FRESH START...2017/12/01  · Fresh Start Page 5 11 Things People Don’t Realize You Are Doing Because Of Your Anxiety Lauren Jarvis-Gibson 1. Decline invites even when you really

NAMI COBB

NAMI Cobb

2017 Leadership Team

Interim President / Communications

Greg Ausham

[email protected]

2nd Vice-President / Outreach

Linda Akanbi [email protected]

Secretary - Nancy Spetnagel

[email protected]

Treasurer and Parliamentarian–

Paul Wiser [email protected]

Membership Chair—Robert Gray

[email protected]

Advocacy Chair—Sylvia Oliphant

[email protected]

CIT/Newsletter Editor – John Avery

[email protected]

Website Management Chair: Tim Link

[email protected]

Fundraising Chair—Reina Panataleon

[email protected]

Past President—Neill Blake

[email protected]

Website: www.namicobb.org

Email: [email protected]

Mailing address:

NAMI-Cobb

P.O. Box 999

Kennesaw, GA 30156

I N S I D E T H I S I S S U E

1 Monthly Meeting

2 Educational Series Speaker

3 Family to Family Class Starting

4 Mental Health Court Graduation

5 11 Things People Don’t Realize You Are Doing Because Of Your Anxiety

7 Testing DNA to find best meds to fight depression

8

10 Meeting and Membership Information

Newsletter Date Volume 1 Issue 1 January 2017 FRESH START

Education Meeting / Speaker’s Bureau

Next meeting will be January 19, 2017

7-8:30 PM Turner Chapel Room 182

492 N. Marietta Pkwy, Marietta 30060

Nancy Garfield, MPA, MSW, LCSW

Her practice consists primarily of individual work with adolescents, young adults and adult men and women. Approximately 30%-40% of her practice is working with adolescents and young adults, many with a history of

treatment resistance.

Page 2 Fresh Start

Education Speaker Series Presents: January 19, 2017

Ever wonder:

How exercise impacts the brain?

Why exercise is so important in the treatment of mental illness?

Which disorders has exercise been shown to have the most significant impact on?

How you can incorporate exercise into your life despite having a mental illness?

Then this is the talk for you. Join us as Nancy Garfield of Psychletherapy™ walks us through the most significant findings related to how exercise can

help mitigate the effects of mental illness.

This event is a FREE community service. All are welcome!

Thursday, January 19, 2017 7:00-9:00 P.M.

Turner Chapel Room 187 492 N. Marietta Pkwy | Marietta, GA 30060

Exercise and the Brain Nancy Garfield, MPA, MSW, LCSW

Fresh Start Page 3

Page 4 Fresh Start Cobb County Mental Health Court Graduation

On January 12, 2017, three more people graduated from the Cobb County Mental Health Court Program. NAMI Cobb was represented well with our own Neill Blake giving remarks during the ceremony. This is quite an accomplishment to those who have completed this program. Our congratulations to all the recent graduates.

Fresh Start Page 5

11 Things People Don’t Realize You Are Doing

Because Of Your Anxiety

Lauren Jarvis-Gibson

1. Decline invites even when you really want to go.

Sometimes, anxiety can be so debilitating, that you can’t muster enough energy to go out. No matter how

excited you were for the event beforehand, when the day actually comes and your anxiety is in full force, you

say no. You don’t want to be a burden to anyone if you were to go, so the best choice for you is to not attend.

2. Obsess over things people normally would never think about twice.

You obsess over everything in your head. Most likely, the things you obsess about would never cross someone’s

mind who doesn’t have anxiety. Maybe you obsess over a conversation you had last week, or the way your boss

looked at you the other day. Maybe you obsess over the fact that your boyfriend hasn’t texted you in a day, and

you worry if you said anything to upset him. Whatever it may be, it’s hard for people without anxiety to

understand why you are so caught up in things that wouldn’t even matter to them.

3. Wake up early in the morning even when you’re tired.

Sleep is always an issue for you. It’s hard for you to get to sleep because you have so many things to digest and

contemplate about the day you just had. Because your mind never seems to shut off, you never fail to wake up

early with worries that have already entered your mind. You tend to wake up super early sometimes because

you need to get going, and get everything done in a timely manner. Sleeping in is definitely a challenge for you

because you can’t switch off your anxiety once you are already awake.

