness or deep breathing techniques to help bring you back to your own inner peace.
  6. Speaking of inner peace, always try to work on building up your own inner peace by being good to yourself, exercising, eating right, maintaining good emotional, physical and mental health and surrounding yourself with people who bring you good and positive energy. BE GOOD TO  YOURSELF!

Being hypersensitive to other people emotions is both a gift and a curse, but look at it like a power that you have to master so that you are in control of your emotions and able to use all of the positive qualities that come along with being sensitive to other people emotions.

 

Abnormal Psychology, Popular Psychology

The Face of Mental Illness

by Torey C. Richards, LMHC3 Comments on The Face of Mental Illness

girl-in-shadows-istockI love working in a psychiatric hospital because it’s rarely boring. The type of people who come through the door are everyday people, no different from you or me, it’s just that what they are dealing with at the time is more than they or most likely any of us can handle.

I remember when I first started working here, a senior co-worker said that the only thing separating us from the patients is that we have the keys that let us in and out.

That’s one reason customer service, even in a mental hospital is so important. We strive on treating everyone, no matter what their circumstances or mental state, fairly and therapeutically because you never know when we or one of our family members or friends will end up in a place like this and it’s fairly easy.

Say the “magic words” to the right person and you may find yourself involuntarily hospitalized. Have an over exaggerated emotional or behavioral reaction and you may end up placed in a mental hospital to help you calm down.

Since I’ve been here I’ve seen correction officers, police officers, teachers, college students, professional athletes, lawyers, daughters of politicians, doctors, nurses and business owners come through our doors under involuntary hospitalization statuses.

People are placed here everyday who feel like they shouldn’t be and some may very well not be, but the majority at least need a cool down period.

For example, last week a college student got into a fight with his girlfriend and someone reported he threatened to kill himself. He denied does accusations, but he was emotionally upset enough that law enforcement thought it was best that he was brought here for his safety and the safety of those around him.

Now that he was here he didn’t want to be here and wanted to leave. He kept trying to convince me and everyone that he didn’t need to be here, but in doing so, he was getting more and more upset and therefore appearing more and more like he needed to be here for his safety and those around him.

I kept trying to talk to him and tell him that if he truly didn’t think he should be hospitalized then he needed to be calm and relaxed, otherwise he was risking looking like every other patient in the hospital who truly needed to be there.

However, he was so agitated and insistent on leaving that we had to place him on an elopement risk which lessened the chance of him being released sooner than he would have been otherwise.

When people think of the patients in a mental hospital, they almost automatically get an image in their head as if mental illness has a face. Those of us who work in the field or know someone or are ourselves suffering from a mental illness know that this couldn’t be further from the truth.

This morning I spoke with the mother of one of our patients who just graduated with an advanced degree and has an extremely high IQ, but has a long history of bipolar disorder and hasn’t been on her medication in over a year.

This is a beautiful young lady who was found sitting outside naked, stating that her old self had died and given birth to her new self with a new name she was calling herself by and a new age. She also believed she had God like powers.

Here at the hospital, for the most part, this young lady was selectively mute and at times appeared catatonic. We even had to carry and pose her limp body at one point when we had to transport her to another part of our facility.

She was definitely in need of some medication to help her start getting back to her “normal” self.

I was really hoping to speak with her, I throughly enjoy talking to people who both have a long history of mental illness and the ability and awareness to really talk about it and analyze their experiences, but she wasn’t speaking to anyone, so I spoke with her mother for a while about her history of treatment and tried to help calm her mother’s fears about her daughter’s recent deterioration.

This young lady reminds me that mental illness is all around us and it’s nothing to be ashamed of or to run from. Sometimes it’s in your face like the guy talking to himself while begging for change or it’s wrapped in the package of a pretty grad school graduate who on most days could hold the most intellectual conversations, but today she’s just staring into out of space unresponsive to the world around her.

 

Popular Psychology

Treatment Of The Mentally Ill In A War Torn Country

by Torey C. Richards, LMHC3 Comments on Treatment Of The Mentally Ill In A War Torn Country

706x410q70simon-somalia-subbedMThe other day I was reading a very interesting article about how mentally ill people are treated in Somalia where they have one of the highest numbers of mentally ill people in the world.

