Treating Chronic Mental Illness Since 1979
888.642.0295

www.hanbleceya.com

Summer 2011

 

About Hanbleceya

Hanbleceya is a long-term, residential-like treatment program designed to teach those afflicted with a chronic mental illness, such as schizophrenia, bipolar, depression and dual diagnoses, the skills necessary to live a happy, healthy and independent life.

"No matter how dark things seem to be or actually are, raise your sights and see possibilities -- always see them for they're always there."
 ~ Norman Vincent Peale, author, speaker and minister

Message From Kerry

Schizoaffective disorder is a life-long illness that can impact all areas of a person's life including daily living skills, work or school, social contacts, and relationships in general. At Hanbleceya, we strive to support our clients afflicted with this illness by helping them develop the tools necessary to overcome these surmountable challenges. With time, willingness and a supportive family system we know that life changing progress can result from treatment in a therapeutic community like Hanbleceya.

Enjoy our latest newsletter and please feel free to contact us if we can be of service to you.

 ~ Kerry Paulson, Owner/Business Manager since 2005

Message From Karlyn

Schizoaffective Disorder and its two subtypes – bipolar type and depressive type – is often challenging to accurately diagnose due to its consisting of both psychosis and mood symptoms. Patients with Schizoaffective Disorder meet the diagnostic criteria for both schizophrenia and a mood disorder – either a major depressive episode or a manic/mixed episode – so making an accurate diagnosis can be complicated. A thorough diagnostic interview, psychological testing, and review of medication and treatment history is essential for making a precise diagnosis, as is ruling out the influence of a substance-induced or medical condition.

A particularly important consideration in determining a diagnosis of Schizoaffective Disorder is the sequential relationship between the psychotic symptoms and the mood symptoms. For example, if the psychotic symptoms occur only within the context of a mood episode, the diagnosis would more likely be a mood disorder with psychotic features. For a Schizoaffective Disorder diagnosis, the psychotic symptoms (i.e. delusions or hallucinations) must occur concurrently with a mood episode, but the psychotic symptoms must be present for at least one month and for at least 2 weeks without the mood symptoms. As you can see, making this diagnosis can be very tricky and underscores the importance of obtaining an inclusive and accurate symptom history.

A comprehensive and multifaceted treatment plan is often indicated for the treatment of Schizoaffective Disorder that will include both pharmacologic and non-pharmacologic elements. Depending on the subtype of the disorder (bipolar or depressive), medication treatment may include anti-psychotics, antidepressants, mood stabilizers, anti-anxiety or anticonvulsant medications, or a combination of such. Psychosocial approaches that include education, family and friend involvement, and psychotherapy techniques such as motivational interviewing and cognitive-behavioral therapy can help increase awareness of the illness, enhance symptom management and effective coping strategies, teach and improve social skills and foster greater life and relationship functioning. While the diagnosis of Schizoaffective Disorder may change over time based on the symptom presentation, it is typically treated as a long-term, possibly life-long condition.

“Everything is complicated; if that were not so, life and poetry and everything else would be a bore.”
~ Wallace Stevens, American Poet

 ~Dr. Karlyn Pleasants, Owner/Co-Program Director, a member of the Hanbleceya Community since 1997

Community Member Forum

When I first came to Hanbleceya on my 2-day assessment I was positive that I didn’t need treatment.  I was an active addict and my schizophrenia was terrible.  Yet I still believed that I could live without any treatment or help with my mental illness.  I begged my parents to support me in getting a job and living without treatment.  They refused and soon I was attending Hanbleceya.

The first few months were very stressful.  I was lying a lot and that landed me a housing suspension for five days.   At one point, I was able to convince everyone, including the psychiatrist, to take me off my medications.  I soon found myself suffering from severe symptoms and I eventually ended up losing my job.  Due to safety concerns, Hanbleceya staff also suspended my driving privileges and I was sent to the hospital four separate times.  Eventuallay, I found that following the program and working hard was the only way to graduate from Hanbleceya and get what I really wanted out of life.  I was soon doing ten hours a week of work development, including job training, and within three months I found a job.  I was able to save up for a car and bought one from my neighbor for $600.