4. You constantly fear the worst scenario in every situation.

Before first dates, you are convinced it’s going to go terribly wrong. Before going on a trip, you envision

everything falling apart. Before going on a road trip, you fear accidents. When you get sick, you get terrified

that there’s something truly wrong with you. The list goes on and on, and it seems silly to others. But for you?

It’s real fears. It’s real to you.

5. You replay conversations over and over in your head.

You try to avoid confrontation at all costs, because it causes your anxiety to get worse. When you have an

argument or even a conversation that seems lovely to the other person, you continue to think about it after it’s

said and done. You can never get it out of your head and you always think you said something wrong. It can

really eat you up inside, and you always have to remind yourself that it’s just your anxiety talking, and

everything is most likely fine.

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6. You become more worried for yourself when people voice concern for you.

When people ask you if you are ok when you are having an anxiety attack, or when people come to you when

you are way over your head with negative thoughts, it makes your anxiety worse. Of course they all mean well,

but when others worry for you, it makes you think – “If they are worried, then I should worry even more about

myself!”

7. You think it’s your fault when someone doesn’t reply right away.

Whether it’s your significant other, your best friend, or sister, you constantly get worked up when people don’t

respond to you. People without anxiety would usually not pay it any mind, but for you it’s a huge deal. Usually

when people don’t answer you or text you back, you think that it’s all of your fault. You always think that you

did something wrong, when most likely, they are just terrible at communication.

8. You sometimes feel like you are having a breakdown every few days, when mention of the

future is brought up.

The future is a huge trigger for you. You hate when people ask you what your plans are for the next five years,

and it will cause you to retreat. Graduating from high school and college for most people is very exciting, but

for you it can be incredibly daunting and scary. You hate when people talk about their own future because it

makes you feel like you aren’t good enough.

9. You constantly compare your success to other people who are the same age as you.

You constantly see on Facebook that people your own age are getting their dream jobs, and it makes your head

want to explode. You don’t want to compare yourself to others, but sometimes your anxiety gets the best of you

and you can’t help it. You worry if you are ever going to measure up to them, and if your goals are ever going

to come true.

10. You replay every mistake you make, and always beat yourself up over it.

Especially if you make a mistake at work, it can consume your thoughts and can ruin your day, or even week.

You constantly strive to do the best that you can do, but when you accidentally send something that you

shouldn’t, or when you do something you weren’t supposed to do in the office, you can get really down on

yourself. Anxiety can truly be your worst enemy.

11. On some days you are too physically and mentally exhausted to get out of bed.

Some days, your anxiety can be so strong, that you truly feel unable to do anything but lie in bed and cry. At

times, the world can be way too much for your mind to handle, and you’ll need to take a few days off and rest

your mind and tired body. Anxiety can have a huge effect on our health, and it is not something to brush off to

the side. It can be truly harmful, and a lot of people don’t understand the effects it can have on an individual.

http://thoughtcatalog.com/lauren-jarvis-gibson/2016/09/11-things-people-dont-realize-you-are-doing-because-of-your-anxiety/

Fresh Start Page 7

Testing DNA to find best meds to fight depression

DNA testing already has been employed against cancer, but now it's being used to determine which drugs might work best for other conditions. (KEVIN CURTIS / Science Photo Library)

Howard Wolinsky Chicago Tribune August 28, 2015, 2:15 PM

Since childhood, Mandy E. has struggled with feelings of hopelessness and inadequacy. She

seemed incapable of having fun. She experienced what she described as "constant discontent."

Her parents felt it was a matter of the will to fix the problem; they didn't accept the possibility of

mental illness.

Finally, a year ago, Mandy, 24, a marketer for a Boston e-commerce startup (she asked that her full name be withheld) sought psychiatric help. "I needed to do something because I wanted to

move my life in a certain direction, and I felt I wasn't going to do that if I didn't get help," she said.

She saw Dr. Mindy Rosenbloom, a psychiatrist in Barrington, R.I., who practices near Mandy's hometown.

Rosenbloom, a clinical assistant professor at Brown University, diagnosed Mandy with

dysthymia, a mild but persistent form of depression. The psychiatrist, who specializes in hard-to-treat cases, said finding the right antidepression drug is a complicated process that can take

months, even years. In Mandy's case, Rosenbloom simplified the trial-and-error process with a genomic test.