Somalia is a country that’s been plagued by war, famine and disease for decades. As a result, at least 1 out of 3 of their 10 million citizens are affected with a mental illness, including many former soldiers, some who joined various armies and fractions at as early as 7 years old and are suffering from post traumatic stress disorder (PTSD).

On top of all this, a very large number of the population uses a drug called Khat, which is a plant that you can chew and it causes psychedelic effects. It’s legal and addicting although it can cause both health and mental damage.

Things are further complicated for the mentally ill in Somalia because of the lack of qualified mental health professionals. Many of the mental health workers in Somalia have only received 3 months of training through the World Health Organization (WHO), which is advocating for the humane and proper treatment of the mentally ill in Somalia and worldwide.

WHO officials have rescued mentally ill people from some very poor conditions. Families who have mentally ill family members in Somalia often don’t know what to do or where to turn for help so they chain them to beds in the house or to trees in the yard, including one lady who was chained by her husband to a tree for eight years and gave birth to three children.

Faith and folklore also play a role in treating the mentally ill in Somalia, with individuals sometimes being flogged to get rid of the “evil spirits”, locked in a room with a hyena for three day stretches in hopes that the hyena would eat away the “evil spirits”, or simply just beaten to death by villagers.

The streets of Mogadishu, Somalia’s capital, are littered with the mentally ill sleeping under bridges or wandering around aimlessly chewing on Khat. Most of these individuals are suffering from some sort of mental trauma and are receiving no help.

Something that makes this story even sadder is that Somalia’s only trained psychiatrist died last year in a car crash. It’s one thing to have one psychiatrist in a country of 10 million people, but when that person dies and there is no one else to take their place, the fate of the mentally ill seems that much dimmer.

A lot of money is going into rebuilding Somalia and helping with diseases like HIV, TB and diarrhea, but not enough funding is going into helping the mentally ill.

I can only imagine that it will be nearly impossible to build a stronger country, economically, educationally and health wise, if such a large portion of the population is suffering from mental trauma.

Where will these workers come from? How can they function if they are suffering from a mental illness without being treated? How will the children who are suffering learn and grow up to be productive citizens?

This is only a snap shot about mental illness in a third world, war torn country and similar terrible conditions are played out everyday around the world.

Hearing about these deplorable conditions initially made me wish I could go to Somalia to help out, but I realized that it also makes me want to advocate even stronger for the rights and proper treatment of the mentally ill here in the United States and across the world through education, information and community service.

Popular Psychology

Defeat Unpleasant Thoughts By Ignoring Them

by Torey C. Richards, LMHC5 Comments on Defeat Unpleasant Thoughts By Ignoring Them

iStock_000009024892XSmall-300x240I recently read an article on psychologytoday.com entitled Why Our Thoughts Are Not Real. This wasn’t the first time I had read an article that talked about the fallaciousness of our thoughts and how we often misinterpret the information our thoughts give us.

Everyday we are filled with thousands of thoughts, most of them aren’t even real, but we assume and act on them as if they are real and that is what causes us to have many of the feelings and behaviors we have that cause us so much strife.

Our thoughts on their own are just thoughts, they don’t exist in reality, you can’t touch them and they really aren’t anything at all until we make them real by engaging in, dwelling on and trying to do something about them.

I try to explain this a lot when I work with clients dealing with anxiety. They will have a thought pop into their head, such as “I don’t think my shirt matches my pants today and everyone is going to notice and I am going to be walking around looking like a fool and people will be laughing behind my back.”

Consciously the client didn’t chose to have this thought, it just popped into her head and if she ignores it for a while, it will likely fade away and she will forget she even had that thought, but what most people do, especially people with anxiety, we try to do something to get rid of the thought which causes us to pay more attention to the thought which causes the thought to become more real and anxiety provoking.

The person in this case is then more likely to continue wondering if she looks stupid, may go look in the mirror and start scrutinizing her attire even more and may go to a coworker asking “do I look stupid in this” and may feel relieved when the co-worker says “No, you look fine” or may create even more anxiety by saying that her coworker is just too nice to hurt her feelings.

Whatever the case, the point is that because she is thinking about the thought, that isn’t even real, she is making it more and more real and creating more and more anxiety, when if she would have just let the thought enter her brain, allow herself to not do anything about it, including thinking about it, the thought most likely would have left her awareness and she would have went on with her day without being overly conscious about her attire.