It took me months to get stabilized on my meds during which time I learned that my schizophrenia was “drug induced.”  As soon as I was stabilized I got my old employer to take me back.  Then I landed a better paying position working for a company in downtown San Diego.  Since recovering from being taken off of my medication, I have been doing very well.

Living in a therapeutic community also helped me in many ways.  I have a group of people that help to monitor my symptoms.  Sometimes I don’t notice if I am particularly losing focus and other people can point it out to me. When I didn’t think that I had schizophrenia my roommate helped me identify times when I was exhibiting symptoms so I could see how my behavior was different than the times when I wasn’t experiencing symptoms.  Without the observations given to me by my roommate and my peers in the community, it would have taken me longer to get a grip on my symptoms.

I thank Hanbleceya for teaching me how to live a sober life and manage my symptoms much better.  While at Hanbleceya, I also learned many skills such as maintaining a clean bedroom and house as well as how to properly do my laundry and cook meals to name a few.  Integrating these tools into my everyday life has helped me to overall become more healthy, productive and independent.

I recently transitioned out of Hanbleceya housing and I am now living on my own.  I am confident that the skills I learned at Hanbleceya will serve me for the rest of my life.  I continue to go to groups and therapy sessions at Hanbleceya and I continue to learn more about how to manage my symptoms.

I credit Hanbleceya for turning my life around.  I was a hopeless addict and was suffering from horrible symptoms before coming here.  Now I have a great job and I am able to live life like any normal person.

~Ryan R., a member of the Hanbleceya Community since July 2009

CD CORNER

Post-Acute Withdrawal Syndrome

When we think of drug or alcohol addiction we usually focus on alcohol and drug symptoms and not the sobriety-based symptoms, such as Post-Acute Withdrawal (PAW). Yet, this is what makes sobriety a difficult process for an individual. Post-Acute Withdrawal Syndrome (PAWS) have been defined by the Ohio State University Medical Center as when the brain undergoes physical changes to cope without the presence of the drug in the body. As the brain improves, the levels of chemicals fluctuate in the process of approaching the new equilibrium. According to Terence T. Gorski, 75-95% of recovering alcoholics and addicts have illustrated brain dysfunction which has been contributed to many cases of relapse. In most cases, symptoms of PAW usually manifest themselves seven to fourteen days after stopping alcohol or drug use and peaks over three to six months. PAW symptoms are not the same for everyone, however, most common symptoms of PAW includes inability to think clearly, memory problems, over-active or numbness in emotions, sleep problems, coordination problems, and inability to cope with stress. The symptoms vary in severity, length, and how often they occur. It is important to keep in mind that PAWS is normal and it is a part of recovering from any substance addiction. According to Ohio State University Medical Center, the best way to keep the PAW symptoms under control is to pursue individual and group therapy, develop and utilize a recovery support network (such as Alcoholics Anonymous or Narcotics Anonymous), and reevaluate behavior and thoughts. It is also important to exercise and keep a well-balanced diet that restricts sugar and fat intake, along with having a caffeine free diet since caffeine causes nervousness and restlessness.

~ Roza Parvin BA, CD Case Manager, a member of the Hanbleceya Community since 2010.

For more information on Post-Acute Withdrawal, please visit these sites:

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Schizoaffective Disorder

Schizoaffective disorder is one of the more common, chronic, and disabling mental illnesses. As the name implies, it is characterized by a combination of symptoms of schizophrenia and an affective (mood) disorder. There has been a controversy about whether schizoaffective disorder is a type of schizophrenia or a type of mood disorder. Today, most clinicians and researchers agree that it is primarily a form of schizophrenia. Although its exact prevalence is not clear, it may range from two to five in a thousand people (- i.e., 0.2% to 0.5%). Schizoaffective disorder may account for one-fourth or even one-third of all persons with schizophrenia.

To diagnose schizoaffective disorder, a person needs to have primary symptoms of schizophrenia (such as delusions, hallucinations, disorganized speech, disorganized behavior) along with a period of time when he or she also has symptoms of major depression or a manic episode. Accordingly, there may be two subtypes of schizoaffective disorder:

  1. Depressive subtype, characterized by major depressive episodes only, and
  2. Bipolar subtype, characterized by manic episodes with or without depressive symptoms or depressive episodes.