The doctor turned to cotton swabs and DNA testing to personalize her recommendations for

Mandy. She used the swabs to collect Mandy's cheek cells and sent them for DNA extraction and a genomic scan to Assurex Health, a precision medicine startup based in Mason, Ohio, "to

identify the antidepressant medication options Mandy would tolerate best and would most likely respond to."

This approach is an emerging field known as pharmacogenomics, or drug-gene testing.

The U.S. Food and Drug Administration in recent years has recognized the power of pharmacogenomics and

lists known genetic factors on package inserts for 137 medications, including several dozen for psychiatric

conditions such as depression and anxiety. (For a list of the drugs with warnings, go to

www.fda.gov/drugs/scienceresearch/researchareas/pharmacogenetics/ucm083378.htm.)

Pharmacist/pharmacogenomist Mark Dunnenberger, who runs the Pharmacogenomics Clinic at NorthShore

University HealthSystem, one of the first clinics in the U.S. dedicated to interpreting the effects DNA has on

drugs, said inroads are being made in the field. The process is to analyze the individual's ability to metabolize

antidepression and antipsychotic medicines as well as medicines to treat arthritis, heart disease, infectious

disease, lung disease, cancer and many other conditions.

Page 8 Fresh Start

Just as we inherit eye and hair color from our parents, we inherit genes that determine how our

bodies respond to medicines, especially genes used to break down drugs in the liver, kidneys and other organs. Genes are the body's manuals that determine how we respond individually to drugs.

Though genomics differ, doctors generally have taken a one-size-fits-all approach to prescribing meds, taking

into consideration age, sex and weight while overlooking growing evidence of differences based on genetic

inheritance.

The NorthShore clinic, in Evanston, Ill., collects pharmacogenomics data on psychiatric illnesses and other

conditions to incorporate the information in the patient's electronic medical record.

Dunnenberger said genomic testing is not a panacea but it helps reduce guesswork: Drugs that likely won't work

can be avoided, and doses can be adjusted based on the individual's genomic makeup.

"We need to help our patients understand pharmacogenomics can be helpful to them when they get certain

medications but not every medication," he said. "And we can discuss cost and risk of getting genetic

information and wrap that up together."

A handful of personalized companies extract DNA from cheek swabs or saliva samples and compare genes with

findings in medical literature of how gene mutations affect the body's ability to metabolize medicines.

Assurex Health, the company that processed Mandy's DNA sample, uses technology licensed by the Mayo

Clinic in Rochester, Minn., and by Cincinnati Children's Hospital, with financial backing from Sequoia Capital,

the Silicon Valley venture capital firm behind Google, Airbnb and PayPal.

Assurex's GeneSight line of tests specializes in psychiatric and neurological disorders. Competitors offer

broader pharmacogenetic testing, which includes psychiatric medications.

Tyler Mamiya, director of pharmacy at Seattle-based Genelex Corp., noted that more than 75 percent of the

population has genetic variations that determine how their bodies process and use drugs. "This applies not only

to prescription medications but also to over-the-counter medicines, herbal and dietary supplements, and

recreational drugs such as marijuana," the pharmacist said.

Mandy had three tests. One was GeneSight Psychotropic, a pharmacogenomic test involving the analysis of 50

markers from six genes and a clinical outcomes-based tool that weighs the influence the markers have on 32

different agents. A second was Genesight ADHD for determining drugs to use for attention deficit hyperactivity

disorder. The third, MTHFR, tested her ability to process folate, a B vitamin. If insufficiently metabolized,

folate can result in deficiencies of three brain chemicals that antidepressants use.

Rosenbloom received the report in a few days with a traffic signal-style list of medicines, a strategy typically

used by testing companies.

Medications listed under green can be used as directed. Those in the yellow category should be used with

caution. Those in the red category should be used with increased caution and more frequent monitoring.

Additional notes explain whether higher or lower doses are indicated, whether the patient's genes may reduce

efficacy of meds or whether a drug simply should be avoided.

Rosenbloom said testing reduces but doesn't eliminate trial and error. She said Mandy "felt tired all day" during

the first days on a green-zone medicine and has felt well on a red-zone option, Wellbutrin XL (bupropion),

prescribed at the lowest dose to compensate for her much slower than average metabolism of that drug.

Most significantly, testing showed Mandy had a single mutation in the MTHFR enzyme critical in metabolizing

folate found in foods or vitamin supplements. Researchers showed in the 1960s that folate deficiency could

Fresh Start Page 9

trigger depression. Genetic testing can reveal enzyme mutations linked to commonly consumed drugs and

vitamins.