When we start given our thoughts attention, that’s when they start to feel real and start to have some control over us because we typically want to do something about it. People with anxiety generally create more anxiety because they attend too much to their anxious thoughts and generally try to get rid of it, by doing something which causes even more anxiety, similar to someone with obsessive compulsive disorder. The same goes for people suffering from depression. They may have the unreal thought “no body likes me” and so they withdraw from people and when they find themselves alone use that as further proof that “no body likes me”.

When it comes to anxiety, I had a client who suffered with anxiety and her boyfriend would break up with her almost every week. When he would break up with her she would have the thought, “If he leaves me I will be alone and miserable for the rest of my life”, that thought would cause her to panic and she would call and text him repeatedly. He wouldn’t respond which would amplify that thought and her anxiety so she would jump in her car and drive fast and recklessly to his house where she would pound on the door and cry until he opened it and they reconciled.

Later she would always be depressed by the frantic and pathetic way she responded, yet the next week she would do it all over again.

I had to help her learn to just sit with her thoughts and feelings and do nothing about them, even though she felt like she needed to. It was hard for her not to call, text and drive to go see him the first few times we worked on this, her anxiety was through the roof,  but when she finally allowed herself to sit with the anxiety, to try to not think about it, she was surprised that after about 20 minutes, the anxiety went from a level 10 to about a 2. It would come back when she thought about it and we had to work on letting it go again, and once again her anxiety would go back down without her doing absolutely anything except not giving it life by attending to it and trying to do something about it.

After a few sessions she was able to sit with her anxiety and not have it cause her whole world to stop or spin out of control and with that, her self-confidence increased and she was able to handle her situations a lot better, without panic, but with a clear level head.

I think this is something we can all practice. Remember that our thoughts are not real until we breathe life until them, and especially when it comes to an uncomfortable thought, sometimes doing nothing about it, including not thinking about it, will allow it to leave our consciousness and fade into nothingness instead of causing us to feel and do erratic and irrational things.

Distraction is a good tool to use when it comes to this. Instead of thinking about the thought, do something to distract yourself. I do it all the time and with practice it becomes really simple. Usually in about five minutes whatever the thought was causing the anxiety, sadness, or whatever, will fade from my consciousness and not have crippled my day or caused me a great deal of distress. This is a simple solution that can help us all live happier, more fulfilled lives.

Therapist are Humans Too

Involuntary Hospitalization

by Torey C. Richards, LMHCLeave a Comment on Involuntary Hospitalization

depression_woman_640Last week I did my very first involuntary hospitalization (or as we call it here in Florida, a Baker ACT) of an adult.

Involuntary hospitalization or commitment is actually a legal procedure where an individual who is showing severe signs of a mental illness such as suicidal thoughts, homicidal thoughts, self-neglect or any other potential to intentionally or unintentionally harm themselves or others is placed into a hospital even if they don’t want to go.

Here in Florida it’s generally a 72 hour hold where the person is evaluated by a nurse and other mental health professionals and then a psychiatrist who will decide if that person is well enough to be released or should stay longer. Technically a 72 hour hold can be extended for as long as a week to much longer in severe cases including state hospitalization which is typically months. It’s a major responsiblity because it’s basically taking away part of someone libery and forcing them into treatment.

In Florida, a doctor, a police officer, a physicians assistant and licensed social workers, marriage and family counselors and mental health counselors all have the authority to put someone involuntarily into the hospital if they feel that person is a threat to themselves or someone else.

I personally don’t take this responsibility lightly, especially working in my new job where I work mostly with adults who’s circumstances generally aren’t as black and white when it comes to meeting criteria to be placed into involuntary hospitalization compared to children. However I know that sometimes it is necessary to keep people safe from themselves, other people and even their illness.

Most of the children and adolescents I had to place into involuntary hospitalization were fairly easy decisions for me. They usually came straight out and told me that they wanted to kill themselves, wanted to kill a parent, or was doing something so outrageous that it was obvious they were imminent dangers to themselves. Most of them, once I told them I was going to have to have them put into the hospital for observation didn’t fight it much. Some cried, but most knew it was for their own good.

Adults however are different. Yes there are plenty of adults who are as obvious as the adolescents, but when it comes to adults, most of them won’t say that they want to kill themselves or someone else, but will skate around it and it becomes not black or white, but grey.

