NAMI Mercer County

Families Meeting the Challenge of Mental Illness

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Understanding Adverse Childhood Experiences (ACEs)

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Our childhood memories, both good and bad, may fade over time as we grow into adults. We meet new people, see new places, and even uncover new passions. We figure out not only what we aspire to do, but also who we aspire to be. However, even as fully-grown adults, we cannot fully detach ourselves from our childhood. As we explore new avenues and steer ourselves in different directions, we never really lose sight of the road that brought us to where we are. Taken together, those experiences we face as children shape who we become.

Unfortunately, many children grow up in environments that are not conducive to a healthy and happy upbringing. Adverse childhood experiences (ACEs) are traumatic events that may result in negative health outcomes as one grows into an adult. ACEs are rather common; according to the CDC-Kaiser ACE study, 64% of people have experienced at least one ACE and 12.5% have experienced at least four.

ACEs often negatively affect health and well-being. Given that those with multiple ACEs often grew up in stressful environments, they are more likely to resort to harmful coping strategies, such as smoking or drinking, as adults. In turn, these harmful behaviors put them at a greater risk for developing diseases (e.g., cancer, cardiovascular disease, etc.). One Welsh study found that adults with at least four ACEs were twice as likely to be diagnosed with a chronic disease before they reach 69 years.

How can we promote health and prevent ACEs? Experts agree that implementing policies to support families is one of the best strategies. By giving communities the resources they need to prosper (e.g., high quality education, better health care, etc.), we can promote healthy environments, and thus, promote health and well-being among communities.

Interested in learning more about adverse childhood experiences? Attend our event, Understanding ACEs: Building Self-Healing Communities, on Thursday, November 3, 2022 from 6:30-8pm. The event will be held at the RWJ Wellness and Fitness Center (3100 Quakerbridge Road, Hamilton, NJ 08619). We hope to see you there!

References
Boullier, M., & Blair, M. (2018). Adverse childhood experiences. Pediatrics and Child Health,
28(3), 132–137. https://doi.org/10.1016/j.paed.2017.12.008
ACEs, R. R. (2014, July). Adverse childhood experiences. In ACEs (Vol. 12, p. 18).

Living with PTSD

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Post-traumatic stress disorder (PTSD) is developed as a result of experiencing or witnessing a traumatic event, and it actually changes the structure of your brain; complex PTSD (C-PTSD) develops as a result of experiencing repeated traumatic events and is more likely to occur if the trauma was experienced at a young age. Common symptoms associated with PTSD include nightmares, flashbacks, stress and anxiety, and hypervigilance. Linked below are a few personal stories from people living with PTSD, and while it’s commonly associated with veterans, these stories show that PTSD doesn’t solely emerge from experiencing combat situations, but that there are multiple situations that may result in its development.

Daniel’s story details how he developed PTSD after undergoing an emergency heart procedure and then experiencing a subsequent anxiety attack that he thought was another heart issue. He explains that he felt chest pain which brought him back to the traumatic night of his procedure, and immediately went to the emergency room because he thought it was happening again, only to be told he was having an anxiety attack. After seeking therapy, he was diagnosed with an anxiety disorder and PTSD. He was able to get on medication and found a variety of techniques to help manage his symptoms.

Rita’s story describes how for her, PTSD manifested in repeated panic attacks that wouldn’t stop no matter how many anxiety-related therapies she tried. Eventually she found a therapist who was able to put a name to her feelings of panic and identify that her PTSD stemmed from childhood. When she started doing EMDR (eye movement desensitization and reprocessing) therapy with this therapist, she finally started feeling some relief after a few weeks’ time.

Denise’s story details how she developed PTSD after a student threatened her and the other students in her classroom with a knife. She blamed herself for the incident and became emotionally volatile, experiencing violent mood swings and suicidal thoughts. She ended up going to her doctor, who gave her a tentative PTSD diagnosis, before going to a psychologist who affirmed it. She was then able to get on medication to help manage her symptoms, and ended up moving to get away from her environmental triggers.

If you or a loved one are experiencing symptoms of PTSD, don’t be afraid to seek out therapy using sites like Psychology Today, or other informational resources online like the APA, the Anxiety and Depression Association of America (ADAA), the National Center for PTSD through the VA, or NAMI’s own website.

Coming Out to Love & Support

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In recognition of June being designated as pride month, as a NAMI Mercer intern I would like to highlight some of the mental health struggles the LGBTQ+ community faces.

The coming out process can be a difficult and emotional experience for members of the LGBTQ+ community due both to difficulties with self-acceptance and uncertainty about the reactions of family and friends. Coming out is a lifelong process and if someone experiences rejection early on, it can prevent them from acknowledging their identity for a long time, leading to increased anguish and unhappiness, resulting in mental health issues. Rejection and/or a lack of understanding/support from loved ones can strain relationships and make the person trying to come out feel unloved.