Rosenbloom gave Mandy a prescription form of processed folate, l-methylfolate, that can cross the blood-brain

barrier and switch on enzymes that would help her metabolize antidepression medicines such as Wellbutrin.

"The rest is history. Mandy applied for and obtained a full-time job in Boston and has been commuting and

doing well," she said.

The test panels are not cheap. GeneSight Psychotropic, Assurex's most commonly prescribed test, lists for

$3,800, which Don Wright, executive vice president and chief operating officer of Assurex Health, said is

comparable to that for many other genetic tests.

He added that multiple studies have shown the testing on average saves patients $2,500 per year in prescription

costs and reduced number of medical office and emergency room visits. Patient co-insurance responsibility for

bills is typically 10 percent to 20 percent for commercial insurance, while Medicare and Medicaid patients have

no out-of-pocket expense.

Mandy said her family's Blue Cross plan covered all but $6 of the testing. Insurance coverage varies.

Dr. James Evans, a medical geneticist at the University of North Carolina and editor-in-chief of Genetics in

Medicine, the official journal of the American College of Medical Genetics and Genomics, is bullish on

genomics. He even has a DNA tattoo on his shoulder.

But he has been skeptical about pharmacogenomics, even as President Barack Obama gave the field a boost in

his 2015 State of the Union along with the promise of a $215 million investment and a genomic study of more

than a million Americans.

He said pharmacogenomics is well-established for cancer but is on shaky ground in many areas, such as testing

for the anti-clotting drug Coumadin (warfarin). "The public clamors for astrology too. It's just not a good reason

to offer a medical test," he said. "Some of it is snake oil." Evans examined the research Assurex Health has

sponsored and was impressed that the researchers are "publishing in peer-reviewed journals and going about

collecting evidence in the right way."

Meanwhile, Rosenbloom said pharmacogenomics is dramatically changing psychiatric practice. She said

psychiatric patients traditionally were, in effect, "guinea pigs" as they tried out a variety of medications in a

variety of doses.

"There were limited criteria to help us select medications," she said. "Personalizing psychiatric prescriptions

based on DNA makes pharmacology safer, better tolerated, improves patient adherence and the likelihood of

their response to the medications we prescribe."

Howard Wolinsky is a freelance reporter.

Copyright © 2017, Chicago Tribune

Page 10 Fresh Start

How to Identify and Cope with Your PTSD Triggers

Cornelia Schauermann/Cultura/Getty Images

By Matthew Tull, PhD - Reviewed by a board-certified physician. Updated May 04, 2016

PTSD triggers may be all around you. Even though it may sometimes feel like PTSD symptoms come out-of-

the-blue, PTSD symptoms rarely spontaneously occur. Instead, whether you are aware of it not, PTSD

symptoms are often triggered or cued by something in our internal (anything that happens within your body,

such as thoughts or feelings) or external (anything that happens outside your body, such as a stressful situation)

environment.

Because certain thoughts, feelings, or situations can bring up uncomfortable PTSD symptoms, such as

memories of a traumatic event or feelings of being on edge and anxious, one way of coping with these

symptoms is by increasing your awareness of these triggers. You can prevent or lessen the impact of certain

PTSD symptoms by identifying what specific types of thoughts, feelings, and situations trigger them, and then,

take steps to limit the occurrence or impact of those triggers.

Kinds of Triggers

Triggers can fall into two categories: Internal Triggers and External Triggers. Internal triggers are things that

you feel or experience inside your body. Internal triggers include thoughts or memories, emotions, and bodily

sensations (for example, your heart racing). External triggers are situations, people, or places that you might

encounter throughout your day (or things that happen outside your body).

Listed below are some common internal and external triggers.

Internal Triggers

o Anger

o Anxiety

o Sadness

o Memories

o Feeling lonely

o Feeling abandoned

o Frustration

o Feeling out of control

o Feeling vulnerable

o Racing heart beat

o Pain

o Muscle tension

Fresh Start Page 11

External Triggers

o An argument

o Seeing a news article that reminds you of your traumatic event

o Watching a movie or television show that reminds you of your traumatic event

o Seeing a car accident

o Certain smells

o The end of a relationship

o An anniversary

o Holidays

o A specific place

o Seeing someone who reminds you of a person connected to your traumatic event

Identifying Your Triggers

Try to think of when your PTSD symptoms usually come up. Ask yourself the following questions to identify

your triggers: What types of situations are you in? What is happening around you? What kind of emotions are

you feeling? What thoughts are you experiencing? What does your body feel like? Get out a sheet of paper and

write down as many internal and external triggers as you can.