Differentiating schizoaffective disorder from schizophrenia and from mood disorder can be difficult. The mood symptoms in schizoaffective disorder are more prominent, and last for a substantially longer time than those in schizophrenia. Schizoaffective disorder may be distinguished from a mood disorder by the fact that delusions or hallucinations must be present in persons with schizoaffective disorder for at least two weeks in the absence of prominent mood symptoms. The diagnosis of a person with schizophrenia or mood disorder may change later to that of schizoaffective disorder, or vice versa.

The most effective treatment for schizoaffective disorder is a combination of drug treatment and psychosocial interventions. The medications include antipsychotics along with antidepressants or mood stabilizers. The newer atypical antipsychotics such as clozapine, risperidone, olanzapine, quetiapine, ziprasidone, and aripiprazole are safer than the older typical or conventional antipsychotics such as haloperidol and fluphenazine in terms of parkinsonism and tardive dyskinesia. The newer drugs may also have better effects on mood symptoms. Nonetheless, these medications do have some side effects, especially at higher doses. The side effects may include excessive sleepiness, weight gain, and sometimes diabetes. Different antipsychotic drugs have somewhat different side effect profiles. Changing from one antipsychotic to another one may help if a person with schizoaffective disorder does not respond well or develops distressing side effects with the first medication. The same principle applies to the use of antidepressants or mood stablilizers.

There has been much less research on psychosocial treatments for schizoaffective disorder than there has been for schizophrenia or depression. However, the available evidence suggests that cognitive behavior therapy, brief psychotherapy, and social skills training are likely to have a beneficial effect. Most people with schizoaffective disorder require long-term therapy with a combination of medications and psychosocial interventions in order to avoid relapses, and maintain an appropriate level of functioning and quality of life.

Reviewed by Dilip Jeste, MD November 2003
Reprinted with permission from the National Alliance on Mental Illness (NAMI), www.nami.org

Schizoaffective Testing and Diagnosis

By Mayo Clinic staff

Diagnosis of schizoaffective disorder usually comes after an in-depth interview with a doctor. As part of this interview, the doctor will likely take a medical, psychiatric and social history and also ask about symptoms and mental well-being. A physical examination can help rule out other conditions, and a mental health professional will likely be consulted.

To be diagnosed with schizoaffective disorder, a person must meet criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association.

DSM criteria for the diagnosis of schizoaffective disorder include:

  • Schizophrenia along with mood symptoms
  • A mood disorder along with symptoms of schizophrenia
  • Both a mood disorder and schizophrenia
  • A psychotic condition other than schizophrenia, plus a mood disorder

Diagnosis requires that the condition is not due to the direct effects of a substance — such as a recreational drug or medication — or due to a general medical condition. In addition, the person must never have met the criteria for any other schizophrenic disorder.

 

Did You Know…About Schizoaffective Disorder

  • Schizoaffective disorder is more common in women.
  • Schizoaffective disorder onset is most common in late adolescence or early adulthood.
  • Schizoaffective disorder is one of the most severe yet most poorly understood affective disorders.
  • Schizoaffective disorder may consist of 1 of 2 subtypes: Bipolar subtype or Depressive subtype.
  • Schizoaffective disorder is one of the most confusing and controversial diagnostic categories in psychiatry.
  • A person with schizoaffective disorder has difficulty in following a moving object with their eyes.

 

Editors:
Susan Daly
Ryan Horon

Contributors:
Roza Parvin
Ryan R.

Thank You to:
NAMI
Mayo Clinic


If you have any comments or questions about this newsletter, or any suggestions for future content, please email us at newsletter@hanbleceya.com


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Resources:

This Center works to focus attention on system reform to ensure access to culturally competent services and treatment for all Americans and to help and support families of color who are dealing with mental illness.

(Support Technical Assistance Resource Center) - funded by CMHS, this center provides support, technical assistance, and resources to help improve and increase the capacity of consumer operated programs to meet the needs of persons living with mental illnesses from diverse communities.

Mental Health America is the nation’s largest and oldest community-based network dedicated to helping all Americans live mentally healthier lives. With our more than 300 affiliates across the country, we touch the lives of millions—Advocating for changes in policy; Educating the public & providing critical information; & delivering urgently needed Programs and Services.

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