Mental illness is curable and treatment goes beyond medication. Discover some of the latest breakthroughs in treatment and how they promise new, effective treatments for mental and behavioral illnesses.
When her depression was at its worst, Patrice Iocco couldn’t eat or sleep normally. She’d retreat to her basement with no energy to resurface. Though she saw a therapist and took medication, her condition didn’t improve.
“I felt like I was living my life in a dungeon,” Iocco says. “I felt hopeless.”
One in five U.S. adults experiences mental illness in a given year. For years, Iocco has been among those 43.8 million people. Thanks to the right treatment, however, Iocco isn’t living in a dungeon anymore. She enjoys being retired. She exercises. She shops. She eats and sleeps normally. She still takes medication, but she lives a normal life.
For many patients diagnosed with mental illness, a “normal life” seems improbable, if not impossible.
“People still don’t want to come forward about mental illness,” says Dr. Syed Anwar, Iocco’s doctor and medical director of behavioral health at Presence Saint Joseph Hospital in Elgin. “But mental illness is like any other illness. It’s important to see it that way.”
Mental illness is curable and treatment goes beyond medication. Electroconvulsive therapy (ECT) and group therapy have risen as effective components in treating major depression, anxiety and other behavioral health disorders. Improved communication about mental illness, thanks to Mental Health First Aid classes available to the general public, is helping as well.
“There’s progress toward open communication about mental illness,” Anwar says. “But more can be done.”
Mental and behavioral health disorders encompass a broad range of diagnoses. Depression, anxiety, schizophrenia, substance abuse disorders and eating disorders are just the tip of the iceberg.
According to Anwar, treatment regimes are significantly improved from even a decade ago. One of the most significant developments has been the improvement of electroconvulsive therapy (ECT).
While it’s unclear exactly how ECT works, Anwar explains to his patients that ECT corrects the cerebral cortex so that neurotransmitters work more effectively. After undergoing anesthesia, patients receiving ECT experience an intentional seizure, which allows changes in brain chemistry to occur at a faster rate than antidepressant medications can cause.
The whole procedure takes less than five minutes.
“When people hear about ECT, they think of ‘One Flew Over the Cuckoo’s Nest,’ but ECT has come a long way,” Anwar says. “It’s a very effective treatment. People are using it a bit more now, but I think it’s still underused.”
Anwar sees patients who are unable to leave the house, unable to go to work and unable to function. ECT is a “boost” for such patients, Anwar says. Though they still need to continue with medications and therapy, many patients who receive ECT are able to return to their normal lives.
“The response is very dramatic,” Anwar says. “Energy levels get better, patients become more spontaneous, you see their mood changing, they’re more active – the whole family sees a difference. It’s a very effective treatment, especially for suicidal patients.”
Iocco became a patient of Anwar three years ago. She knew about ECT from a pamphlet her therapist gave her, and since her medication for major depression hadn’t been effective, she agreed to begin ECT treatments when Anwar suggested it.
Seven treatments later, Iocco feels as though ECT has saved her life.
“When you wake up from ECT, you’re confused at first, but you don’t feel that darkness and that heaviness on your mind and heart any longer,” Iocco says. “It’s like rebooting a computer – you feel brand new and rejuvenated.”
Thanks to the successful ECT treatments, Iocco now takes just one pill instead of a daily medication cocktail. Waking up to face a new day is no longer daunting.
Anwar typically uses ECT to treat patients with major depression or depression with psychotic features, such as bipolar disorder and schizophrenia. He also suggests ECT for manic patients, or patients unable to sleep through the night. Oftentimes, one treatment is all it takes to help a patient sleep regularly. ECT can also be used in patients with less-severe levels of depression.
“There are some patients who don’t have time and luxury to play with medications,” Anwar says. “With medications, you have to wait a long time to see how they affect you, and meanwhile, your life is going by. ECT shouldn’t be a last resort.”
Anwar says patients might be nervous about ECT because they’re concerned about having memory problems. While ECT can affect the memory, Anwar says the impact is only temporary.
Iocco loses parts of her memory after ECT treatment, but she says it always returns.
“Actually, it comes back stronger,” Iocco says. “I can remember being two years old now. ECT kind of feels like time travel – you always come back. I came back with a different point of view on life.”
Additional services within the Presence Saint Joseph Hospital Behavioral Health Program treat patients in an Inpatient Behavioral Health Unit when they are at risk to harm themselves or others.
The Focus Unit treats patients who have lost hope and have either attempted suicide or are seriously contemplating it. The Acute Program cares for patients who are psychotic or suffering manic episodes.
Additional services include recreation therapy, art therapy, pet therapy, substance abuse assessments with a dual diagnosis, family therapy and school transition.
To inquire about the behavioral health services available at Presence Saint Joseph Hospital-Elgin, call (847) 931-5521 or visit PresenceHealth.org.
Iocco returns to Anwar every 90 days simply to monitor her well-being and refill her one medication.
“I thank Dr. Anwar for giving me my life back,” Iocco says. “If it weren’t for him, I’m not sure I’d be here.”
There is no cookie-cutter cure for mental illness. Medications that work for one person might not work for someone else. That’s one reason group therapy is beneficial.
Group therapy is different from a support group, says Shira Greenfield, clinical manager of outpatient behavioral health at Centegra Hospital-McHenry.
While support groups tend to meet monthly, group therapy sessions tend to meet at least weekly. Centegra Health System offers intensive outpatient programs in which people attend group therapy sessions nine to 25 hours a week for a few weeks.
“It’s a different dynamic,” Greenfield says. “When you look at a support group, it’s usually people coming together around the same issue, like having had a stroke, or experiencing grief following the loss of a loved one. But group therapy is more intensive. Some members may have more than one diagnosis, such as depression mixed with social anxiety. People don’t necessarily have the same issues or background, but there’s something bringing them all together.”