Coping with Triggers

Now, the best way of coping with triggers is to avoid them altogether. However, this is almost impossible to do.

Why? Well, you cannot really avoid your thoughts, emotions, and bodily sensations. Much of these are out of

our control. In regard to external triggers, we can take some steps to manage our environment (for example, not

going to certain places that we know will trigger us), but we cannot control everything that happens to us. For

example, you might inadvertently come into contact with a news story or conversation that reminds you of your

traumatic event.

Because we often cannot avoid triggers, it is important to learn ways of coping with triggers. Effective, healthy

coping strategies for lessening the impact of triggers include:

Mindfulness

Relaxation

Self-soothing

Grounding

Expressive writing

Social support

Deep breathing

The more strategies you have available to you, the better off you will be in managing your triggers. In addition,

the more coping strategies you have, the more likely you will be able to prevent the development of unhealthy

coping strategies, such as alcohol and drug use.

Further, simply being more aware of your triggers can be beneficial. As a result of this increased awareness,

your emotional reactions may begin to feel more understandable, valid, predictable, and less out of control. This

can definitely positively impact your mood and overall well-being.

Some Final Important Information About Triggers

Although it is important to increase your awareness of your triggers, doing so can cause some distress. Some

people might actually become triggered by trying to identify their triggers. Therefore, before you take steps to

identify your triggers, make sure you have a safety plan in place in case you experience some distress.

Page 12 Fresh Start

NAMI Cobb News

NAMI Connections Weekly Support Group

Our NAMI Connections Support Group for persons with a mental health diagnosis continues to meet every Monday from 7:00-8:30 p.m. in Room 046 at First Presbyterian Church located at 189 Church Street in Marietta. We have a good core group of people who are committed to living in wellness - please come join this drop-in group any Monday or every Monday! Contact Paul Miner: [email protected] for more information.

Weekly Family Support Group

Our Family Care and Share Support Group is a drop-in group for family members and caregivers for someone with a mental health diagnosis. The group meets every Monday from 7:00-8:30 p.m. in Room 048 at First Presbyterian Church, 189 Church St in Marietta. If your family member is in crisis, come any or every Monday to receive support from others. And if your family member is doing well, please come to give your support and share your experiences with others! Contact Greg Ausham at 330-801-0328, Susie Allen at 770-565-4335 or Sylvia Oliphant 678-471-5907 for more information.

Fresh Start Page 13

Thank you so much for your interest in joining NAMI Cobb Affiliate! Please complete the form below, and mail this with your check made out to

NAMI Cobb. (If you wish to pay by credit card, go to www. nami.org and click on “Become a Member”. You will start receiving our monthly

electronic newsletter within the month. You are also invited to attend our monthly education and support meetings at St. James Episcopal Church in

Marietta, 161 Church St. NE, on the third Thursday of each month at 7:30pm (there is a time to look at resources and brochures at 7pm). You are not

alone. Come join us.

NAMI Cobb January 2017

P.O. Box 999

Kennesaw, GA 30156

TO:

Yes, I would like to join NAMI Cobb of Georgia! Date:____________________

New

Renewal

$3 Financial Hardship Membership (Please note there has been a slight increase in membership fees nationally).

___________Donation (I would like to give an additional donation

to support NAMI-Cobb programming and outreach) Name(s):______________________________________

Address:______________________________________

_______________________________________

Phone: _______________________________________

Email: _______________________________________

I am interested in volunteering. My skill is ________________________.

Support Group Meetings

For families of those with a mental illness

1st Presbyterian Church

189 Church St

Marietta, GA

MONDAYS Time: 7-8:30 PM

Family Support Group Room 048

Connections Support Group Room 046

Contact Neill Blake at 770-427-5353 or

[email protected] with questions

about either support group."

Monthly NAMI Cobb General Meeting

Next Educational Meeting

January 19, 2017

7:00 PM Networking/Social

7:30 PM Program

**Please mail this form along with your check to:

NAMI Cobb, P.O. Box 999 Kennesaw, GA 30156

Thank you for your membership!