Working in a mental hospital makes it even worst because many of the adults present with some signs of psychosis and it’s not illegal to show sings of psychosis or to be symptomatic, meaning, I can’t hospitalize a schizophrenic just because she’s hearing voices and talking to herself, or a manic woman just because she’s speaking at a thousand miles an hour and bouncing from topic to topic driving her husband and kids up the wall, not as long as both of those people aren’t homicidal or suicidal and are oriented which is the majority of the case.

Often times people will want these people placed into the hospital against their will because they are acting “crazy”, but that doesn’t meet criteria to take away someones liberty and placing them into the hospital.

Because adults have been much more complicated than children when it comes down to deciding if they meet criteria for involuntary hospitalization or not, I was always nervous about writing my first adult involuntary hospitalization order, but when I got this current job, I knew it was only a matter of time. At least 2 to 3 times a week I was asked to evaluate an adult to see if they met criteria for involuntary hospitalization, but most of the time the adults were just symptomatic, maybe in need of some medication, but didn’t meet criteria for involuntary hospitalization.

That was until last week. Last week I was in a training when I got asked me to come evaluate a woman because her therapist thought she may need to be placed into the hospital for her safety.

I met with and evaluated the woman who was obviously in distress. Through my evaluation she told me she hadn’t eaten, slept or bathed in days, nor has she taken her medication because “demons” were telling her not to and were physically holding her down at night.

She then started telling me about being commanded by her deceased mother to do things like book an airplane ticket to another state. She also did not know where she was or what year it was. It was obvious to me that she needed to be hospitalized for her own safety so I had to write an involuntary hospitalization order and she was subsequently placed into our hospital where she would be evaluated, stabilized and released to go back home with a follow up plan of both medication and therapy.

I was nervous as I wrote it, but this one was obvious enough where I felt confident that I wasn’t violating anyones rights and where the power I have to place someone in the hospital against their will was being used for the right reason.

So that was my first adult involuntary hospitalization and I know there will be many more to come because as a licensed mental health counselor I evaluate people’s mental state everyday and working in a large mental health hospital where people come for medication appointments and therapy appointments, but sometimes end up presenting in ways that suggests they need to be placed in the hospital for stabilization, writing involuntary hospitalization orders is part of my job and it’s a responsibility I don’t take likely.

Popular Psychology

Young Stars Bright Futures Cut Short By Suicide

by Torey C. Richards, LMHC3 Comments on Young Stars Bright Futures Cut Short By Suicide
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Lee Thompson

I have been a fan of Lee Thompson since my college days when I would find myself watching The Famous Jett Jackson on the Disney channel despite it being meant for teens between the ages of 12 and 16.  After all, here was an African-American movie star/spy who lived with his father and grandmother and got into various adventurous with his friends, how could I not find that interesting?

Lee also starred in the movie Friday Night Lights and was in Akeelah and The Bee .

Tragically however, Lee, who was currently starring in TNTs police drama Rizzoli & Isles, committed suicide on August 19th. He was just 29 years old.

I personally was shocked by the news of his death because he was a fairly low key actor. I never heard about him getting into trouble with the law, abusing drugs or alcohol or even much about him having any mental or emotional instability. I always assumed he was just doing fine and that is the danger when it comes to suicide.

As I have stated before, I have done a lot of crisis counseling in the aftermath of people who have committed suicide and often the words I hear from family members and friends is that they thought the person was doing just fine and their suicide came as a huge shock.

And this is where some of the stigma that surrounds mental illness comes into play. According to sources, Lee may have been battling depression quietly for a long time. Some are saying that he really changed once he started practicing an African religion called Yoruba, but it’s very likely that in an attempt to ease his depression, he sought refuge in religion and when that failed to lighten his depression, he unfortunately thought his only alternative was death.

Sources say that his mom was worried about him because many of his friends that lived in Los Angeles with him had moved and that he was surrounded mostly by “industry types” and not real friends. If this is true, definitely having a lack of a support system/network increases the chances of someone with suicidal thoughts to actually act on them.

Apparently Lee was close to his mother and sister, but probably out of pride and/or shame (stigma even), never told them about his depression or at least about how bad it really was. Many times men feel weak for feeling depressed and will hold it in and take their lives without anyone knowing how long they had been suffering.

His coworkers on the set of the show Rizzoli & Isles got suspicious when he didn’t show up for work and sent an officer to his house to check on him and that is where he was found dead. Jackson didn’t leave behind a suicide note, but sources say that he took his life with a gun.