Therapy groups typically consist of eight to 12 people. Centegra’s intensive outpatient programs offer three categories of group therapy sessons. Process groups, typically unstructured, allow participants to share what’s on their minds and receive encouragement and feedback from other individuals within the group. Psychoeducational groups educate participants and provide them with skills to use out in the world, such as combating the temptations of substance abuse. Expressive therapy groups engage in nonverbal assignments, such as yoga or art, which help group members to express themselves.
“It’s just so powerful to see people create something that articulates what they couldn’t necessarily say,” Greenfield says. “We know people hold not just stress, but also traumatic memories, in their bodies. We like to respect the different ways people learn.”
In addition to emotional support, members in group therapy receive ideas, suggestions and advice from other group members in a non-judgmental environment. Whether it’s advice about managing a stressful conversation, a suggestion for a relaxing place to go fishing, or information about volunteer work, the conversation is linked to recovery.
In individual therapy, the professional doesn’t typically reveal much about his or her personal life, Greenfield says. However, in group therapy, especially within a process group, the conversation focuses on multiple individuals and their experiences. The variety of perspectives can help group members to feel more comfortable, Greenfield explains.
Accountability is also an important aspect of group therapy.
“The peer component is so powerful,” Greenfield says. “One of the most powerful things I hear over and over is the sense of universality, the sense that ‘I am not alone.’ A lot of people feel shame, embarrassment. They feel that no one understands. But then they hear other people talk and that isolation melts away. People show up because they feel accountable to others within the group.”
The leader of a group therapy session should be a qualified therapist, a licensed social worker, a certified alcohol and drug counselor, or someone with a specific understanding of the group process, Greenfield says. In addition to these certified technical skills, a group leader must also be respectful, non-judgmental and capable of managing a safe environment.
Greenfield says it’s normal to feel uneasy about trying group therapy. If it’s an open group, meaning people can start at any time, she recommends observing a session in order to find a place that feels safe and welcoming.
“It takes a lot of guts,” Greenfield says. “There are so many people who struggle with social anxiety and who are fearful of being in a group setting, fearful of trying something new, fearful of going anywhere by themselves. People in general don’t really do anything by themselves, like go to a movie or out to dinner. My advice is to try and go once. Like anything else, allow yourself to experience it.
The nice thing is that you can go to group therapy and just observe the first few times until you feel comfortable. In our programs, we don’t make people share. People can absolutely observe and participate gradually.”
Greenfield encourages those interested in an intensive outpatient program that is rooted in group therapy to call Centegra’s behavioral health intake line at (800) 765-9999 to schedule a consultation for additional information or to schedule an inkate appointment.
Mental Health First Aid
Most people are familiar with CPR courses, in which individuals learn how to resuscitate someone whose breathing or heartbeat has stopped.
Fewer people know how to recognize and respond to the signs of common behavioral health disorders, says Denise Elsbree, a community liaison for Mental Health First Aid (MHFA) courses offered at Northwest Community Hospital, in Arlington Heights, in partnership with Linden Oaks Behavioral Health Services.
Mental Health First Aid courses were designed in Australia in 2001 to help the general public to recognize symptoms of various behavioral health disorders and to approach individuals who may need ongoing help. The worldwide program entered the U.S. in 2008.
“When I teach a class, I’ll ask how many people have taken CPR, and always, over half of the people raise their hands,” Elsbree says.
“Then I ask how many people use those skills, and fortunately many hands drop. Now, that’s not to say CPR skills are unimportant, but when you think about how one in five U.S. adults experiences some kind of mental health problem, and you realize the lack of training to recognize and approach someone with a mental health problem, you realize how necessary Mental Health First Aid classes are. Most people know someone who’s experienced a mental health challenge, yet few people know what to do about it.”
The class covers the topics of depression and mood disorders, anxiety disorders, trauma, psychosis and substance use disorders. A five-step action plan teaches the class how to assess for risk of suicide or harm, listen non-judgmentally, give reassurance and information, encourage appropriate professional help, and encourage self-help and other support strategies.
The major goal of the course, however, is to challenge how people think about mental illness, help registrants understand that there are physiological reasons behind mental illness, and reinforce that recovery is not only possible, but probable.
“We encourage people to see that mental health disorders are an illness, just like cancer, just like diabetes, just like heart disease,” Elsbree says. “There are physiological reasons why people experience depression and anxiety. You wouldn’t say to someone with cancer, ‘Well, just get over it.’ The class helps people have more empathy.
“Think about it,” Elsbree continues, “Our brain is the most complicated organ in our bodies and we don’t necessarily know that much about it. We’re the least forgiving when the brain doesn’t work right. If you have heart disease, we usually have a little more empathy, but when the brain isn’t working, we’re more inclined to say, ‘Snap out of it.’ This class aims to change that mentality.”
Oftentimes, Elsbree will teach MHFA classes to the entire staff of an organization like the police department or school district. But just as often, she teaches the class to groups of individuals, typically ages 18 and older. High school psychology students have also been known to take the class.
Since 2010, more than 7,000 people have taken a MHFA class coordinated through Linden Oaks. Northwest Community Hospital has offered the class for the past two years and will continue to offer classes on a quarterly basis. The 8-hour class can either be taken in one day or in two 4-hour sessions. Registration is $40 and can be completed at nch.org or eehealth.org/servicesbehavioral-health.
Organizations interested in setting up a MHFA class can contact (630) 646-5200.
“It’s good that there’s more of an interest in mental and behavioral health,” Elsbree says. “We’ve come a long way, but the conversation needs to continue.”