Members of the LGB community are twice as likely as their straight counterparts to experience mental health issues and feelings of hopelessness; transgender individuals are nearly four times as likely as their cisgender counterparts to experience these issues. LGBTQ+ youth are also four times as likely as their straight counterparts to attempt suicide. Among the major risk factors associated with these mental health issues is receiving negative reactions upon coming out, as cited by The Trevor Project, a well-known suicide prevention organization for LGBTQ+ youth.

The most important thing loved ones can do to mitigate the risk of depression and suicide among members of the LGBTQ+ community is to be supportive during the coming out process, even if they have mixed feelings about this news. Parents can demonstrate support by actively listening to what their child is trying to tell them –without interruption, without finishing their thoughts for them. There’s a high likelihood that someone coming out has been thinking about their identity for years, and in this moment, they need to feel heard. They’ll be happy to answer any questions, provided they are asked in a respectful manner.

A psychiatrist at the Child Mind Institute notes, “when people feel loved and supported, they are more capable; they have greater resilience.” You can support a person coming out by treating them the way you did prior to their coming out, staying calm, getting to know their romantic partners, and educating yourself about this community. Helping someone feel loved is the most important thing you can ever do.

There are various resources online, available both to family members and LGBTQ+ individuals, to help them navigate the coming out process. Strong Family Alliance provides information and resources to LGBTQ+ people and their families. Their website details stages of coming out, how different parental actions can help or hurt an LGBTQ+ child, and the challenges parents and children may face after coming out. The Trevor Project is another valuable resource, as is a local LGBTQ+ center. Each person’s coming out experience is different but the need for love and support is common to everyone. Let’s make it a point to extend that love and support to anyone who needs it, this month and every month.

By NAMI Mercer Summer 2022 Intern Alexis

Hope After 40 Years with Depression

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A NAMI Mercer community member shared their story of living with depression, and finding hope after 40 years.

TW: mention of suicide attempt, discussion of depression symptoms

I was born broken. No, not a hole in my heart or some organ disease, but in the head. I believe this. You can come to your own conclusions.

I don’t remember much about my childhood. I know I was awful to my brother and sister. I was sullen and non-communicative and just generally unhappy. I was bullied pretty badly, but a lot of people were as kids and I don’t put much stock in it. I do know that I felt very different and alienated. I was taken for psychological testing when I was 14, and I still have the 5-page report of the doctors’ findings. It isn’t pretty.

When I was 15, my family had enough of my nonsense and sent me to boarding school in upstate NY. I had pretty much failed out of public high school, and was asked not to return after my freshman year. Boarding school brought me out of my shell a little, but I also learned to self-medicate with drugs and alcohol. College was a lot of fun, but again – too much drinking and drugs, and in the back of my head, I knew something wasn’t right. Of the first 9 classes I took in college, I failed 6. I was given a one year academic suspension and returned the following year, doing well enough to graduate in 5 years but it is not an academic record to be proud of. I majored in psychology because it sounded interesting, but I had no real plan – I drifted through college. I realize now that I was refusing to think about career paths because I was terrified of graduating, of joining the adult world, of growing up.

After a brief post-graduation trip around Europe with my brother, I returned to my father’s house in September of 1994. This is really where the story begins. I had to get a job, to begin my real, actual life, and I had no idea what or how to do it. I was terrified. I put a bare-bones resume together and sent out one or two job applications a day as the pressure and the terror continued to escalate. My father would yell at me seemingly every night about the fact that I was drifting, and I knew I was. I knew the feelings I was having weren’t normal, but I didn’t know what to do. On October 28, 1994, I finally snapped. I left my childhood and walked to my mother’s house – my parents had by then been divorced for 6 years but lived about a mile apart, and I cried to my mother and step-father for 2 hours, blubbering about anything and everything. The next day I was taken for evaluation, and I was given medication for the first time, and diagnosed with a word with which I was familiar but didn’t fully understand: depression.

There was no weight lifted from my shoulders – I settled into a morass of self-pity and spent the next 3 months in bed, trying to wrap my head around this new reality. I lay in bed and cried for three months while the TV played in the background. My mother and father both thought I should get out of the house, so I spent a few hours a day at my father’s office in Manhattan, inputting data into spreadsheets and taking frequent breaks to cry in front of my computer. It must have been somewhat embarrassing for him to have a 24-year old sitting in front of a computer in his office, crying while typing in data, and I still feel bad about that. I started working at my fathers office, and if I showed up three days out of five, it was a good week. 1994 through 1998 were filled with doctor’s visits, sleeping, isolating and generally still trying to wrap my head around the fact that I had a disease – that it was me, not someone else, but me that had one. In 1998, my father finally threw me out of his office after my mood swings became too much for him to tolerate. I got a part time job answering phones and fixing computers at a small private school in New York City, which lasted 9 months before the stress and anxiety got to me and I quit abruptly.