This comes right after reality television star Gia Allemand (who was also 29) of Bachelor and Maxim modeling fame committed suicide by hanging herself with a vacuum cleaner cord two hours after her NBA boyfriend Ryan Anderson told her that he didn’t love her any more on August 12th.

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Gia

According to Gia’s father, she had a long history struggling with dealing with rejection when it came to friends and boyfriends.

Honestly I didn’t know much about Gia until this happened. I remember getting ready for work when it came on the morning news show and I paused to listen to the story. It’s troubling to me when anyone who commits suicide, but it’s especially painful when people who are in the spot light commit suicide because that often sends a message to their fans and others that it’s okay to end your life if you think there is no other solution.

There are ALWAYS other solutions.

Unfortunately when you are in the middle of a deep depression or a mental/emotional/psychological break down, it’s easy to imagine that life will never get better, that it will never be as you want it to be and that death is an easy escape.

Suicide is a permanent decision to a temporary problem is a popular saying, but unfortunately suicidal people ususally believe that their problem is indeed permanent even when it’s not.

**If you or someone you know needs help, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255)**

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Tips for College Freshmen

by Torey C. Richards, LMHCLeave a Comment on Tips for College Freshmen

istock_000004524452small-520x487It’s that time of the year again when students of all ages are headed back to class, but for college freshmen, this time of year can be full of excitement and loads of anxiety that can send them packing back home or spinning into a dangerous cycle of poor choices.

A few of the high school clients I worked with last year are feeling this same since of angst so I wanted to share some of what I have shared with them about creating an environment for success their freshmen year of college.

Live Like a Broke College Student

Sometimes when students go off to college they forget that they may not have the constant source of income they had while they were home, and yet there is more things that they want to do that cost more money.

College is expensive. Take advantages of free things, there are usually a lot of free things on campus from food to clothing.

Students have to learn how to live with less funds which means learning how to budget, given up some of their favorite meals or even activities. They will have to learn how to survive with less, which is a challenge, but it can be fun and creative. College student are notorious for coming up with inexpensive and free ways to have fun and that is something that should be embraced if you don’t want the lack of finances to be an added source of stress.

Don’t Be Afraid to Ask for Anything, Especially Help

A lot of times college is the first time young people are given total responsibility over themselves and many don’t know how to handle it. They think being an adult means you don’t have to ask for help, but that is where they get into trouble.

In college, you are treated like an adult. No one is going to remind you to read assignments, or to work on your paper, or to study. It’s up to you, so students need to learn to ask for help by being proactive in their relationships with their professors and not just thinking that the professor will let them know if they are not doing well in a particular course.

Building a support system is also crucial so that you have people you can turn to for advice, support and encouragement. A good support network should include upperclassmen, a professor they trust and look up to, as well as any administrators they feel they can turn to for advice or guidance.

Also, being part of a support group is extra helpful for students who need extra support or counseling, which is generally free on most college campuses. Asking for help is not about appearing weak, it’s about preparing for success.

Get Involved

When I speak to the college freshmen who are having the most difficult times adjusting, nearly all of them have done nothing to actually get involved or to get engaged on campus. It’s important to be open minded to both new experiences and people. Making real connections is one of the best ways to feel like you are apart of the college environment.

Many of the young people I work with who are college freshman come from the inner-city and sometimes feel out of place on college campuses where the majority of the student body doesn’t look like them. I always encourage them to join multicultural clubs and student support services in order to help them adjust and begin to engage with the entire student body.

At the same time, I let them know that it’s okay to take time to adjust and for them to not feel so overwhelmed if after a week or two they still don’t feel quite comfortable. The thing is, I want them to avoid feeling lonely which can lead to numerous issues including isolation, depression, poor grades and even dropping out of school.

Time Management

It’s good for college students to have some routine and a schedule that they can follow, but not a schedule that is so rigid that it doesn’t leave room for fun and other activities. Having a schedule such as when to study, when to workout, etc., can bring some order to a time that may appear chaotic.

This includes making time to take classes that they can manage and also allowing themseves to take a couple of fun classes like yoga or basketball, after all, it may be the last time they can take fun classes before they get into the really heavy stuff.

The first year of college is filled with lots of sometimes contradicting emotions, but being prepared to face those challenges will make it that much more exciting and fulfilling as well as prepared to accomplish all of their personal, social and academic goals.