I’m going to fast-forward a little. The 2000’s were better, although I still suffered deep depressive episodes. In May of 2003, I woke up one morning with a new friend: anxiety. It started abruptly, and it made all previous anxiety seem like child’s play. It was persistent and all-consuming, and psychiatry was still very much in the dark ages at that point. They raised my Xanax to ridiculous levels, switched to Ativan, then Clonazepam, than back to Xanax. It didn’t do anything. I married my wife in 2005, we had my son in 2006 and another son in 2008. We moved to New Jersey in 2008. These events made me happy, but things still weren’t right. By this point I was on a combination of 7 or 8 different anti-depressants, and none of them really helped. I saw doctors and therapists, and none of them made a bit of difference. I am glossing over a lot of tough times in the 2000’s, but suffice to say I was a spectator in my own life, participating little and enjoying even less.

Then things got really bad.

In 2009, I lost my job in the housing crash, and I couldn’t look for another job. In 2010, I was hired as an IT Coordinator, and the stress and anxiety and depression went up another notch. By 2012, I was unable to function, and I took a three month hiatus from work and checked myself into another psychiatric facility. I was in two different hospitals in the summer of 2012, and I underwent 20 sessions of electro-convulsive therapy (ECT), of which I did most outpatient. It was horrible and traumatic. I remember my wife driving me home from one of the sessions as my breakfast sat forgotten in my lap. My head was leaning against the passenger-side window as drool ran down my chin. It didn’t help; I merely lost a lot of memory. I returned to work later that summer, and I tried my best to function. By 2013, I would step out of my office every morning, drive to a nearby parking lot and sob in my car. Sometimes I would call my wife or my mother and tell them that I just couldn’t take it anymore. Usually I just cried alone. By the end of 2013, this was happening two or even three times a day. In February 2014, I left at lunchtime and drove home. I never went back.

In 2014 I was hospitalized five times for depression, in New Jersey, then in Maryland, then in Connecticut. On September 20th of 2014, I attempted to end my life. On the next day, I tried again.

I won’t go into a blow by blow, but my family was by and large very angry. I did another two weeks inside a locked facility, and then it was decided that I wouldn’t return to my family, but rather live in my mother’s basement, which I did for the remainder of 2014 and most of 2015. I attended a day program in New York and changed medications, had individual and group therapy, and visited my family on the weekends. I eventually moved back into my house. A suicide attempt on your permanent record is a big black mark. My wife wouldn’t touch me. I was as miserable as ever.

I don’t remember much between 2016 and 2018, but I went through the motions. I saw a psychiatrist and a psychologist. Nothing worth remembering happened. I stopped reading and listening to music, I cut myself off from friends – I cut myself off from life. My psychiatrist gave up on me – we had tried every medication and every possible combination of medications available, and she was out of options. I switched doctors with no real change. At some point in there I tried experimental Ketamine infusions, which had shown so promise in patients with severe, clinical depression. It didn’t work.

On December 4th of 2018, my psychiatrist tried a new medication, probably out of desperation. Within 2 hours I felt noticeably better. I have burned by “feeling better” by medications before; the placebo effect usually lasts for three days and then the symptoms revert, so after 25 years of medications, I kept waiting for the other shoe to drop. And it never did.

We played around with the dosage, but there was no question that I felt better. Now I had a mess to clean up. 2019 was spent fixing up my head, dealing with brand new sleeping problems, and still waiting for the other shoe to drop. I don’t remember much about 2019 either, but I must have done some hard work internally. The depression was cut way down, although the anxiety was still there. When the pandemic arrived, I buried myself in music and continued to heal. My BDI (Beck’s Depression Inventory) self-assessment scores continued to drop from their baseline of 54, which is pretty bad. I made new friends online and got rid of old ones that I no longer needed. And some clarity returned to my thinking, for the first time since I was a pre-teen.

At some point during the very beginning of 2021, I realized that the anxiety was gone. I realized that there was a new sensation in my heart – love. It was a strange feeling; not one to which I was accustomed. 2020 was the best year of my life.

I am no longer symptomatic; I have my bad days like everyone, but I still wake up excited and ready for the next day. I see life now as a gift to be savored. I want to live forever. I appreciate the big things and the little things. I am a little sad about the years I lost, but my focus is on the future. I catch myself smiling at random times during the day. I feel confident, positive, and sharp. I went through almost 40 years of hell, but I am out the other side.